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ODM and OhioMHAS Continue to Expand Telehealth

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.

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.