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Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

Client Alert

The Ohio Department of Medicaid Announces Four Next Generation MyCare Plans

November 11, 2024On November 1, 2024, the Ohio Department of Medicaid (ODM) announced four managed care organizations that will become ODM’s Next Generation MyCare plans starting January 2026. MyCare Ohio is a managed care program that supports Ohioans across 29 counties enrolled in both Medicare and Medicaid.Client Alert

Ohio Department of Medicaid Proposes Changes to Dental Reimbursement and Coverage Rule

July 29, 2024The Ohio Department of Medicaid is proposing amendments to Ohio Administrative Code. There will be a hearing on the proposed rule changes August 12, 2024.Client Alert

New Medicare Billing Rules: What MFTs, MHCs, and IOP Providers Need to Know

July 9, 2024Starting January 1, 2024, Medicare began covering services provided to Medicare beneficiaries by marriage and family therapists, mental health counselors, and Intensive Outpatient Program (IOP) services. With this change, Medicare has become the primary payer for these services.Client Alert

Increased Medicaid Rates to Take Effect This Month for Ohio Providers

January 5, 2024As required by House Bill 33, Ohio’s 2024-2025 operating budget bill, reimbursement rates paid by the Ohio Department of Medicaid will increase for a wide range of providers starting on January 1, 2024.Blog Post, Multimedia

Ending the Public Health Emergency - Medicaid Updates

April 14, 2023Watch the recording from week two of our Ending the Public Health Emergency webinar series!Client Alert

Wondering What’s Happening with Telehealth Legislation in Ohio?

February 10, 2022In 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.Client Alert

Interesting Trends Revealed in 50-State Medicaid Budget Survey

November 3, 2021Results of the KFF annual survey of state Medicaid directors reveal some fascinating trends in Medicaid service delivery and benefit coverage. Read on for a summary of the highlights we find most noteworthy. Background As a preliminary matter, many of the trends KFF identifies and that we highlight below are no doubt a result of the Covid-19 pandemic. The pandemic triggered a public health emergency and economic crisis that resulted in increased Medicaid enrollment, service offerings, and flexibility in service delivery, along with a heightened awareness of disparities in access to care and health outcomes.Client Alert

Medicaid Announces Next Generation of Managed Care Organizations

April 13, 2021For the first time since 2005, the Ohio Department of Medicaid (“ODM”) made significant changes to the structure of the Medicaid program by finalizing the Medicaid Managed Care Procurement process. The Procurement process began in 2019 at the behest of Governor Mike DeWine who had a goal to make Medicaid managed care more focused on the health and well-being of individuals.Client Alert

HHS Announces an Additional $20 Billion In Provider Relief Grants

October 5, 2020The U.S. Department of Health and Human Services (“HHS”) announced an additional $20 billion in new funding for providers on October 1, 2020. Eligible providers include those that have already received Provider Relief Fund payments as well as previously ineligible providers, such as those who began practicing in 2020, and an expanded group of behavioral health providers confronting the emergence of increased mental health and substance use issues exacerbated by the pandemic. The new Phase 3 General Distribution is designed to balance an equitable payment of 2% of annual revenue from patient care for all applicants plus an add-on payment to account for revenue losses and expenses attributable to COVID-19.Client Alert

Provider Relief Fund Phase 2 & Reporting Requirement Updates – Deadline to Request Phase 2 Funds is August 28, 2020

August 21, 2020On July 31, 2020, the Department of Health and Human Services (“HHS”) announced that certain Medicare, Medicaid (managed care and fee-for-service), CHIP, and other providers would be given another opportunity to receive additional Provider Relief Fund payments. HHS has allocated around $15 billion for Phase 2 distribution. Providers are eligible for these new distributions if they fulfill the following criteria and have not yet received a Provider Fund payment equal to approximately 2% of their revenue from patient care.Blog Post

Webinar Recording: Telemedicine Legal and Practical Considerations for Physicians Practices

