Ohio Legislative Service Commission
297.7 million (13.5%). The majority of the all funds negative monthly
variance was related to Upper Payment Limit (UPL) payment timing. UPL
allows the state to direct supplemental payments from non-GRF funds –
up to the difference between the Medicare and Medicaid amounts – to
providers. The UPL payment of $154.9 million for April will likely now be Through April,
made near the end of the fiscal year due to a delay from the federal GRF Medicaid
Centers for Medicare and Medicaid Services (CMS) in processing a state
For the first ten months of FY 2016, GRF Medicaid expenditures were
were $15.10 billion, $404.7 million (2.6%) below estimate, while non-GRF $
Medicaid expenditures were $5.01 billion, $1.56 billion (23.7%) below below estimate;
estimate. Across all funds, Medicaid expenditures totaled $20.11 billion, non-GRF
this negative year-to-date variance was related to timing of certain
payments for hospitals (see below for more details).
1.96 billion (8.9%) below their year-to-date estimate. A large portion of Medicaid
The Ohio Department of Medicaid (ODM) is primarily responsible
for administering Medicaid, with the assistance of five other state agencies $1.56 billion
Developmental Disabilities, Job and Family Services, Health, Aging, and below estimate.
Mental Health and Addiction Services. As seen from Table 5, ODM, the
largest agency within this program category, also had the largest
year-to-date variance. For the first ten months of FY 2016, ODM's GRF
expenditures totaled $14.6 billion, which was $414.3 million (2.8%) below
estimate, and its non-GRF expenditures totaled $3.32 billion, which was
1.42 billion (30.0%) below estimate. Across all funds, ODM's
expenditures were $1.84 billion (9.3%) below their year-to-date estimate. Through April,
GRF and non-GRF Medicaid expenditures from the Department of all-funds
Developmental Disabilities (DDD), the second largest agency within this
program category, totaled $1.98 billion for the first ten months of FY 2016, Medicaid
which was $124.2 million (5.9%) below estimate. Together, ODM and expenditures
DDD account for about 99% of the Medicaid expenditures total.
Table 6 details all-funds Medicaid expenditures by payment $1.96 billion
category. As seen from the table, Hospitals had the largest negative below
year-to-date variance at $1.18 billion (44.6%), of which $920.2 million is
due to UPL and the Hospital Care Assurance Program (HCAP), estimate.
309.8 million and $610.4 million, respectively. The UPL and HCAP
payments originally scheduled between February and April will not be
made until the end of FY 2016. UPL is described above. Under HCAP,
Ohio makes subsidy payments to hospitals that provide uncompensated
care to low-income and uninsured individuals at or below 100% of the
federal poverty level.