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Healthcare Provisions in the Ohio FY 22-23 Budget

Client Alert

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.


Valley National Bank/Trulieve Loan: A Big Step Out of the Shadows

In a late December press release, Trulieve announced that it had secured a $71.5 million commercial bank loan. In addition to the amount of the loan, which may be the largest commercial bank loan to date to a cannabis company, the release prominently identified Valley Bank and featured both a quote from Valley’s Senior Vice President, John Myers, and a description of the Bank’s service platform and commitment to the cannabis industry.

The End of Non-Competes? The Impact It Will Have on the Healthcare Industry

On January 5, 2023, the Federal Trade Commission (“FTC”) announced a proposed rule that, if enacted, will ban employers from entering into non-compete clauses with workers (the “Rule”), and the Rule would void existing non-compete agreements. In their Notice, the FTC stated that if the Rule were to go into effect, they estimate the overall earnings of employees in the United States could increase by $250 billion to $296 billion per year. The Rule would also require employers to rescind non-competes that they had already entered into with their workers. For purposes of the Rule, the FTC has defined “worker” to also include any employees, interns, volunteers, and contractors.”

2022 Healthcare Recap and 2023 Healthcare Check-Up

As the country begins to return to a new “normal” following the COVID-19 pandemic, there are many healthcare rules changing on both the federal and state levels as a result. Thus, it is important for healthcare providers and their employers to be aware of these changing rules, and any implications they may have on their practice. Look back on healthcare in 2022 and find a checklist for 2023.

Direct Support Professional Retention Payments

On December 15, the Ohio Senate and House passed House Bill 45, which authorizes the Department of Developmental Disabilities (DODD), in conjunction with the county boards of developmental disabilities, to launch their initiative to issue retention payments to Direct Support Professionals (DSPs). These retention payments will be distributed quarterly to participating home and community-based waiver providers to address the workforce crisis in the direct provider sector. Governor DeWine needs to sign the Bill to begin the payments, but he is expected to do so by the end of 2022.

Real Estate Investors Position for 2023 Opportunities

Real estate investors weathered another year in a post-pandemic world, with the year closing with yet another interest rate increase coupled with both uncertainty and heightened interest carrying into 2023. Just last Wednesday, the Federal Reserve raised its benchmark interest rate 0.50 percentage points, shifting the target range to 4.25% to 4.50%. The new level is the highest the fed funds rate has been since December 2007 and marks the seventh rate hike this year. So what does this mean to investors, brokers, lenders, and others in the real estate world? Read a few perspectives below from stakeholders familiar with our BMD clients and the markets in which they do business.