As Introduced

136th General Assembly

Regular Session H. B. No. 552

2025-2026

To amend section 5164.16 of the Revised Code to make changes to the law regarding Medicaid reimbursement for hospice providers.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

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 That existing section 5164.16 of the Revised Code is hereby repealed.