CHS-Lake Erie, Inc. v. Ohio Dept. of Medicaid

Citations

• 145 N.E.3d 335
• 2020 Ohio 505

Syllabus

Judgement affirmed in part reversed in part. The common pleas court erred in reversing a portion of the Ohio Department of Medicaid's adjudication order. Although the common pleas court concluded that the department ignored the evidence demonstrating that Medicare would not have applied the liquidation of liabilities rule in the Medicare prospective payment system, the record demonstrated that the department had addressed such evidence and concluded that the liquidation of liabilities rule could apply to the nursing facilities' 2003 cost reports as the Ohio Medicaid prospective cost-based payment system differed from the Medicare prospective payment system. The common pleas court did not err in upholding the portion of the department's adjudication order concluding that the nursing facilities could not introduce evidence of unpaid days or unpaid claims for service at the R.C. Chapter 119 hearing, or in upholding the department's conclusion that the department presented prima facie evidence to support its adjustments in the days audits. The nursing facilities forfeited the arguments they did not raise in the common pleas court.