The Supreme Court of Ohio has ruled in favor of LeadingAge Ohio and Ohio’s nursing home associations in the case State ex rel. LeadingAge Ohio et al. v. Ohio Department of Medicaid. The decision grants the writ of mandamus sought by the associations, compelling the Department of Medicaid and its director to recalculate and pay nursing-home quality incentive payments according to the formula set forth in Ohio Revised Code 5165.26. The Court further held that the Department and its director violated their duty to apply the law as enacted by the General Assembly.
This ruling represents a significant victory for Ohio’s nursing homes, which have faced underfunding since the passage of House Bill 33 in July 2023.
LeadingAge Ohio has been in conversations this week with its co-plaintiffs, the Ohio Healthcare Association and the Academy for Senior Health Sciences, as well as legal team to discern the immediate next steps for providers impacted by the underfunding. Notably, the decision is silent on how the Department of Medicaid should act in terms of addressing the 2+ years of quality payments that were miscalculated. The decision also does not set forth a concrete timeline for the Department to recalculate the quality payments. Finally, while LeadingAge Ohio was able to bring this suit on behalf of Ohio providers, it does not have the ability to negotiate a resolution on behalf of its members.
LeadingAge Ohio will provide more clarity to members on an all-member call next week (time TBA).
Related: States are reneging on promised nursing home payments. Providers are turning to the courts