HB 675

As Introduced
136th General Assembly
   Regular Session  H. B. No. 675
       2025-2026
  Representatives Stephens, Deeter
  To establish a temporary program for hospital  1
  payments made by Medicaid managed care  2
  organizations and to name this act the Healthier  3
  Rural Hospitals Act.  4
 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
     Section 1. (A) The Department of Medicaid shall establish  5
a program under which hospitals in counties in this state with a        6
population less than one hundred thousand residents receive  7
specified payments from a Medicaid managed care organization in  8
accordance with this section. As part of the program, the  9
Department shall calculate the statewide average payment rate  10
paid by Medicaid managed care organizations to all hospitals for        11
hospital services provided to Medicaid recipients.  12
     (B) The Department shall determine a hospital's  13
eligibility to receive payments under the program by calculating        14
a score for each county in this state with a population less  15
than one hundred thousand residents. Scores shall equal the sum  16
of a county's ranking in the following categories:  17
     (1) The county's rank in this state based on the county's  18
age-adjusted rate of cancer deaths per one hundred thousand  19
residents for calendar year 2022. A rank of one shall reflect  20
H. B. No. 675  Page 2
As Introduced
the highest rate of cancer deaths in this state.  21
       (2) The county's rank in this state based on the county's  22
percentage of population at or below one hundred fifty per cent  23
of the federal poverty level. A rank of one shall reflect the  24
highest per cent of individuals at or below one hundred fifty  25
per cent of the federal poverty level in this state.  26
       (3) The county's rank in this state based on the county's  27
age-adjusted rate of deaths from chronic lower respiratory  28
disease per one hundred thousand residents for calendar year  29
2022. A rank of one shall reflect the highest rate of deaths in  30
this state.  31
       (4) The county's rank in this state based on the county's  32
age-adjusted rate of death from stroke per one hundred thousand  33
residents for calendar year 2022. A rank of one shall reflect  34
the highest rate of deaths in this state.  35
       (5) The county's rank in this state based on the county's  36
average annual age-adjusted rate of unintentional drug overdose  37
death for calendar years 2017 through 2021. A rank of one shall  38
reflect the highest average annual rate of deaths in this state.  39
       (C) After calculating scores under division (B) of this  40
section, the Department shall rank all counties in this state  41
with a population less than one hundred thousand residents from  42
lowest to highest. The twenty lowest-ranked counties shall be  43
eligible to participate in the program established under this  44
section.  45
       (1) For counties ranked one through ten, a Medicaid  46
managed care organization shall pay each hospital located in an  47
eligible county a payment rate for hospital services that is at  48
least one hundred fifty per cent of the statewide average rate  49
H. B. No. 675  Page 3
As Introduced
calculated by the Department under division (A) of this section.  50
       (2) For counties ranked eleven through twenty, a Medicaid  51
managed care organization shall pay each hospital located in an  52
eligible county a payment rate for hospital services that is at  53
least one hundred twenty-five per cent of the statewide average  54
rate calculated by the Department under division (A) of this  55
section.  56
       (D) In making payments under division (C) of this section,  57
a Medicaid managed care organization shall not reduce the  58
payment rate made to a hospital not participating in the program  59
as a means of making payments in accordance with this section.  60
       (E) The Department shall terminate the program two years  61
after the effective date of this section.  62
       Section 2. This act shall be known as the Healthier Rural  63
Hospitals Act.  64