An Ohio representative from Cuyahoga County has introduced legislation to undo the bundling of some Medicaid reimbursements to nursing homes — a change wrought by last year’s biennial budget bill that has resulted in denying some patients services and threatening small business suppliers.
Rep. Kenny Yuko, a Richmond Heights Democrat, wants to reverse some of the unintended consequences caused by a last-minute amendment to the budget bill that was aimed at plugging a $3.2 billion shortfall. Yuko’s bill also proposes changing the way nursing homes pay for some prescription drugs to offset the additional cost of unbundling the Medicaid reimbursements.
Yuko was joined by nursing home patients, patient advocates, equipment and service providers and nursing home administrators at a Wednesday press conference at St. Augustine Health Campus in Cleveland for his legislative announcement.
The amendment made to the budget bill in late June changed the way the state reimburses nursing homes for Medicaid patient services like transportation, oxygen, over-the-counter drugs, and occupational, physical and speech therapies, as well as for equipment like wheelchairs that are customized with padding and other supports.
Instead of directly reimbursing companies that supply oxygen, dialysis treatment, complex rehabilitative wheelchairs and related therapies on a fee-for-service basis — as the state Medicaid program always had — the program now pays nursing homes a flat $3.91 daily rate per Medicaid resident to cover the services and equipment.
Even before the budget bill passed, wheelchair manufacturers and suppliers said they had been sacrificed in the state’s budget negotiations in a way that would cost jobs, damage their industry and threaten nursing home patients’ access to rehabilitative wheelchairs.
“I fully recognize the intent was to give the money to the nursing homes to provide these services, but that is not what has happened,” Yuko said in a written statement. “Instead, we have nursing home patients who cannot get transportation, are unable to get their wheelchairs repaired due to the expense, and this is frankly not acceptable.”
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Some patients who are dependent on oxygen, dialysis or custom wheelchairs now can’t get these services, Yuko said. In addition, some service providers have seen a big drop-off in business and face unpaid bills for services rendered before the reimbursement change. “My bill will restore these services and keep the providers in business,” he said.
To offset additional costs of returning to direct reimbursement for patient services, Yuko wants to provide money to nursing homes to pay for some prescription drugs that the state now purchases. This money, along with a federal Medicaid match, should replace any nursing home losses from unbundling services, Yuko said.
