Environment
No direct effect
Neutral — no direct effect identified.
Benefits
- No material direct effect identified.
Risks
- No material direct effect identified.
StateOhioIntroduced
HB 1005: Regards Medicaid managed care organization payment rates
Marilyn John
HB 1005 status: Introduced (updated Sep 8, 2026).
Source
OpenStates
Confidence
Low
Analysis basis
OpenStates summary
01
What this bill does
Official summary alongside an AI-generated read on where it stands and why.
Overall Score
60OUT OF 100
Score:60/100 civic fit
Risk:Moderate Risk
Impact:Moderate Impact 55/100
Constitutionality95%
Bipartisan50%
Public opinion50%
Bill summary
What changes
The bill mandates the establishment of specific payment rates or structures for Medicaid managed care organizations when purchasing durable medical equipment (DME), complex rehab technology (CRT), and prosthetics/orthotics.
Who is affected
Medicaid managed care organizations operating in Ohio, providers of specialized medical equipment, and Medicaid beneficiaries requiring these devices.
Requirements and enforcement
Managed care plans will be required to comply with new reimbursement standards dictated by the enactment of section 5167.052 of the Revised Code.
Costs and funding
The fiscal impact is not currently stated; exact costs will depend on the final payment rates mandated by the legislature or the relevant oversight department.
When it takes effect
The bill is in the introductory stage as of September 2026.
Potential benefits
Potential for improved consistency in patient access to necessary medical devices and standardized reimbursement that may help stabilize the network of specialized equipment providers.
Risks and tradeoffs
Potential for increased costs to the state Medicaid program and risks associated with market disruption if the set rates do not align with actual market costs for equipment.
What is still unknown
The specific numerical rates, the methodology used to calculate them, and the degree of impact on current MCO provider contracts remain unknown.
02
Impact analysis
✦ AI analysisModeled effects across six domains, estimated from bill text and comparable legislation.
Economy
Positive outlook
60%
Benefits
- Standardizes reimbursement for medical providers
- Reduces rate variability across Medicaid MCOs
- Promotes predictable revenue for equipment suppliers
Risks
- Potential for increased state Medicaid expenditure
- May alter profit margins for managed care plans
- Risk of reduced provider competition if rates are insufficient
Society
No direct effect
Neutral — no direct effect identified.
Benefits
- No material direct effect identified.
Risks
- No material direct effect identified.
Technology Industry
No direct effect
Neutral — no direct effect identified.
Benefits
- No material direct effect identified.
Risks
- No material direct effect identified.
Civic Accountability
No direct effect
Neutral — no direct effect identified.
Benefits
- No material direct effect identified.
Risks
- No material direct effect identified.
Public Health & Safety
Positive outlook
60%
Benefits
- Ensures reliable access to durable medical equipment
- Supports specialized care through complex rehab technology
- Maintains standards for orthotic and prosthetic services
Risks
- Risk of narrow networks if rates underperform market costs
- Potential for service delays during contract renegotiations
- Dependency on MCO compliance with new statutory rates
03
How trustworthy & consequential it is
Sourcing already shown above, this is what the analysis found worth flagging.
Source
OpenStates
Official bill text or data from OpenStates.
Confidence
Low
Information is limited or incomplete.
Analysis basis
OpenStates summary
Source used for this bill's analysis.
Source note
The financial impact of mandatory rate adjustments is not yet quantified by fiscal analysts.
Analysis scope
Source material is limited to an abstract; specific rate formulas are unavailable.
04
Where it stands
Official record- IntroducedCurrent
- CommitteeUpcoming
- Chamber votesUpcoming
- Final agreementUpcoming
- GovernorUpcoming
- EnactedUpcoming
05
How it affects your district
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06
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