Ohio Medicaid payment plan draws ire of some nursing home residents

A new payment system for nursing home care and supplies that was enacted as part of the new state budget in July has come under fire after payment was not properly processes for some nursing home resident (Source: “A plea for Medicaid changes,” Columbus Dispatch, Sept. 14, 2009).

Under the new rules, ancillary-care services such as transportation, therapy, over-the-counter medications and durable medical equipment such as wheelchairs, are no longer billed directly to the state's Medicaid program. Instead, nursing homes receive $3.91 per day per Medicaid patient to cover those expenses.

State Sen. Tom Niehaus, R-New Richmond, said the new billing system was a way for the state to draw more federal Medicaid funds and that the $3.91 figure was based on 2008 expenditures for such services divided by Medicaid beds.

"These services are not being cut. (Medicaid patients) are entitled to them," he said. "This was a way to ensure that these ancillary-care services continued."

However, Sen. Dale Miller, a Cleveland Democrat who opposed new rules, argues that nursing homes now have a financial incentive to provide as little service as possible.

"I'm very concerned that the new system is going to encourage nursing homes to turn away certain types of patients that aren't going to work well for them financially," he said.