Ohio's Medicaid physician fee schedule will not be impacted by the Kasich Administration’s proposal to close a funding gap which was created in the 2017/18 budget of approximately $1.3 Billion. According to the Kasich Administration, this shortfall was a result of House/Senate assumed budget savings from hospital and nursing home rate reductions that ultimately were unrealized.
An initial proposal called for a 5%-7% across-the-board cut in Medicaid provider rates, including the physician fee schedule. However, the administration announced recently that it will be implementing a 5%-cut to hospital inpatient/outpatient services, increase the Medicaid Managed Care Organization (MCO) withhold by 2%, and synchronize the Medicaid Fee-for-Service/MCO payment schedule. In addition, nursing homes will not receive their legislatively approved rate increases, since Gov. John Kasich vetoed that language from the budget.
One other item of note, the Administration has proposed to partially continue the Comprehensive Primary Care (CPC) pilot program ($106M over two years). The program will continue for existing participants and others that meet the initial qualifications (more than 5,000 Medicaid patients and national certification) but at this point won’t be expanded to smaller practices.
For more information about the plan to close the funding gap, click here.