August 20, 2020This webinar discusses the latest developments in telemedicine for physician practices, including Medicare, Medicaid and commercial payor reimbursement requirements, state licensure considerations and HIPAA requirements. Speakers: -Kyle Sharp, MHA, FACHE, Interim Associate VP & Executive Director, OSU Physicians, Inc. -Ronnen Isakov, CPA, Managing Director, Healthcare Advisory Services, Medic Management Group LLC -Kate Hickner, Healthcare & Hospital Law Partner, BMD -Kevin Cripe, Healthcare & Hospital Law Attorney, BMD The speakers will share their personal experiences working with health care providers to implement and grow their telemedicine practices during recent months. The webinar will provide listeners with practical guidance and take-aways that will be useful in their own organizations.Client Alert

July 20 is Important Deadline for HHS Fund Distributions to Medicaid and CHIP Providers

June 19, 2020On June 10, 2020, the U.S. Department of Health and Human Services (“HHS”) released details on the distribution of more CARES Act Provider Relief Fund payments. After allocating $50 billion to Medicare providers through its General Distribution fund, HHS has now announced that it will distribute $15 billion to eligible Medicaid and CHIP providers who apply by the deadline through a Targeted Distribution. Applicants must apply through the Enhanced Provider Relief Fund Payment Portal. The application form itself can be found on the HHS website and is due by July 20, 2020.Client Alert

DOJ Updates Corporate Compliance Plan Guidance

June 18, 2020With the passage of the Affordable Care Act in 2010, all healthcare providers were required to adopt and implement a corporate compliance plan. Historically, having an effective corporate compliance plan in place has been key to defending healthcare providers in fraud and abuse actions by Medicare, Medicaid, and commercial payers. Over the past couple of years, the U.S. Department of Justice’s (DOJ) Criminal Division has increased the number of prosecutions against U.S. corporations, including healthcare providers. Earlier this month, the DOJ’s Criminal Division updated its “Evaluation of Corporate Compliance Programs” guidance to educate prosecutors on how a corporate compliance program will be evaluated going forward.Client Alert

IRS Responds - Economic Impact Payments Do Not Belong to Nursing Homes or Care Facilities

June 17, 2020In response to the concerns that some nursing homes and care facilities have been taking patients economic impact payments (“EIP”) and claiming the EIP belongs to the facility, the IRS issued a reminder that the EIP does not belong to a nursing home or care facility even if that facility receives the individual’s payments, either directly or indirectly. The EIP does not count as income or a resource in determining an individual’s eligibility for Medicaid or other federal programs for a period of 12 months from when the EIP is received. What this means: an individual’s EIP does not have to be turned over by the benefit recipient.Client Alert

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

May 7, 2020This week, Governor DeWine announced $775 million in cuts to the state operating budget due to financial repercussions resulting from the COVID-19 pandemic.Client Alert

Healthcare Providers: Comparison of New OIG Waivers and Flexibilities under Anti-Kickback Statute in Response to COVID-19

April 21, 2020On March 30, 2020, the Centers for Medicare & Medicaid Services (CMS) issued several temporary regulatory waivers to further enable the American healthcare system to respond to the COVID-19 pandemic with more efficiency and flexibility (the “Blanket Waivers”).Client Alert

BMD COVID-19 Healthcare Provider Resource Guide

March 18, 2020Providers - for the latest information related to Medicaid/Medicare, Telehealth, HIPAA, CPT Codes, as well as Ohio and Federal Information, click here for a comprehensive resource guide to navigating during the Coronavirus pandemic.Client Alert

CLIENT ALERT: Proposed New Rules to both the Stark Law and the Anti-Kickback Statute

October 14, 2019On October 9, 2019, as part of the “Regulatory Sprint to Coordinate Care,” the Centers for Medicare and Medicaid Services (“CMS”), along with the US Department of Health and Human Services, Office of Inspector General (“OIG”), proposed new rules to both the physician self-referral law (“Stark Law”) and the Anti-Kickback Statute (“AKS”). Rule changes are aimed at fostering innovative arrangements for coordinating care consistent with a shift to a value-based system. Both proposed rules are expected to be published to the Federal Register on October 17, 2019. Public comments are due 75 days after publication.