Ohio’s newly passed Medicaid oversight bill could drive more patients into skilled nursing facilities, with disability advocates warning that new requirements for home care providers may reduce access to community-based services.
The legislation follows concerns about Medicaid fraud in Ohio’s home care system, which prompted Gov. Mike DeWine to impose a six-month moratorium on new home care providers and support additional oversight measures aimed at curbing abuse.
For skilled nursing providers, the most important issue is the potential shift in care settings.
The tighter eligibility and provider requirements, combined with the moratorium on new providers, could make it harder for individuals with disabilities and complex care needs to maintain services in the community. If home care agencies lose staff, close operations or are unable to add new caregivers, affected individuals may have few alternatives.
In those situations, hospitals and skilled nursing facilities could become the default safety net.
Prior to the bill’s passage, disability advocates’ pushback against certain provisions forced lawmakers to make changes, including removing a ban on paid family caregivers. However, the bill retains mandates for electronic visit verification, GPS-based tracking for many caregivers, and additional fraud-prevention measures – policies that advocates say place further pressure on home care providers, according to a story in STAT News.
If signed into law, the bill is expected to further complicate matters for the home care industry, which is already grappling with provider shortages and Medicaid funding cuts that are deepening financial pressure at the state level.
“What is happening in Ohio is a bellwether for what we’re going to see in states all over the country,” Nicole Jorwic, chief program officer at Caring Across Generations, an aging and disability advocacy nonprofit, told STAT. “And the complete microscope that the Trump administration is putting on states to find bad actors is causing disarray.”
If similar policies spread without addressing workforce shortages, these advocates argue that more individuals could be pushed from home- and community-based services into institutional care settings, increasing demand for skilled nursing facilities while potentially reversing long-standing efforts to support care in the home.
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