Health

Rural Ohio health system still waiting on $80 million in federal Medicaid payments

Marietta, Ohio • November 1, 2026 • By Press Pass USA

Editorial illustration: a rural hospital beside an unfinished hospital construction site with a crane at dusk in an Ohio river town

Editorial illustration — Press Pass USA

Marietta-based Memorial Health System is waiting on approximately $80 million in Medicaid supplemental payments still pending approval from the federal Centers for Medicare and Medicaid Services, its chief executive told Becker's Hospital Review on October 31 — a delay that has stalled financing for a new women's and children's hospital in Belpre.

About $60 million of the total is tied to the Ohio Rural Tax Pilot Program, a state-directed payment program — the first of its kind in Ohio for rural hospitals — that has awaited CMS approval for 15 months, CEO Scott Cantley told Becker's. The remaining roughly $20 million comes from Ohio's 2026 Hospital Additional Payments Program, which Cantley said has gone unpaid for the first time in his 32 years working in Ohio hospitals.

The delay has direct consequences for the Belpre project, which broke ground in October 2024 as a partnership between Memorial and Akron Children's Hospital. Cantley said Memorial counted on the pilot program's payments to support the debt needed to finish the hospital, and he cannot ask the board to approve that financing until the funds are approved. The project, which received $30 million in state funding, was first expected to be finished in late 2026.

“In my opinion, the rural hospitals may be the ones that need the most attention,” Cantley told Becker's. “I think this is the right use of CMS' Medicaid state-directed payment program, and this is where it should be focused because these are the hospitals that are most vulnerable.”

The Ohio Department of Medicaid told Becker's it has supported the federal review by providing requested information and completing all required submissions, and that the program is now awaiting CMS action. Ohio's proposed program relies on county-level funding, similar to programs CMS has approved in Texas, New Jersey and Florida; in September 2026, CMS approved $12 billion in Texas Medicaid funding after months of negotiations, Becker's noted.

Cantley said he remains optimistic the pilot program will be approved. “I'm very hopeful that CMS will expedite its review and come to the conclusion we all anticipate — that this is an appropriate payment and one that was filed appropriately by the state of Ohio, approved by the governor, and should be released to be paid to its hospitals,” he told Becker's.

Sources: Becker's Hospital Review (Oct 31, 2026); Columbus Dispatch (Oct 28, 2026).