Ohio Administrative Code
Title 5160 - Ohio Department of Medicaid
Chapter 5160-1 - General Provisions
Section 5160-1-97 - One-time medicaid provider relief payments
Universal Citation: OH Admin Code 5160-1-97
Current through all regulations passed and filed through September 16, 2024
The department of medicaid (ODM) will make relief payments available to Ohio medicaid hospitals defined in paragraph (A) of this rule, as authorized under Section 270.15 of Amended Substitute House Bill 45 of the 134th General Assembly:
(A) ODM will make available a one-time lump sum payment to the following hospital types:
(1)
"Critical access
hospitals," as defined in rule
5160-2-05 of the Administrative
Code.
(2)
"Rural hospitals," as defined in rule
5160-2-05 of the Administrative
Code.
(B) The payment will be established in the following manner:
(1)
The
total sum to be made available to all eligible Ohio medicaid hospitals as
defined in paragraph (A) of this rule is sixty-two million dollars less the
amount described in paragraph (B)(2) of this rule.
(2)
Any hospital
located in a county in the Northwest region as defined in the appendix of rule
5160-2-05 of the Administrative
Code with a population of less than forty-two thousand residents and less than
three hundred square land miles according to the United States census bureau
(July 1, 2021) will qualify for an additional payment of two million one
hundred thousand dollars.
(3)
No individual hospital will receive a total calculated
payment that exceeds three million dollars.
(4)
For each
hospital, the value of the final one-time payment will be calculated as
follows:
(a)
Base payment data to be utilized for establishing provider
payment amounts are fee-for-service (FFS) payments for state fiscal year 2022
and reflected in the ODM management information technology system (MITS) on
January 31, 2023.
(b)
Each payment is the product of the ratio of each
hospital's total FFS payments to the total FFS payments for all eligible
hospitals as defined in paragraph (A) of this rule, multiplied by the amount
listed in paragraph (B)(1) of this rule.
(c)
For each
hospital, if the total calculated payment in paragraph (B)(4)(b) of this rule
exceeds the amount described in paragraph (B)(3) of this rule, the hospital's
payment amount is limited to the amount defined in (B)(3) of this
rule.
(d)
For hospitals with a payment amount limited as
described in paragraph (B)(4)(c) of this rule:
(i)
Subtract the
amount calculated in paragraph (B)(4)(c) of this rule from the amount
determined in paragraph (B)(4)(b) of this rule then sum these amounts for these
hospitals.
(ii)
Distribute the sum of the amounts determined in
paragraph (B)(4)(d)(i) of this rule, to all hospitals that have not exceeded
the payment amount calculated in paragraph (B)(3) of this rule, using the same
methodology described in paragraph (B)(4)(b) of this rule until all remaining
funds from the amount calculated in paragraph (B)(4)(d)(i) of this rule are
expended.
(5)
If a hospital's
calculated payment amount in paragraph (B)(4)(b) of this rule is less than four
thousand dollars, no payment will be made to that hospital.
Replaces: 5160-1-97
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