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Ohio Permitting Deferral of Health Care Premiums for Employer Plans

Client Alert
March 25, 2020

Effective March 20, 2020 and continuing through the expiration of the state of emergency declared by Governor DeWine on March 9, 2020, the Ohio Department of Insurance is requiring all health insurance companies operating in Ohio to give their insureds the option of deferring premium payments coming due, interest free, for up to 60 calendar days from each original premium due date.  See Department of Insurance Bulletin 2020-03.

The Ohio Department of Insurance is also requiring insurers to:

  • permit employers to continue covering an employee under group policies even if the employee would otherwise become ineligible due to a decrease in hours worked per week; and
  • permit employers to continue providing coverage to employees under group policies regardless of any “actively at work” or similar eligibility requirements in the policy.

Additionally, the Ohio Department of Insurance is prohibiting insurers from increasing premium rates based on an employer group’s decreased enrollment or participation due to COVID-19. Click here for a link to the full bulletin.

If you have any questions, please contact Adam D. Fuller at adfuller@bmdllc.com, or feel free to contact your primary BMD Attorney.

Health Care PremiumsEmployer PlansDeferralOhioState of EmergencyDepartment of InsuranceAdam D. Fuller
Client Alert

Laboratory Specimen Collection Arrangements with Contract Hospitals - OIG Advisory Opinion 22-09

May 3, 2022On April 28, 2022, the Department of Health and Human Services, Office of Inspector General (“OIG”) published an Advisory Opinion[1] in which it evaluated a proposed arrangement where a network of clinical laboratories (the “Requestor”) would compensate hospitals (each a “Contract Hospital”) for specimen collection, processing, and handling services (“Collection Services”) for laboratory tests furnished by the Requestor (the “Proposed Arrangement”). The OIG concluded that the Proposed Arrangement would generate prohibited remuneration under the federal Anti-Kickback Statute (“AKS”) if the requisite intent were present. This is due to both the possibility that the proposed per-patient-encounter fee would be used to induce or reward referrals to Requestor and the associated risk of improperly steering patients to Requestor.Client Alert

Property Owner Protection from Tax Valuation Challenges

April 29, 2022New legislation provides significant new protections for commercial property owners against challenges to valuation primarily by local school boards and prohibiting side agreements to avoid tax valuation changes. The Ohio Legislature has approved House Bill 126 which will go into effect July 2022 but will effectively apply to the 2023 tax valuation year.Client Alert

No Surprises Act Update: The IDR Portal is Open

April 25, 2022The No Surprises Act (“NSA”) became effective January 1, 2022, and has been the subject of lawsuits and criticisms since its inception. The goals of the No Surprises Act are to shield patients from surprise medical bills, provide to uninsured and self-pay patients good faith estimates of charges, and create a process to resolve payment disputes over surprise bills, which arise most typically in emergency care settings. We have written about Part I and Part II of the NSA previously. This update concerns the Independent Dispute Resolution (“IDR”) procedure created by Part II but applicable to claims covered by Part I. The Centers for Medicare & Medicaid Services (“CMS”) finally opened the Portal for providers to submit disputes to the IDR process following some updated guidance regarding the arbitration process itself.Client Alert

Updated FAQs for the No Surprises Act - Good Faith Estimates

April 7, 2022The No Surprises Act (“NSA”) became effective January 1, 2022. Meant to protect consumers from surprise medical bills, the new law is good for consumers, but vexatious for health care providers and facilities. One particular source of frustration is the operationalization of the Good Faith Estimate (“GFE”) requirement, governed by Part II of the regulations that implement the NSA. The GFE requirements apply broadly to all healthcare providers and facilities that practice within the scope of their state-issued license.Client Alert

IMPORTANT PRF UPDATE! HRSA Allows Providers the Opportunity to Correct Missed Period 1 Reporting

April 7, 2022Late Wednesday, April 6, HRSA announced that it was going to allow providers with extenuating circumstances that prevented them from preventing a completed Period 1 Report to submit a Request to Report Late Due to Extenuating Circumstances.
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