Client Alerts, News Articles & Blog Posts

Everything you need to know about BMD and the industry.

Updated Guidance on Ohio Department of Medicaid Telehealth Rules During the Covid-19 Public Health Emergency

In its initial response to the COVID-19 public health emergency, the Ohio Department of Medicaid (“ODM”) issued emergency rule 5160-1-21, which dramatically expanded reimbursable telehealth services, telehealth providers, allowable technology, location of both providers and patients, and covered billing provider types. See BMD’s initial COVID-19 and Telehealth Resource Guide here. This emergency rule provides wide flexibility for patients to receive necessary healthcare services while Ohio’s Stay-At-Home Order remains in place. Regulations are continually changing in response to the public health crisis, and on April 13, 2020, ODM issued new guidance further expanding telehealth services reimbursable under Ohio’s Medicaid program.

  1. Expanded Telehealth Services, Providers, and Billing Provider Types

First, ODM is now covering the following telehealth services:

  • Limited oral evaluation
  • Hospice home care and long-term care
  • Direct skilled nursing services in the home health or hospice setting
  • Services of home health or hospice aides
  • Additional occupational therapy, physical therapy, speech language pathology, and audiology services
  • End stage renal disease (ESRD) related services

Second, the following practitioner types are now allowed to provide telehealth services and seek reimbursement from ODM:

  • Dentists
  • Registered Nurses and Licensed Practical Nurses working in a hospice or home health setting
  • Licensed and credentialed health professionals working in a hospital or nursing facility setting
  • Home health and hospice aides

Finally, the following provider types may now bill for covered services:

  • Professional dental groups
  • Home health and hospice agencies 
  1. Updated Billing Guidance

Most important in this update is the new billing guidance from ODM. This guidance will help ensure that providers are appropriately reimbursed for services provided to Medicaid beneficiaries through telehealth during this emergency. For all services, excluding ESRD-related services and some skilled therapy services (which will be updated at a later date), the telehealth changes found in 5160-1-21 will be implemented in the claims processing systems on Wednesday, April 15, 2020. This will be updated for fee-for-service, the Managed Care Plans, and MyCare Ohio Plans.

Once the system updates are in place, providers are encouraged to follow the new billing guidelines, which can be found here for non-OHMAS certified providers, and here for OHMAS certified providers. 

  1. Reminder on Previous Medicaid Telehealth Expansion

Pursuant to the emergency rule from ODM, the definition of telehealth now includes the use of telephone calls, fax, email, and other communication methods that may not have audio and video elements. Medicaid beneficiaries can be in any location and receive telehealth services, including homes, schools, temporary housing, hospitals, nursing facilities, group homes, and any other location, except for a prison or correctional facility. Likewise, eligible providers can deliver telehealth services from any location, including their own home offices and other non-institutional settings. Telehealth services are available even if the patient and provider do not have a pre-existing relationship.

For more information of Medicaid reimbursement during the COVID-19 public health emergency, please visit the Updated Telehealth Rule FAQs or contact a BMD health care attorney. 

BMD Appellate Win Clarifies Waiver of Contractual Right to Arbitrate

Brennan, Manna & Diamond, LLC attorneys David M. Scott, Lucas K. Palmer, and Krista D. Warren prevailed before the United States Court of Appeals for the Sixth Circuit regarding if/when a party waives a contractual right to arbitrate. Borror Property Management, LLC v. Oro Karric North, LLC, No. 20-3146 (the “Decision”).

Relief for Ohio Under the Federal American Rescue Plan Act

On March 11, 2021, President Biden signed the American Rescue Plan Act (the “Act”) — a $1.9 trillion COVID-19 relief package — a significant portion of which will be directed to the State of Ohio to support economic recovery, as outlined below.

Cleveland Manufacturer Violated OFAC Sanctions By Allowing Shipments To Iran - Know Your Customer and Know Their Customer

UniControl, Inc., a Cleveland, Ohio manufacturer of process controls, airflow pressure switches, boiler controls and other instruments, agreed to pay the Office of Foreign Assets Control “OFAC,” the financial enforcement agency of the U.S. Treasury Department, $216,464 to settle its liabilities for violations of the Iran Sanctions Program. OFAC stated that “this enforcement action highlights the importance of identifying and assessing multiple warning signs that indicate a foreign trade partner may be re-exporting goods to a sanctioned jurisdiction.”

Ohio Breach of Contract Statute of Limitations Shortened to 6 Years

On March 16, 2021, Governor DeWine signed into law S.B. 13 which shortens Ohio’s statute of limitations for filing lawsuits based on breach of contract. A statute of limitation is the time period within which a party must file a lawsuit before its claim expires as a matter of law.

Chinese Product Tariff Challenge Causes Flurry of Importer Lawsuits

A lawsuit filed late in 2020 at the U.S. Court of International Trade (“CIT”) challenging the U.S. Trade Representative’s (USTR) implementation of Section 301 “List 3” and “List 4” duties on products from China, HMTX Industries LLC et al. v. United States (Court No. 20-00177), has resulted in the filing of thousands of additional lawsuits brought by other affected importers. There are now 3,700+ companies added to the list, including Ford, Home Depot, Target, Tesla, and Walgreens, along with many other smaller importers.