Last week, CMS approved Ohio’s Medicaid ARPA-HCBS Immediate Provider Relief (1135 SPA) plan for community behavioral health providers, home health, and other non-institutional providers. Shortly after, Governor DeWine signed the executive order authorizing the emergency rule to distribute these funds to BH providers and other eligible non-waiver providers. The emergency rules authorize payment to provider and allow flexibility with use of funds.  As reference, the distribution methodology for these payments is equal to approximately 10% of paid claims, using claim period from July 1, 2020, through June 30, 2021, as the basis, and distributed to providers as a lump sum. On March 25, the Ohio Department of Medicaid shared the following updates on distribution of funds:

• Medicaid FFS Only Claims:  These provider payments were processed March 24 through MITS. Providers should have received the EFT payments March 30 with paper checks set to be mailed the first week of April. Providers will receive a separate remittance advice that includes the code HB169COVIDPMT.
• Medicaid MCO and MyCare Ohio Claims: CMS approvals that are still pending for the “managed care preprints.” As soon as CMS approval is received, funds will be released for the MCOs and MyCare Plans to make payments.

ODM also announced a new tool that will be available to providers. It is a Tableau dashboard that will allow providers to enter their Medicaid billing ID and view payments that will be dispersed to them from FFS, Managed Care, and MyCare per House Bill 169. This includes all the categories of provider relief from HB 169, ARPA-HCBS and non-ARPA/GRF funds except for assisted living (RCFs) and DODD waiver providers. Providers can access this Tableau through the ARPA HCBS page of our website linked here: ARPA HCBS Update | Medicaid (ohio.gov). ODM continues to work closely with CMS and impress upon them the urgency in which to move these payments as quickly and efficiently as possible. For questions about any of these provider payments, please email [email protected].

As always, The Ohio Council will continue to share updates as we receive them. While this is progress, we appreciate ODM’s continued efforts to urge CMS to act swiftly to approve the managed care preprints given the urgency of need in our communities.