§ 5124.15 — Amount of payments

Ohio § 5124.15

• Jurisdiction: Ohio
• Title 51: Public Welfare
• Ch. 5124: Intermediate Care Facility for Individuals with Intellectual Disabilities Services

Text

(A) Except as otherwise provided by section5124.101of the Revised Code, sections5124.151to5124.154of the Revised Code, and division (B) of this section, the total per medicaid day payment rate that the department of developmental disabilities shall pay to an ICF/IID provider for ICF/IID services the provider's ICF/IID provides during a fiscal year shall equal the sum of all of the following:

(1) The per medicaid day capital component rate determined for the ICF/IID under section5124.17of the Revised Code;

(2) The per medicaid day direct care costs component rate determined for the ICF/IID under section5124.19of the Revised Code;

(3) The per medicaid day indirect care costs component rate determined for the ICF/IID under section5124.21of the Revised Code;

(4) The per medicaid day other protected costs component rate determined for the ICF/IID under section5124.23of the Revised Code;

(5) The sum of the following:

(a) The per medicaid day quality incentive payment determined for the ICF/IID under section5124.24of the Revised Code;

(b) A direct support personnel payment equal to two and four-hundredths per cent of the ICF/IID's desk-reviewed, actual, allowable, per medicaid day direct care costs from the applicable cost report year;

(c) For state fiscal year 2026, a professional workforce development payment equal to ten and four hundred five thousandths per cent of the ICF/IID's desk-reviewed, actual, allowable, per medicaid day direct care costs from the applicable cost report year.

(B) The department shall adjust the total per medicaid day payment rate otherwise determined for an ICF/IID under this section as directed by the general assembly through the enactment of law governing medicaid payments to ICF/IID providers.

(C)(1) In addition to paying an ICF/IID provider the total per medicaid day payment rate determined for the provider's ICF/IID under divisions (A) and (B) of this section for a fiscal year, the department may do either or both of the following:

(a) In accordance with section5124.25of the Revised Code, pay the provider a rate add-on for ventilator-dependent outlier ICF/IID services if the rate add-on is to be paid under that section and the department approves the provider's application for the rate add-on;

(b) In accordance with section5124.26of the Revised Code, pay the provider for outlier ICF/IID services the ICF/IID provides to residents identified as needing intensive behavioral health support services if the rate add-on is to be paid under that section and the department approves the provider's application for the rate add-on.

(2) The rate add-ons are not to be part of the ICF/IID's total per medicaid day payment rate.

Last updated August 13, 2025 at 8:59 AM

Legislative History

Effective: June 30, 2025 | Latest Legislation: House Bill 96 - 136th General Assembly