Ohio lawmakers approved legislation to pay nursing homes $875 million months after a state Supreme Court ruling found they were underpaid. The next step is for the governor to sign the bill and bring a final victory on the matter to providers, said Scott D. Wiley, CEO of the Ohio Health Care Association. 

“This is a big win for Ohio providers. We look forward to working with the Department of Medicaid to move these payments out quickly and appropriately, and we encourage the governor to sign the bill without delay,” he said.

The nearly $1 billion was included in an omnibus budget correction bill.

In September 2025, the Ohio Supreme Court ruled that the state used the wrong formula to calculate Medicaid payments meant to reward high-quality nursing homes. The court said the error led to about $527 million in underpayments during the 2024–25 budget and ordered the state to recalculate and payback the missing funds.

Under the bill approved by the legislature, the $875 million payment will be split between the state and federal governments, with Ohio responsible for $310 million and the federal government $565 million.

Waiting on the Guv

Wiley said once the governor signs the bill, the Department of Medicaid will move to distribute approximately $875 million to nursing facilities.

“Operationally, providers without a change of operator or ownership will see funds move quickly — the bill requires the department to make those payments without delay,” he said.

 For facilities that have undergone a change of operator or ownership (CHOP/CHOW) since July 1, 2023, the bill requires clarity before payment:

• Exiting and entering parties must jointly notify the state who is entitled to receive the payment.

• If the prior entity no longer exists, the new operator can provide unilateral notice with proof.

• If there is any disagreement, the department is prohibited from issuing payment until both parties submit a signed agreement identifying the proper payee.

• More broadly, the department cannot release funds until it has sufficient documentation confirming who should be paid.

  
  

“So, providers with straightforward ownership should be paid promptly, while CHOP/CHOW situations may take additional time to resolve,” Wiley said.

Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.