Ohio Planning To Develop New Medicaid Nursing Facility Rates & Transition To PDPM

The Ohio Department of Medicaid (ODM) is planning to develop new Medicaid nursing facility rates and transition to the Patient Driven Payment Model (PDPM) from their current Resource Utilization Group IV (RUG-IV) model. To support this effort, ODM released a request for proposals (RFP ODMR 2425-0016) for clinical and fiscal expertise and consulting in Medicaid nursing facility rate development processes under new methodologies, including the RUG-IV, PDPM, and potential innovative alternatives for one or more of the rate-setting components. 

The state is under a federal deadline to transition its nursing facility reimbursement methodology by October 2025 . . .