Resources

Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

CLIENT ALERT: Ohio Managed Care Organization (MCO) Open Enrollment

Client Alert
May 1, 2018

Open Enrollment started April 30, and will continue through May 25, 2018, for your MCO (Managed Care Organization).  Every State Fund Ohio employer can select their MCO for the coming policy year.  The MCO is responsible for helping to manage Ohio Workers’ Compensation claim costs.  All State Fund employers will begin to receive correspondence urging them to select that particular MCO, or urging them not to make a switch.               

 

Legislation introduced in 1993, which eventually became law after amendments, made managed health care a part of the Ohio Workers’ Compensation system.  That system has evolved over the years, and MCOs now make initial decisions involving most medical management issues in state fund claims.  Their importance cannot be overstated, as the medical management often dictates the path a particular claim will take.  It would be a mistake for any State Fund Ohio employer to simply allow the “default” MCO manage their claims.  Instead, they should examine their MCO (every State Funded employer has one – and if the employer has not selected one, then one is selected for that employer at random), and decide whether they want to switch or keep their MCO.

 

The Ohio BWC provides helpful information for those looking for basic information (which can be found at https://www.bwc.ohio.gov/downloads/brochureware/brochures/MCOGuide.pdf).  Of course, anyone who wants to discuss their overall claims situation is free to contact Richard Williger, and I’d be happy to spend some time looking at their overall Experience.

Workers' CompensationManaged Care Organizations
Client Alert

USCIS Policy Updates: Implications for Business Immigration

August 20, 2025In August 2025, USCIS issued three key policy updates enhancing vetting, good moral character (GMC) evaluations, and scrutiny of "anti-American" conduct in immigration adjudications. These policy memos will impact employers sponsoring foreign workers, including H-1B, L-1, EB visas, adjustments, and naturalization.Client Alert

Ohio Passes Antidiscrimination Provision for CRNA Reimbursement

August 14, 2025Ohio has passed House Bill 96, introducing a provider nondiscrimination provision that requires health plans to reimburse certified registered nurse anesthetists (CRNAs) at the same rate as physicians for the same services. The law aims to improve patient access to care by eliminating payment discrimination against CRNAs and will take effect on September 30, 2025.Client Alert

Ohio Board of Pharmacy | Administrative Code Rule Changes

July 16, 2025The Ohio Board of Pharmacy (“BOP”) recently posted notices of Ohio Administrative Code rule changes related to record keeping and the sale and distribution of certain ephedrine-containing products.Client Alert

A Shift in Coverage: HHS Reinterprets “Federal Public Benefit” Under PRWORA

July 16, 2025The U.S. Department of Health and Human Services rescinded a 1998 interpretation of “federal public benefit” used in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) on July 10, 2025. This notice removes "outdating exclusions" and includes additional programs under “federal public benefit."Client Alert

Supreme Court Upholds Coverage under the Affordable Care Act

July 10, 2025The U.S. Supreme Court has upheld the authority of the U.S. Preventive Services Task Force under the ACA, ensuring continued no-cost coverage for over 100 preventive health services. The decision impacts millions of Americans and preserves provider reimbursement through insurance.
Older posts