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Ohio Department of Medicaid (ODM) is pleased to announce that it has received approval from the Centers for Medicare and Medicaid Services (CMS) for the second half of the managed care portion of provider relief payments as appropriated by the Ohio General Assembly in H.B. 169. This latest approval impacts the following categories:
- MyCare.
- Hospice.
- Home Health.
- Community behavioral health.
- Non-institutional durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS).
Payments will be distributed via the following methods:
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Category
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Percentage
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Reference Period
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MyCare
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Approximately 10% of paid claims
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Claim period from November 1, 2020, through October 31, 2021
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Hospice
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Approximately 10% of paid claims
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Claim period from July 1, 2020, through June 30, 2021
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Home Health
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Approximately 10% of paid claims
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Claim period from July 1, 2020, through June 30, 2021
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Community behavioral health
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Approximately 10% of paid claims
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Claim period from July 1, 2020, through June 30, 2021
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Non-institutional DMEPOS
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Approximately 10% of paid claims
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Claim period from July 1, 2020, through June 30, 2021
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Medicaid managed care plans will process these payments directly to providers. We are working with them to distribute this final round of funding as quickly as possible.
Note: It is highly likely that providers will receive multiple checks from multiple plans. To determine the totals due by each managed care organization, log into the ARPA Provider Relief Dashboard.
PROVIDER RELIEF DASHBOARD ENSURES TRANSPARENCY, ACCURACY, AND ACCOUNTABILITY
ODM has updated its provider dashboard tool to allow providers to enter their Medicaid billing ID and view ALL payments that will be dispersed to them from Managed Care, and MyCare per H.B. 169. The dashboard details all categories of provider relief from H.B. 169 (ARPA HCBS and non-ARPA/GRF funds) EXCEPT for Assisted living (RCFs), PACE, and DODD waiver providers. Providers can access the tableau through the ARPA HCBS page of our website by clicking the LAUNCH button. Linked here: ARPA Provider Relief Dashboard.
VERY IMPORTANT – PLEASE NOTE:
- The managed care preprint relief payment is calculated as 10% of claims.
- ODM has reconciled provider’s total claims to actual CY22 claims experience and determined a final relief payment.
- Based on actual claims experience, some providers will receive more money than originally estimated, some less and fewer will owe money back. It will be up to each managed care plan on how or whether to recover any funds.
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There is no action required on the part of the provider during this reconciliation process.
- We appreciate everyone’s patience throughout this process.
Community provider relief payments are contained in Ohio’s American Rescue Plan Act Home- and Community-Based Services (ARPA HCBS) plan. Additional information about the Ohio plan can be found here: ARPA HCBS Update | Medicaid (ohio.gov).
For questions about any of these provider payments, please email ProviderReliefInquiries@medicaid.ohio.gov.
Maureen Corcoran, Director
Ohio Department of Medicaid
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