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Increased Medicaid Rates to Take Effect This Month for Ohio Providers

Client Alert
January 5, 2024

As required by House Bill 33, Ohio’s 2024-2025 operating budget bill, reimbursement rates paid by the Ohio Department of Medicaid will increase for a wide range of providers starting on January 1, 2024. The rate increases total roughly $3.4 billion per year and apply to the following types of providers:

  • Non-institutional providers:
    • Ambulatory surgical centers / dialysis
    • Testing / lab / X-ray / durable medical equipment
    • Physicians / advanced practice registered nurses / physician assistants / clinics / skilled therapy
    • Vision and eye care
  • Community behavioral health providers
  • State plan private duty nursing / home health providers
  • Home and Community Based Services waiver providers:
    • PASSPORT waiver providers
    • Assisted living waiver providers
    • Ohio home care waiver providers
    • MyCare Ohio waiver providers
    • Individual Options waiver
    • Level 1 waiver providers
    • Self-Empowered Life Funding (SELF) waiver providers
  • Department of Developmental Disabilities providers

Beginning on January 1, 2024, the majority of the codes in the Ohio Medicaid fee schedule for non-institutional providers increased by 5% or more. Specifically, there was approximately a 5% increase for physicians, APRNs, PAs, clinics, skilled therapy providers, ambulatory surgical centers, laboratories, dialysis providers, X-ray providers, and DME providers. Additionally, there was a 5.7% dispensing fee rate increase for pharmacies, a 79% rate increase for transportation providers, and a 93% rate increase for dental providers. There was no rate increase for FQHCs. However, there was a 10% baseline rate increase for community behavioral health rates.

The increased reimbursement rates authorized by HB 33 apply to dates of service starting January 1, 2024, and beyond. Note that ODM will reimburse all services based on the date the service was rendered, not the date the provider bills for the service. ODM also reminded providers that, even after the rates are increased due to HB 33, providers must continue to charge their reasonable and customary rates regardless of anticipated reimbursement from the department. ODM’s fee schedules and rates are codified in the Ohio Administrative Code and accessible for providers on ODM’s website.

If you have questions about ODM’s reimbursement rate increases, please contact your local BMD Healthcare Attorneys Daphne Kackloudis at dlkackloudis@bmdllc.com or Ashley Watson at abwatson@bmdllc.com.

Daphne KackloudisAshley Watsonjordan burdickMedicaid
Client Alert

New Vaccine Requirement for Select CMS-Participating Facilities

November 10, 2021On November 4, 2021, the Centers for Medicare and Medicaid (“CMS”) released a new rule requiring certain healthcare facilities to implement policies requiring employees to be vaccinated against COVID-19. It does not matter if a staff member does not perform patient treatment services, they must still be vaccinated if an employee of an applicable facility.Client Alert

OSHA COVID-19 EMERGENCY TEMPORARY STANDARD (ETS) Vaccination, Testing, Recordkeeping, and Reporting

November 5, 2021The Occupational Safety and Health Administration has issued its long-awaited COVID-19 Emergency Temporary Standard (ETS). Note that the ETS does not apply to employers covered under the Safer Federal Workforce Task Force COVID-19 Workplace Safety: Guidance for Federal Contractors or Subcontractors (see here), or to settings where employees provide healthcare services subject to OSHA’s ETS for the healthcare industry (see here).Client Alert

Interesting Trends Revealed in 50-State Medicaid Budget Survey

November 3, 2021Results of the KFF annual survey of state Medicaid directors reveal some fascinating trends in Medicaid service delivery and benefit coverage. Read on for a summary of the highlights we find most noteworthy. Background As a preliminary matter, many of the trends KFF identifies and that we highlight below are no doubt a result of the Covid-19 pandemic. The pandemic triggered a public health emergency and economic crisis that resulted in increased Medicaid enrollment, service offerings, and flexibility in service delivery, along with a heightened awareness of disparities in access to care and health outcomes.Client Alert

Changes to Physician Assistant Statutes in Florida

October 22, 2021In the last year, there have been many changes to the scope of practice and collaboration/supervision requirements for advanced practice providers such as APRNs and physician assistants in the state of Florida. In a previous Client Alert we discussed House Bill 607, which expanded the autonomous practice of APRNs providing primary care services in Florida.Client Alert

Ohio Senate Bill 49 – Ohio Expands Lien Rights for Design Professionals

October 20, 2021Effective September 30, 2021, Ohio granted limited lien rights to design professionals, including architects, landscape architects, engineers, and surveyors. Ohio Governor Mike DeWine signed Senate Bill 49 into law on July 1, 2021. This new law established a statutory right to lien commercial real estate by Ohio design professionals who, until now, could not file a lien for non-payment of professional services. Senator Vernon Sykes, a primary sponsor of Senate Bill 49, stated that the “legislation ensures that architects, engineers and other designers will get paid for their work, regardless of the outcome of their projects . . . It will support hardworking Ohioans by protecting the value of their labor . . ..”
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