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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.


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.

Banking & Cannabis: The Next Frontier Webinar

On Tuesday, September 21st, BMD’s own Banking and Cannabis Partner, Stephen Lenn, hosted a star-studded cast of panelists in a webinar titled Banking & Cannabis: Cannabis Lending, The Next Frontier. The webinar, which had to suspend registrations when hitting a maximum cap of 500, aimed to explore issues related to cannabis and banking, with a particular emphasis on lending. With the sponsorship and support of the Bankers Associations of Arizona, Colorado, Ohio and Utah, Steve was able to recruit an elite group of bankers, bank regulators, cannabis industry players, and cannabis regulators, who took the topic head on. The discussion kicked off with an opening from the keynote speaker, VP of Congressional Affairs for the American Bankers Association, Tanner Daniel.

Is Your Bonus System Creating Wage and Hour Violations? A Hidden Impact of the Labor Shortages

As employers struggle with attracting and retaining talent, many have turned to incentives such as Signing Bonuses and Retention Bonuses. In doing so, employers may be inadvertently exposing themselves to overtime law violations. Employers with non-exempt employees know that the Fair Labor Standards Act (FLSA) requires an overtime premium to non-exempt for work in excess of 40 hours per week. However, all too often, employers miscalculate the “regular rate” of pay, which is used for calculating the “overtime rate.” The miscalculation is becoming more prevalent in today’s market when employers fail to include supplemental compensation, such as certain Signing Bonuses and Retention Bonuses into the regular rate of pay. An example: A non-exempt employee is hired at a rate of $20 per hour, and also receives a retention bonus of $1,200 after working for 12 weeks. In her 11th week of work, employee works 50 hours. In her 14th week of work, employee works 50 hours. What is her paycheck in week 11? What is her paycheck in week 14?

No Surprises Act – Notice Requirements

On July 1, 2021, the Biden Administration passed an interim final rule: Part 1 of the “Requirements Related to Surprise Billing Act,” in an attempt to curb excessive costs patients are required to pay in relation to surprise billing. The rule is set to take affect January 1, 2022, and will only affect those who are enrolled in insurance via their employers, as federal healthcare programs already prohibit this type of billing.[1]