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Ohio hospices urge lawmakers to fix 95% room-and-board reimbursement and pause EVV denials
Summary
Hospice providers told the Senate Medicaid Committee that current Medicaid rules paying hospices 95% of nursing-facility room-and-board rates force hospices to absorb costs, and they urged lawmakers to require parity and to delink electronic visit verification from immediate claims denials while the vendor's system is unreliable.
Hospice and home-care providers pressed the Ohio Senate Medicaid Committee on May 8 to fix two separate but related problems they say threaten access to end-of-life and home-based care: a long-standing 95% hospice pass-through for nursing-facility room and board, and ongoing failures in the state's electronic-visit-verification (EVV) system.
"Valley Hospice paid the full 100% to nursing facilities while Medicaid reimbursed only 95%," said Andrea Hale, chief executive officer of Valley Hospice. "For us, that amounted to over $180,000 in unreimbursed costs last year alone." The policy dates from early Medicare-era rules, witnesses said,…
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