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Ohio Permitting Deferral of Health Care Premiums for Employer Plans

Client Alert

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.


CMS to Once Again Reprocess Outpatient Clinic Claims

The Hospital Outpatient Prospective Payment System (OPPS) Rule was passed in November 2018, which was intended to prevent the Centers for Medicare and Medicaid Services (CMS) from paying more for services rendered in outpatient settings than what they paid for the same services rendered in physician offices that are simply owned by hospitals or health systems.[1]

New Vaccine Requirement for Select CMS-Participating Facilities

On November 4, 2021, the Centers for Medicare and Medicaid (“CMS”) released a new rule requiring certain healthcare facilities to implement policies requiring employees to be vaccinated against COVID-19. It does not matter if a staff member does not perform patient treatment services, they must still be vaccinated if an employee of an applicable facility.

OSHA COVID-19 EMERGENCY TEMPORARY STANDARD (ETS) Vaccination, Testing, Recordkeeping, and Reporting

The Occupational Safety and Health Administration has issued its long-awaited COVID-19 Emergency Temporary Standard (ETS). Note that the ETS does not apply to employers covered under the Safer Federal Workforce Task Force COVID-19 Workplace Safety: Guidance for Federal Contractors or Subcontractors (see here), or to settings where employees provide healthcare services subject to OSHA’s ETS for the healthcare industry (see here).

Interesting Trends Revealed in 50-State Medicaid Budget Survey

Results of the KFF annual survey of state Medicaid directors reveal some fascinating trends in Medicaid service delivery and benefit coverage. Read on for a summary of the highlights we find most noteworthy. Background As a preliminary matter, many of the trends KFF identifies and that we highlight below are no doubt a result of the Covid-19 pandemic. The pandemic triggered a public health emergency and economic crisis that resulted in increased Medicaid enrollment, service offerings, and flexibility in service delivery, along with a heightened awareness of disparities in access to care and health outcomes.

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.