HB 552: Regards Medicaid reimbursement for hospice providers
This bill amends the Medicaid program to cover one or more state plan home and community-based services for Medicaid recipients of any age with countable income not exceeding 225% of the federal poverty line. The bill eliminates the requirement for a level of care determination for eligibility in these services. Starting January 1, 2028, Medicaid hospice providers will be reimbursed for room and board at 100% of the nursing facility or icf/iid rate for days when the patient receives routine or continuous home care.
| Oct. 29, 2025 | Referred to committee: Medicaid |
| Oct. 28, 2025 | Introduced |
As Introduced
136th General Assembly
Cosponsors: Representatives Brennan, Ritter, Rogers, Baker, Brewer, Upchurch
make changes to the law regarding Medicaid
reimbursement for hospice providers.
Section 1. That section 5164.16 of the Revised Code be
amended to read as follows:
Sec. 5164.16. (A) The medicaid program may cover one or
more state plan home and community-based services that the
department of medicaid selects for coverage. A medicaid
recipient of any age may receive a state plan home and
community-based service if the recipient has countable income
not exceeding two hundred twenty-five per cent of the federal
poverty line, has a medical need for the service, and meets all
other eligibility requirements for the service specified in
rules adopted under section 5164.02 of the Revised Code. The
rules may not require a medicaid recipient to undergo a level of
care determination to be eligible for a state plan home and
community-based service.
(B) Effective not later than January 1, 2028, the director
shall adopt rules specifying that a medicaid hospice provider
shall be reimbursed for room and board for a hospice patient who
is a resident of a nursing facility or an ICF/IID at an amount
equal to one hundred per cent of the rate established for the
nursing facility or ICF/IID for days when the patient receives
routine home care or continuous home care.
Section 2. That existing section 5164.16 of the Revised
Code is hereby repealed.