Resources

Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

Governor Mike DeWine and The Ohio State University Introduce the SOAR Study on Ohio Mental Illness

Client Alert

On January 19, Ohio Gov. Mike DeWine and The Ohio State University announced a new research initiative, the State of Ohio Adversity and Resilience (“SOAR”) study, which will investigate all factors influencing Ohio’s mental illness and addiction epidemic. SOAR will focus on Ohio families across generations to:

  • Identify factors or risks that lead to persistent distress, mental illness, substance abuse, use disorders, or overdose,
  • Understand how exposure to such risks impacts one’s behavior, biology, and brain function,
  • Identify patterns of intergenerational transferal of illnesses, and
  • Discover methods to promote resilience allowing one to face adversity.

The Ohio State University Wexner Medical Center and College of Medicine will collaborate with a number of Ohio universities to lead the study. Bowling Green State University, Case Western/ University Hospital-Cleveland, Central State University, and Nationwide Children’s Hospital, among others, will join Ohio State in the study.

Beginning its initiative, the SOAR study will start with two paralleled projects. First, under the SOAR Wellness Survey, as many as 15,000 Ohioans will be surveyed to collect information on social and psychological makeup, life experiences, and the participants’ mental health. Second, the SOAR Brain Health Study will examine about 3,000 Ohio families to study biological, psychological, and social factors to determine who does well facing adversity, and who does not.

Over the past decade, Ohio has witnessed a rise in mental illness and drug overdose, which has been heightened by the COVID-19 pandemic. Evidencing the state’s attempt to improve these issues, the Ohio Department of Mental Health and Addiction Services has funded the SOAR study with an initial $20 million grant.

In performing extensive analysis on Ohio individuals, families, and multiple generations, SOAR study researchers hope these findings lead to “new strategies” that support resilience and enable families to “break the chain” of mental illness and substance abuse.

If you have questions about the content of this Client Alert, please contact BMD Healthcare Member Daphne Kackloudis at dlkackloudis@bmdllc.com.


Ohio’s Managed Care Overhaul Delayed – New Implementation Timeline

At the direction of Governor Mike DeWine, the Ohio Department of Medicaid (ODM) launched the Medicaid Managed Care Procurement process in 2019. ODM’s stated vision for the procurement was to focus on people and not just the business of managed care. This is the first structural change to Ohio’s managed care system since the Centers for Medicare & Medicaid Services' (CMS) approval of Ohio’s Medicaid program in 2005. Initially, all of the new managed care programs were supposed to be implemented starting on July 1, 2022. However, ODM Director Maureen Corcoran recently confirmed that this date will be pushed back for several managed care-related programs.

Laboratory Specimen Collection Arrangements with Contract Hospitals - OIG Advisory Opinion 22-09

On April 28, 2022, the Department of Health and Human Services, Office of Inspector General (“OIG”) published an Advisory Opinion[1] in which it evaluated a proposed arrangement where a network of clinical laboratories (the “Requestor”) would compensate hospitals (each a “Contract Hospital”) for specimen collection, processing, and handling services (“Collection Services”) for laboratory tests furnished by the Requestor (the “Proposed Arrangement”). The OIG concluded that the Proposed Arrangement would generate prohibited remuneration under the federal Anti-Kickback Statute (“AKS”) if the requisite intent were present. This is due to both the possibility that the proposed per-patient-encounter fee would be used to induce or reward referrals to Requestor and the associated risk of improperly steering patients to Requestor.

Property Owner Protection from Tax Valuation Challenges

New legislation provides significant new protections for commercial property owners against challenges to valuation primarily by local school boards and prohibiting side agreements to avoid tax valuation changes. The Ohio Legislature has approved House Bill 126 which will go into effect July 2022 but will effectively apply to the 2023 tax valuation year.

No Surprises Act Update: The IDR Portal is Open

The No Surprises Act (“NSA”) became effective January 1, 2022, and has been the subject of lawsuits and criticisms since its inception. The goals of the No Surprises Act are to shield patients from surprise medical bills, provide to uninsured and self-pay patients good faith estimates of charges, and create a process to resolve payment disputes over surprise bills, which arise most typically in emergency care settings. We have written about Part I and Part II of the NSA previously. This update concerns the Independent Dispute Resolution (“IDR”) procedure created by Part II but applicable to claims covered by Part I. The Centers for Medicare & Medicaid Services (“CMS”) finally opened the Portal for providers to submit disputes to the IDR process following some updated guidance regarding the arbitration process itself.

Updated FAQs for the No Surprises Act - Good Faith Estimates

The No Surprises Act (“NSA”) became effective January 1, 2022. Meant to protect consumers from surprise medical bills, the new law is good for consumers, but vexatious for health care providers and facilities. One particular source of frustration is the operationalization of the Good Faith Estimate (“GFE”) requirement, governed by Part II of the regulations that implement the NSA. The GFE requirements apply broadly to all healthcare providers and facilities that practice within the scope of their state-issued license.