OH HB461

Establishes a private room per day rate of $25 for state fiscal year 2023 to be paid by the Department of Medicaid to nursing facilities providing services to Medicaid recipients in private rooms, effective July 1, 2022.

Defines "private room" as a room with permanent walls containing one licensed or certified bed occupied by one individual, with direct unshared access to a hallway and unshared access to toilet and sink shared by not more than one other private room.

Requires the Department of Medicaid to calculate each nursing facility's private room capacity based on the number of resident rooms occupied or available, minus licensed beds, with capacity adjustments allowed only when facilities remove licensed beds or surrender certified beds.

Prohibits nursing facilities from billing the Department for more private room days than the facility's calculated private room capacity, with the Department authorized to recoup excess payments using vendor offsets.

Amends sections 5165.01 and 5165.15 of the Revised Code to incorporate the new private room payment rate into the total per Medicaid day payment calculation for nursing facilities.