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Nursing-home groups press Senate to fix PDPM conversion after proposed Medicaid change would cut payments
Summary
LeadingAge Ohio and provider groups told the Senate Finance Committee a technical omission in proposed Medicaid language would shift case-mix measurement from RUGS to PDPM and effectively cut many nursing-home reimbursements unless a statutory conversion factor is added now.
LeadingAge Ohio and other long-term care advocates urged the Ohio Senate Finance Committee on Wednesday to restore a technical fix to the Medicaid reimbursement language in the budget after they said a shift from the RUGS case-mix system to PDPM would produce large, unintended cuts for nursing facilities.
The organizations told senators the change was likely an omission in the budget text, not an intentional reduction, and that state law currently pins many reimbursement details in the Ohio Revised Code, limiting the Department of Medicaid’s ability to make an administrative fix.
"It would be about $70 on average, across the state, to nursing homes," Susan Wallace, representing LeadingAge Ohio, told the committee,…
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