As Introduced

136th General Assembly

Regular Session H. B. No. 675

2025-2026

To establish a temporary program for hospital payments made by Medicaid managed care organizations and to name this act the Healthier Rural Hospitals Act.

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

Section 1. (A) The Department of Medicaid shall establish a program under which hospitals in counties in this state with a population less than one hundred thousand residents receive specified payments from a Medicaid managed care organization in accordance with this section. As part of the program, the Department shall calculate the statewide average payment rate paid by Medicaid managed care organizations to all hospitals for hospital services provided to Medicaid recipients.

(B) The Department shall determine a hospital's eligibility to receive payments under the program by calculating a score for each county in this state with a population less than one hundred thousand residents. Scores shall equal the sum of a county's ranking in the following categories:

(1) The county's rank in this state based on the county's age-adjusted rate of cancer deaths per one hundred thousand residents for calendar year 2022. A rank of one shall reflect the highest rate of cancer deaths in this state.

(2) The county's rank in this state based on the county's percentage of population at or below one hundred fifty per cent of the federal poverty level. A rank of one shall reflect the highest per cent of individuals at or below one hundred fifty per cent of the federal poverty level in this state.

(3) The county's rank in this state based on the county's age-adjusted rate of deaths from chronic lower respiratory disease per one hundred thousand residents for calendar year 2022. A rank of one shall reflect the highest rate of deaths in this state.

(4) The county's rank in this state based on the county's age-adjusted rate of death from stroke per one hundred thousand residents for calendar year 2022. A rank of one shall reflect the highest rate of deaths in this state.

(5) The county's rank in this state based on the county's average annual age-adjusted rate of unintentional drug overdose death for calendar years 2017 through 2021. A rank of one shall reflect the highest average annual rate of deaths in this state.

(C) After calculating scores under division (B) of this section, the Department shall rank all counties in this state with a population less than one hundred thousand residents from lowest to highest. The twenty lowest-ranked counties shall be eligible to participate in the program established under this section.

(1) For counties ranked one through ten, a Medicaid managed care organization shall pay each hospital located in an eligible county a payment rate for hospital services that is at least one hundred fifty per cent of the statewide average rate calculated by the Department under division (A) of this section.

(2) For counties ranked eleven through twenty, a Medicaid managed care organization shall pay each hospital located in an eligible county a payment rate for hospital services that is at least one hundred twenty-five per cent of the statewide average rate calculated by the Department under division (A) of this section.

(D) In making payments under division (C) of this section, a Medicaid managed care organization shall not reduce the payment rate made to a hospital not participating in the program as a means of making payments in accordance with this section.

(E) The Department shall terminate the program two years after the effective date of this section.

Section 2. This act shall be known as the Healthier Rural Hospitals Act.