Ohio's Republican-controlled legislature approved an $875 million Medicaid payment on Wednesday night to correct a yearslong reimbursement formula error that the state Supreme Court found had systematically underpaid nursing homes across Ohio — money that now heads to Governor Mike DeWine for his signature.
The payment was included in a budget correction measure passed by the legislature this week, resolving litigation brought by nursing home operators who argued the state had failed to properly calculate Medicaid reimbursement rates as required under state law. Ohio Medicaid pays nursing facilities a daily rate for each Medicaid-enrolled resident, with higher-quality facilities receiving additional funding. The state is required by law to periodically adjust those rates for inflation — a process known as rebasing — but the dispute centered on how those adjustments were calculated, with the Supreme Court ultimately siding with operators who said they had been shorted by hundreds of millions of dollars over an extended period.
"The family caregiver piece was never part of the fraud. I'm not sure how it got in there or why it got in there, but I'm glad that it is out." — Rep. Jason Stephens (R-Kitts Hill)
The same budget correction process also produced a notable victory for disabled Ohioans and their families after the legislature quietly included — and then removed — a provision in a separate bill that would have banned Medicaid payments to family caregivers of disabled relatives. The provision, which was inserted into House Bill 795 — a fraud-prevention measure targeting home health providers — was stripped after dozens of disabled Ohioans traveled to the Statehouse to testify against it. Marlana Kendrick, who drove two-and-a-half hours from Cleveland with her 11-year-old son Osiah to speak against the proposal, made clear she was grateful it was removed but furious it had ever been included. "I don't care if the bill changed. It should never have been in there," she told the committee.
House Bill 795 continues through the legislative process with its fraud-prevention elements intact — including increased penalties for Medicaid fraud, new restrictions on home health providers, and electronic visit verification requirements — but without the family caregiver payment ban. Rural legislators raised concerns about the electronic verification mandate, noting that connectivity gaps in parts of the state could inadvertently penalize caregivers who lack reliable cell service through no fault of their own.
The home health fraud provisions in House Bill 795 were prompted by a Daily Wire report alleging hundreds of millions of dollars in fraudulent Medicaid payments to home health providers in Ohio in 2024. The state has not fully confirmed the scope of the alleged fraud and says the matter remains under investigation. Democrats have argued the reported figures are inflated. The House Medicaid Committee is expected to take up the bill again for further consideration.
The $875 million nursing home payment is a straightforward act of fiscal accountability — the state made an error, the courts confirmed it, and the legislature is correcting it. Less straightforward was the family caregiver episode, which serves as a useful reminder of how easily targeted fraud-prevention measures can sweep in unintended victims when lawmakers move quickly. The families who drove hours to testify deserve credit for making that case in person. The legislators who listened deserve credit for acting on it.