Ohio Provider Relief and Quality Care Update March 2022

Stakeholder Update: Provider Relief and Sustaining Quality Care and Services March 4, 2022 Presented by: Ohio Department of Aging, Ohio Department of Developmental Disabilities, Ohio Department of Medicaid, Ohio Department of Mental Health and Addiction Services

Agenda Opening remarks from Directors Purpose: Review provider relief that was authorized by H.B. 169 and ARPA Home and Community Based Plan Update on status of federal ARPA HCBS plan approvals Approvals: Appendix K DD & NF level of care. Also, RCF/AL. Discuss what to expect re: distribution of provider relief Next Steps Final points and closing remarks

Logistics for Todays Webinar Please put your name and organization in the chat. Put questions or comments in the chat feature. We ll collect and provide follow up. Information from today s presentation will be posted with other ARPA HCBS resources at: ARPA HCBS Update | Medicaid (ohio.gov)

HB 169 Provider Relief Components HB 169 was passed by the General Assembly & signed into law by Gov. DeWine in Dec. 2021 HB 169 gives spending authority for $529 million in provider relief for a combination of ARPA HCBS & Non-ARPA funds For the 3 other buckets of ARPA HCBS funding, the following will be required Legislative authorization CMS approval of the HCBS plan components Additional CMS authorities, e.g., Appendix K, 1135, Managed Care Pre-print as well as state rules. Workforce Support: Sustain and Expand Other Program & System Enhancements Technology Enhancements Provider Relief 4

Reminder: Payment and Distribution Methodology Distribution plan is approximately 10% of annualized claims payments The payment process will be more complicated than earlier CRF funding. There will be several venues of payment: DODD will distribute relief payments thru its regular waiver reimbursement mechanism ODM will issue relief payments to all other provider types (except PACE) thru MITS using special payment cycles PACE will go thru the normal rate review process The OBM portal will be used for processing payments to RCF/Assisted Living Facilities Distribution thru MCOs will require payments to providers from each MCO. 5

Updated Guidance from CMS- As of 3/4/22 Since we last spoke, ODM received updated guidance from CMS that we must submit Managed Care Directed Payment Preprints for all the managed care portions of provider relief payments For the following, the 1135 SPA s address FFS & ODM has submitted individual Managed Care Directed Payment Preprints for the following: MyCare Home Health Hospice Non-institutional DMEPOS Behavioral Health (Type 84 & 95) 6

Overview of Provider Relief Grid

Approvals To Date (as of 3-4-22) ODM has received Appendix K approvals for the following provider relief payments: All the DD-level of care waivers (IO, Level 1, and SELF) NF-level of care waivers (Ohio Home Care, PASSPORT) (Not MyCare) Gov. DeWine signed an Executive Order (EO) on March 1 authorizing the filing of emergency rules for both the above, in addition to Residential Care Facilities (RCF)/AL providers. Emergency rules have been filed. Notice went out to stakeholders on March 2nd. 9

Payment Overview PASSPORT & Ohio Home Care Providers will receive the payments in approximately seven days, with a separate remittance advice that includes the code HB169COVIDPMT ODA: RCF/Assisted Living Training conducted yesterday Use the OBM portal. Step 1: Register as a state supplier Step 2: Apply for the provider relief funds DODD administered waivers Provider s payments have been processed Providers should receive by the middle of next week 10

Approvals Pending & Other Updates (as of 3-4-22) APPROVALS PENDING NF/ICF-IID/Hospice FFS PACE: rate changes submitted in early February Others: 1135 Spas & managed care directed payment preprint MyCare Home Health Hospice Non-institutional DMEPOS Behavioral Health (Type 84 & 95) OTHER UPDATES: Hospice: still exploring options with CMS re: remaining funds PACE: will go thru cap rate setting process. Waiting for approval. Hospital: no update 11

Independent Providers Summary: Independent providers may receive one or several payments, depending on which sources/waivers are billed for services Payment Source for Services Payment(s) from Status 3/4 DD waivers (IO, L1 or SELF) DODD App K Approved Ohio Home Care ODM App K Approved PASSPORT ODM App K Approved MyCare 1 or multiple MCOs 1135 & MC-DPP* pending State Plan: HH, Nursing ODM 1135 & MC-DPP* pending *MC-DPP is Managed Care Directed Payment Preprint 12

Final Points We remain committed to getting provider payments distributed as quickly as possible after federal approval is received, and emergency rules are adopted. Please understand that we take this very seriously, understand the pressure on providers, and are working with great urgency with CMS. No final decisions have been made regarding the remainder of Ohio s ARPA HCBS plan anything further will require additional stakeholder participation, and federal and state/legislative approval 13

Questions regarding Provider Relief: PASSPORT waiver services ODA s mailbox: Provider_Inquiry@age.ohio.gov Re payment/remittance advice: ODM provider call center 1-800-686-1516 RCFs/ AL beds ODA mailbox: Provider_Inquiry@age.ohio.gov Ohio Home Care Waiver ODM provider call center 1-800-686-1516 ICF-IIDs & DD Waivers: Individual Options, Level 1 and SELF DODD: Provider.Certification@dodd.ohio.gov or phone 1-800-617-6733 Nursing Facilities, Home Health, DMEPOS, Behavioral Health, Hospice ODM provider call center 1-800-686-1516 Underscore between Provider & Inquiry Underscore between Provider & Inquiry 14

Questions: American Rescue Plan Act - Home and Community Based Services Stakeholder Update Alapso@age.ohio.gov Vanessa.mcmahon@mha.ohio.gov Jeremiah.wagner@dodd.ohio.gov Lindsey.Brigano@medicaid.ohio.gov