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Ohio Permitting Deferral of Health Care Premiums for Employer Plans

Client Alert

Effective March 20, 2020 and continuing through the expiration of the state of emergency declared by Governor DeWine on March 9, 2020, the Ohio Department of Insurance is requiring all health insurance companies operating in Ohio to give their insureds the option of deferring premium payments coming due, interest free, for up to 60 calendar days from each original premium due date.  See Department of Insurance Bulletin 2020-03.

The Ohio Department of Insurance is also requiring insurers to:

  • permit employers to continue covering an employee under group policies even if the employee would otherwise become ineligible due to a decrease in hours worked per week; and
  • permit employers to continue providing coverage to employees under group policies regardless of any “actively at work” or similar eligibility requirements in the policy.

Additionally, the Ohio Department of Insurance is prohibiting insurers from increasing premium rates based on an employer group’s decreased enrollment or participation due to COVID-19. Click here for a link to the full bulletin.

If you have any questions, please contact Adam D. Fuller at adfuller@bmdllc.com, or feel free to contact your primary BMD Attorney.


What Inpatient Behavioral Health Providers Need to Know About ODM's New Draft Rule for Reimbursements

Ohio Department of Medicaid (ODM) recently released a draft rule that will transform how inpatient behavioral health services are reimbursed for some hospitals. ODM will migrate inpatient payments for behavioral health and substance use disorder services (BH/SUD) provided by freestanding psychiatric hospitals (FSPs) from the APR-DRG payment methodology to a per diem payment methodology derived from the APR-DRG system.

BMD Named to the 2024 U.S. News – Best Lawyers® “Best Law Firms”

Brennan Manna & Diamond (BMD) is recognized among the leading law firms in the nation according to the 2024 Edition of U.S. News – Best Lawyers®  "Best Law Firms." The firm has ranked in in 13 practice areas and has earned “National Tier 1” rankings in Health Care Law and Litigation-Trusts & Estates.

Friendly Physician Models: The Basics Through 5 Frequently Asked Questions

During the past several years, many health law practices have noticed a dramatic increase in the number of telehealth businesses and private equity backed health care providers. Both of these trends often rely heavily on corporate structures commonly referred to as “friendly physician,” “captive PC” or “MSO” models. Although friendly physician models are used by non-physician health care providers (e.g., physical therapists, psychologists, and dentists), this article focuses on physicians and how the model is used in connection with the provision of professional medical services.

The DOL and EEOC Enter a Partnership to Strengthen Federal Employment Law Enforcement

On September 13, the U.S. Department of Labor’s (DOL) Wage and Hour Division and the Equal Employment Opportunity Commission (EEOC) entered into a Memorandum of Understanding (MOU) agreeing to work together in enforcing federal employment laws. The MOU forms a partnership between the two agencies to encourage coordination through information sharing, joint investigations, training, and outreach.

Proposed Laboratory Arrangement Draws Heightened Scrutiny from the OIG

On September 25, 2023, the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) issued Advisory Opinion 23-06 (AO). The Opinion involved a proposed arrangement between an independent laboratory and other physician laboratories for the purchase of the technical component of anatomic pathology services. The OIG ultimately concluded that the arrangement at issue, if it was entered into with the requisite intent, would implicate the Federal Anti-Kickback Statute (AKS) and constitute grounds for sanctions.