Supporting Private Providers

by   |   Tue, Jul 12th, 2016

The Integral Role of County Boards

Medicaid has been a huge provider of resources for private providers and for county boards of developmental disabilities. There has been much confusion over how Medicaid funds are disbursed to private providers and how the Tuscarawas County Board of DD contributes to the Medicaid payments that are sent to providers.

The confusion results from the Medicaid reimbursement system. Private providers submit an invoice to the State of Ohio Department of DD (DODD) and the DODD then invoices Medicaid for the funds needed to pay the invoice. When the Medicaid funds are received and the billing has been approved, the DODD sends a check to the private provider for the full amount of the invoice.

What is not apparent is that the TuscBDD is responsible to reimburse Medicaid for 37.5% of the funds paid out for waiver services. 37.5% is equal to ⅜ of the payment the private provider receives. The payments are considered to be matching funds by Medicaid, so the payment is referred to as "Medicaid Match".

TuscBDD makes the payment directly to the Treasurer of the State of Ohio. The private provider never sees a check from the TuscBDD because the Board's contribution has been added to the State fund for Medicaid services.

TuscBDD is responsible to reimburse Medicaid $37.50 of every $100 paid to private providers. So that the funds of county boards will not be exhausted by paying Medicaid match, the State of Ohio allocates a specific amount of State funds to each county for that purpose. The amount is different for every county.

In 2015, the State of Ohio contributed $661,425 towards the match payment required of the TuscBDD. As a result, the TuscBDD paid $1,184,236 in cash for Medicaid match in 2015. Those payments enabled private providers to receive $4,917,828 in Medicaid funds.

Tue, Jul 12th, 2016