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The Reasoning Behind Governor DeWine's $775 Million Budget Reduction

This week, Governor DeWine announced $775 million in cuts to the state operating budget due to financial repercussions resulting from the COVID-19 pandemic.

The Reductions –The DeWine administration will reduce General Revenue Fund spending by $775 million between now and the end of the state fiscal year (June). The following reductions will be made for the next two months:

  • Medicaid: $210 million
  • K12 Foundation Payment Reduction: $300 million
  • Other Education Budget Line Items: $55 million
  • Higher Education: $110 million
  • All Other Agencies: $100 million

Recent Timeline The state is required by statute to have a balanced budget each biennium. As Ohio enters month 11 of its 24-month budget, the motivation to balance the budget is forcing the cuts. In making his announcement, the Governor chronologically broke down how Ohio arrived at its present condition:

  • February, the state was running $200 million above budget estimates;
  • April, the state was forced to shut down to mitigate COVID-19;
  • As of May 6, 2020, the state is $776.9 million in the red; and
  • He expects the state to continue to experience budgetary concerns for months. 

The ReasoningGovernor DeWine anchored his reasoning to future-facing concerns. He cautioned that, “[w]hile we do not know what the coming months will hold, COVID is here with us and will be here for months to come.” He hedged his possible cautionary actions by pointing to his unwillingness to draw from the Rainy Day Fund for the rest of this fiscal year (two months), but will likely need to tap the budget stabilization fund in the next fiscal year beginning in July. 

On MedicaidThe Governor said that cuts to Medicaid will not come at the cost of essential services, and that he believes they will be able to find savings within the system even as the state responds to the COVID-19 pandemic. Subsequently, the Director of the Office of Budget and Management indicated that much of the Medicaid cuts will be achieved as an adjustment to Medicaid managed care plan rates.

For more, contact Daphne L. Kackloudis 614.246.7508, dlkackloudis@bmdllc.com.

Provider Relief Funds – Continued Confusion Regarding Reporting Requirements and Lost Revenues

In Fall 2020, HHS issued multiple rounds of guidance and FAQs regarding the reporting requirements for the Provider Relief Funds, the most recently published notice being November 2, 2020 and December 11, 2020. Specifically, the reporting portal for the use of the funds in 2020 was scheduled to open on January 15, 2021. Although there was much speculation as to whether this would occur. And, as of the date of this article, the portal was not opened.

Ohio S.B. 310 Loosens Practice Barrier for Advanced Practice Providers

S.B. 310, signed by Ohio Governor DeWine and effective from December 29, 2020 until May 1, 2021, provides flexibility regarding the regulatorily mandated supervision and collaboration agreements for physician assistants, certified nurse-midwives, clinical nurse specialists and certified nurse practitioners working in a hospital or other health care facility. Originally drafted as a bill to distribute federal COVID funding to local subdivisions, the healthcare related provisions were added to help relieve some of the stresses hospitals and other healthcare facilities are facing during the COVID-19 pandemic.

HHS Issues Opinion Regarding Illegal Attempts by Drug Manufacturers to Deny 340B Discounts under Contract Pharmacy Arrangements

The federal 340B discount drug program is a safety net for many federally qualified health centers, disproportionate share hospitals, and other covered entities. This program allows these providers to obtain discount pricing on drugs which in turn allows the providers to better serve their patient populations and provide their patients with access to vital health care services. Over the years, the 340B program has undergone intense scrutiny, particularly by drug manufacturers who are required by federal law to provide the discounted pricing.

S.B. 263 Protects 340B Covered Entities from Predatory Practices in Ohio

Just before the end of calendar year 2020 and at the end of its two-year legislative session, the Ohio General Assembly passed Senate Bill 263, which prohibits insurance companies and pharmacy benefit managers (“PBMs”) from imposing on 340B Covered Entities discriminatory pricing and other contract terms. This is a win for safety net providers and the people they serve, as 340B savings are crucial to their ability to provide high quality, affordable programs and services to patients.

DOL Finalizes New Rule Regarding Independent Contractor Status, But Its Future Is In Jeopardy

On January 6, 2021, the Department of Labor announced its final rule regarding independent contractor status under the Fair Labor Standards Act. As described in a prior BMD client alert, this new rule was fast-tracked by the Trump administration after its proposal in September 2020. The new rule is set to take effect on March 8, 2021, and contains several key developments related to the "economic reality" test used to determine whether an individual is an independent contractor or an employee under the FLSA.