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Wondering What’s Happening with Telehealth Legislation in Ohio?

Client Alert

Introduction

In December 2021, Governor DeWine signed into law HB 122, which will expand telehealth services in Ohio. The law takes effect in March 2022 and is in response to more patients relying on telehealth over the past two years during the height of the COVID pandemic, and more providers becoming comfortable with delivering services virtually. Telehealth is now a normalized healthcare delivery system nationwide. Beyond the safety benefits inherent in telehealth services, telehealth has made healthcare more accessible and more affordable for more people.

HB 122 At a Glance

HB 122 broadly expands the list of providers who can bill for telehealth services and replaces outdated regulations that limited access to telehealth care. Before HB 122, only physicians, physician assistants and advanced practice registered nurses could provide services via telehealth. HB 122 expands telemedicine use to include psychologists, speech and hearing therapists, physical therapists, counselors and social workers, dietitians, optometrists, chiropractors and several other health care specialties.[1] The law also removes the requirement that a patient’s initial visit be in-person and instead allows initial and annual patient visits to be conducted virtually.  

HB 122 requires both public (i.e., Medicaid and Medicare) and private insurance to cover telehealth services. Additionally, the law prohibits health plans from imposing cost sharing for telehealth services that exceeds the cost sharing for equivalent in-person services. 

Finally, HB 122 applies to more regulated treatment modalities. The law will allow physicians authorized to prescribe medical marijuana to conduct the required in-person patient exams via telehealth. While most patients that are prescribed a schedule II controlled substances are required to still attend their initial visit in-person, HB 122 sets forth several exceptions that allow for an initial visit via telehealth, including if 1) the patient is in palliative or hospice care; 2) the patient receives medication-assisted treatment for opioid use disorder; 3) the patient is currently under treatment for a diagnosed mental health condition; or 4) the patient is treated in an emergency situation. 

To ensure compliance with the new state telehealth laws, please contact Kevin Cripe at kmcripe@bmdllc.com, 614.246.7506, or your existing BMD healthcare attorney.

[1] The full list of allowed providers is: Advanced practice registered nurses; Optometrists licensed to practice under a therapeutic pharmaceutical agents certificate; Pharmacists; Physician assistants; Physicians; Psychologists and school psychologists, including school psychologists licensed under State Board of Education rules; Chiropractors; Audiologists and speech-language pathologists; Occupational therapists and physical therapists; Occupational therapy assistants and physical therapist assistants; Professional clinical counselors, independent social workers, and independent marriage and family therapists; Independent chemical dependency counselors; Certified Ohio behavior analysts; Dietitians; Respiratory care professionals; and Genetic counselors.


The NLRB Limits the Reach of Confidentiality and Non-Disparagement Provisions in Severance Agreements Overruling Trump-Era Policies

Employers should exercise caution and closely examine the content of severance agreements to ensure compliance with a recent National Labor Relations Board (“NLRB”) decision.  On February 21, 2023, the NLRB restricted the breadth of permissible language of confidentiality and non-disparagement clauses when it issued its decision in McLaren Macomb and overruled its Trump-era decisions in Baylor University Medical Center and IGT d/b/a International Game Technology.

Ohio Medical Board Releases New Telehealth Rules

On Tuesday, February 21, 2023, the State Medical Board of Ohio released its final telehealth rules to implement Ohio’s telehealth statute (O.R.C. 4743.09) for physicians, physician assistants, dieticians, respiratory care professionals and genetic counselors. Ohio’s advanced practice registered nurses (“APRNs”) should also take note of these rules. While the Medical Board does not govern APRNs directly, those APRNs who are required to have a collaborating physician and standard care arrangement (namely nurse practitioners, certified nurse midwives, and clinical nurse specialists) are still affected by the rules. Generally, if an APRN’s collaborating physician is limited in their practice, then the APRN will also be limited.

The End of the Public Health Emergency is (Finally) Here

The COVID-19 Public Health Emergency (“PHE”) that has been in effect for over three years is finally slated to end on May 11, 2023.[1] With the end of the PHE will come many changes for healthcare providers to be aware of; however, some changes may not come until much later.

Multi-340B Contract Pharmacy Locations on the Brink? The Third Circuit’s Ruling Gives a Hint.

The 340B drug discount program requires pharmaceutical manufacturers to offer to sell their products at significant discounts to safety net providers called “covered entities.” In 1996, the Health Resources and Services Administration (HRSA) issued guidance authorizing covered entities to enter into a contract pharmacy arrangement with a single third-party contract pharmacy, to which the manufacturer would ship 340B medications but bill the covered entity. In 2010, HRSA issued revised guidance permitting covered entities to enter into an unlimited number of contract pharmacy arrangements.

Five Opportunities for Operations and Compliance Excellence in 2023

With the holidays behind us and the rest of the year ahead, now is the perfect time to get your operational/compliance house in order! Though your list might be a mile (or an inch) long, here are five places to start.