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ODM and OhioMHAS Continue to Expand Telehealth

Client Alert

On July 17, 2020, Governor DeWine signed Executive Order 2020-29D, which allowed the Ohio Department of Medicaid (“ODM”) to immediately rescind old provisions and file a new rule (5160-1-18) and the Ohio Department of Mental Health and Addiction Services (“OhioMHAS”) to amend their current rule (5122-29-31), both expanding telehealth and introducing even more flexibility into Ohio’s healthcare system. 

Both rules will expire on November 14, 2020, unless adopted through the normal JCARR process. This is a significant move for ODM as they were previously operating off of a newly added emergency rule (“Telehealth During a State of Emergency”), but the department is now transitioning these expanded telehealth rules directly into their rule that existed prior to the public health emergency. 

In general, if a service does not have some type of in-person requirement (surgery, procedure, test etc.), then it most likely is appropriate to conduct via telehealth. 

ODM – 5160-1-18 

  • Telehealth can either be:
    • Synchronous, interactive, real-time electronic communications using both audio and video; or
    • Asynchronous activities that do not have both audio and video (calls, emails, images through fax) 
  • Patient site and practitioner site – the physical location of each at the time of service 
  • Eligible Providers:
    • Physician
    • Psychologist
    • Physician assistant
    • Certified nurse specialist, certified nurse-midwife, certified nurse practitioner
    • LISW, LIMFT, LPCC
    • LICDC
    • Supervised practitioners and supervised trainees
    • Audiologist, speech-language pathologist, speech-language pathology aids, and audiology aids
    • Occupational and physical therapist and occupation and physical therapist assistants
    • Home health and hospice aids
    • Private duty registered nurse or licensed practical nurse in a home health or hospice setting
    • Dentists
    • Dietitians
    • Behavioral health practitioners 
  • Provider types eligible to bill for services rendered through Telehealth:
    • Any practitioner
    • Professional medical group
    • Professional dental group
    • FQHC/RHC
    • Ambulatory health care clinics
    • Outpatient hospitals
    • Private duty nurses
    • Home health and hospice agencies
    • Behavioral health providers 
  • Requirements:
    • Must comply with current HIPAA guidance from Office of Civil Rights
    • Practitioner site responsible for maintaining appropriate documentation
    • Patient and practitioner sites should be consistent with CPT and HCPCS guidelines for the service being provided 
  • Payment may be made for all of the following services in the appendix here. 
  • Claims should be submitted in accordance with Telehealth billing guidance and those detailed provisions in subparagraph (E) of this new rule 

OhioMHAS – 5122-29-31

Telehealth means real-time audiovisual communications with quality to permit accurate and meaningful interactions and includes asynchronous modalities that do not have both audio and video elements 

  • Originating site (client) and distant site (provider) are where each are located at the time of service 
  • No initial in person visit is necessary to initiate services using telehealth 
  • Prior to initiating services, a provider must inform the patients of potential risks of telehealth and document that patient understood and agrees to those risks (clinical aspects, security considerations and confidentiality considerations) 
  • Services:
    • General services
    • CPST
    • Therapeutic behavioral services and psychosocial rehabilitation
    • Peer recovery
    • SUD case management
    • Crisis intervention
    • ACT
    • IHBT 
  • Provider must have a physical location in Ohio or have access to a physical location in Ohio where individuals may opt to receive services that are being provided by telehealth modalities 

Please contact a BMD healthcare attorney if you have any questions regarding these telehealth rules, any telehealth questions in general, or any other healthcare questions.


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.