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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. 

Lockdowns, Landlords, & Litigation: Abercrombie & Fitch Flips The Script on Simon Property Group Inc.

Novel litigation between commercial property owners and tenants arises from COVID-19 lockdowns. Typically, owners sue for nonpayment of rent. But in Franklin County, Ohio, a large retail tenant turned the tables and sued the owner to recoup payments.

UPDATE: Ohio Businesses Remain Required to Post Exceptions to State-Wide Mask Mandate at All Entrances

On August 1, 2020, Lance D. Himes, Interim Director of the Ohio Department of Health, issued an amended order continuing the requirement that Ohio businesses post at all entrances any permitted exceptions they provide to customers, patrons, visitors, contractors, vendors and similar individuals to use facial coverings.

2020 Marcum National Construction Survey Marks a New, Post-Pandemic Construction Environment

The results of the 2020 Marcum National Construction Survey are in, and the construction industry’s outlook for the remainder of 2020 and beginning of 2021 remains cautiously optimistic despite the COVID-19 global pandemic. Ability to find skilled labor, healthcare expenses, and material costs remain the top concerns for the industry, while “lack of future work” joins the list.

Wrongful Death Lawsuits in the Wake of COVID-19

Several major “essential business” employers, including Walmart and Tyson, have been served with wrongful death lawsuits in relation to COVID-19. As many Ohio employees begin to return to work, employers should be prudent in following workplace safety practices.

We are Working in a Virtual, Video-Conferencing World – But What About Wiretapping?

Businesses and other organizations often have a need or desire to record telephone conversations related to their business interests and customer dealings; however, this practice is not always permissible as federal and state laws vary on this issue. Knowing and understanding your jurisdiction’s rules and regulations on this practice is essential to remaining in compliance with the law.