Resources

Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

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

Client Alert

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.


CLIENT ALERT: Prohibition on Recoupment Prior to Exhaustion of Administrative Remedies

In April, the Fifth Circuit Court of Appeals, in Family Rehabilitation, Inc. v. Azar No. 17-11337 (5th Cir. 2018), held that district courts are authorized to enjoin the Centers of Medicare & Medicaid Services (“CMS”) and its contractors from recouping alleged overpayments prior to the completion of the administrative appeal process.

CLIENT ALERT: Low Volume Appeals Settlement for RAC Appeals

In April, the Centers for Medicare & Medicaid Services (“CMS”) issued a new settlement proposal to providers with outstanding appeals at the Office of Medicare Hearings and Appeals (“OMHA”) and the Medicare Appeals Council (“MAC”). Essentially, CMS is offering to pay up to 62% of the claim to the provider for qualifying claims that are currently in the appeal process. Interested providers may submit an Expression of Interest (“EOI”) to CMS by June 8, 2018. Providers should explore this settlement opportunity and submit an EOI to receive an offer of settlement. Providers may decline the offer after the EOI is submitted. Brennan, Manna & Diamond, LLC’s Provider Relations, Audit, and Appeals Unit, a division of its Healthcare Department, is able to assist providers with filing the EOI, analyzing the outstanding claims subject to the settlement, and reviewing the Administrative Agreement that is offered by CMS.

CLIENT ALERT: Ohio Managed Care Organization (MCO) Open Enrollment

Open Enrollment started April 30, and will continue through May 25, 2018, for your MCO (Managed Care Organization). Every State Fund Ohio employer can select their MCO for the coming policy year. The MCO is responsible for helping to manage Ohio Workers’ Compensation claim costs. All State Fund employers will begin to receive correspondence urging them to select that particular MCO, or urging them not to make a switch.

Medical Marijuana Rules and You

The Ohio Medical Board has adopted regulations in conjunction with the Ohio Pharmacy Board that would govern physicians who may elect to participate under the Ohio Medical Marijuana statutes.

BMD Obtains Dismissal of ADA Title III Suit Against National Outlet Mall Chain

On January 12, 2018, Brennan, Manna & Diamond obtained the dismissal of an Americans with Disabilities Act (“ADA”) lawsuit filed against Tanger Factory Outlet Centers, Inc. in the U.S. District Court for the Western District of Michigan. The suit, which was brought under Title III of the ADA, alleged that Tanger’s Byron Center, Michigan outlet mall contained barriers to access in violation of the ADA’s accessibility requirements. The plaintiff demanded prospective injunctive relief, including a retrofit of the entire mall, as well as expert witness and attorneys’ fees.