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Healthcare Provisions in the Ohio FY 22-23 Budget

Governor Mike DeWine signed Ohio’s Fiscal Year 2022-2023 budget bill (HB 110) into law on July 1, 2021. At almost 1,000 pages and 74.1 billion dollars, the budget lays out the State’s spending for the next two years. Below are a few highlighted provisions from the budget that will be important for the healthcare industry in Ohio:

Medicaid

Overall, Medicaid received an investment of $31.0 billion for the fiscal year 2022 and $32.2 billion for the fiscal year 2023 in order to:

  • Support the procurement and reorganization of Ohio's managed care system to improve wellness and health outcomes while emphasizing a personalized care experience. This includes new Medicaid Managed Care Organizations, OhioRISE, and the implementation of a single pharmacy benefit manager.
  • Continue funding of Medicaid's Behavioral Health Care Coordination program.
  • Continue and expand Medicaid's Emergency Telehealth program, to continue telehealth services for medical, clinical, and behavioral health.
  • Provide an additional $4 million per year for the prevention of custody relinquishment of multi-system youth children.

Moms & Babies

  • Increased funding for Help Me Grow by $1.9 million each fiscal year, which will provide for more home visiting services for at-risk, expectant mothers, and families of young children at or below 200 percent of the federal poverty level.
  • $25 million towards increased support for the lead hazard control programs including a new, statewide Lead-Safe Housing Fund that will provide competitive grants to Ohio communities to abate lead hazards in their housing.
  • $2.25 million for housing initiatives for pregnant mothers through the Development Services Agency, along with the Department of Health and the Governor’s Children's Initiative.
  • Medicaid coverage for mothers up to 200 percent of the federal poverty level for a full year after giving birth, an increase from the current coverage of 60 days after birth. 

Nursing Homes & Long-Term Care

  • Additional oversight and enforcement of nursing home and long-term care laws to ensure the health and safety of older Ohioans and additional new worker training opportunities through the Department of Aging.
  • $490 million for quality outcome incentives for Medicaid nursing home services that will reward nursing homes for providing high-quality, outcome-driven care.
  • Implementation of a Nursing Home Bed Reduction Program to costly excess unused bed capacity.

RecoveryOhio & Substance Use Disorder Treatment

  • $4.5 million to expand early identification programs including increased screening, early intervention, and connections to treatment.
  • $3 million to address health disparities on minority, poor, and underserved populations.
  • $41 million to continue the support of crisis services for children, youth, families, and adults with mental health and substance abuse disorder needs.
  • $29 million to expand access to the Tobacco Use Prevention and Cessation Program and to establish the My Life, My Quit youth-centered quit program also seeks to educate Ohio youths of the risks of vaping/e-cigarette use.
  • $10 million to expand Specialized Dockets within courts with the purpose of connecting individuals with support services around mental health, substance use disorder, trauma care, and other services to better the individual's wellbeing.
  • Continuation of support to local health providers’ harm reduction efforts for accidental drug overdose rates and deaths.

Mental Health

  • Over $11 million increase in funding to strengthen multi-system adult collaboration to connect people with serious mental health issues to needed care, recovery supports, stable housing, and positive community participation.
  • Expanding access to treatment within Ohio's correctional facilities by increasing recovery services, counseling, peer support, technology, and medication. Recovery services provided during incarceration significantly increase the likelihood that these individuals become productive members of society when released.

Conscience Clause

  • Added late in the budget process, this statute allows any medical practitioner, health care institution, or health care payer to “decline to perform, participate in, or pay for any health care service which violates the practitioner's, institution's, or payer's conscience as informed by the moral, ethical, or religious beliefs or principles held by the practitioner, institution, or payer." 

Hospital Licensure

  • Ohio will now require hospitals to be licensed. Once the Ohio Department of Health develops corresponding rules, Ohio hospitals will have three years to comply and become licensed. For more information on hospital licensure, see this BMD Client Alert by Member Vicki Ferrise along with Jacob Davis.

In addition to all of the items above included in the FY 22-23 budget, Governor DeWine also issued several line-item vetoes immediately prior to signing the bill. Most important to the healthcare area, DeWine vetoed provisions that would have required Medicaid to revise its procurement process and would have likely delayed the implementation of the new Medicaid Managed Care structure.

These are just a handful of the many, many provisions included in the Ohio budget for the next two years. If you have any questions about how these changes may affect your healthcare practice or business, please reach out to Ashley Watson at abwatson@bmdllc.com or any BMD healthcare attorney.

Changes to Physician Assistant Statutes in Florida

In the last year, there have been many changes to the scope of practice and collaboration/supervision requirements for advanced practice providers such as APRNs and physician assistants in the state of Florida. In a previous Client Alert we discussed House Bill 607, which expanded the autonomous practice of APRNs providing primary care services in Florida.

Ohio Senate Bill 49 – Ohio Expands Lien Rights for Design Professionals

Effective September 30, 2021, Ohio granted limited lien rights to design professionals, including architects, landscape architects, engineers, and surveyors. Ohio Governor Mike DeWine signed Senate Bill 49 into law on July 1, 2021. This new law established a statutory right to lien commercial real estate by Ohio design professionals who, until now, could not file a lien for non-payment of professional services. Senator Vernon Sykes, a primary sponsor of Senate Bill 49, stated that the “legislation ensures that architects, engineers and other designers will get paid for their work, regardless of the outcome of their projects . . . It will support hardworking Ohioans by protecting the value of their labor . . ..”

Primary Care Practice Officially Defined in Florida for APRNs Practicing Autonomously

As many providers in Florida are aware, House Bill 607 (the “Bill”), which was passed in February of last year, gives certain APRNs in Florida the ability to practice autonomously. The only catch is that they must work in primary practice. When the Bill was initially passed, there was question as to what was exactly considered primary care, absent a definition from the Florida Board of Nursing. However, as of February 25, 2021, “primary care practice” has officially been defined.

Part II of the No Surprises Act

The Department of Health and Human Services (“HHS”) published Part II of the No Surprises Act on September 30, 2021, which will take effect on January 1, 2022. The new guidance, in large part, focuses on the independent dispute resolution process that was briefly mentioned in Part I of the Act. In addition, there is now guidance on good faith estimate requirements, the patient-provider dispute resolution processes, and added external review provisions.

Safer Federal Workforce Task Force - Guidance for Federal Contractors and Subcontractors

The Safer Federal Workforce Task Force has issued its Guidance for Federal Contractors and Subcontractors (Guidance). Note that the Guidance applies only to “covered contracts,” which are contracts that include the clause (Clause) set forth in Sec. 2(a) of Executive Order 14042 (Ensuring Adequate COVID Safety Protocols for Federal Contractors). The Federal Acquisition Regulatory Council (FARC) is to conduct rulemaking and take related action to ensure that the Clause is incorporated into federal contracts. Until that happens, federal contractors likely will not see the Clause in its contracts. Following is a broad summary of the Guidance.