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

Client Alert

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

The Reductions –The DeWine administration will reduce General Revenue Fund spending by $775 million between now and the end of the state fiscal year (June). The following reductions will be made for the next two months:

  • Medicaid: $210 million
  • K12 Foundation Payment Reduction: $300 million
  • Other Education Budget Line Items: $55 million
  • Higher Education: $110 million
  • All Other Agencies: $100 million

Recent Timeline The state is required by statute to have a balanced budget each biennium. As Ohio enters month 11 of its 24-month budget, the motivation to balance the budget is forcing the cuts. In making his announcement, the Governor chronologically broke down how Ohio arrived at its present condition:

  • February, the state was running $200 million above budget estimates;
  • April, the state was forced to shut down to mitigate COVID-19;
  • As of May 6, 2020, the state is $776.9 million in the red; and
  • He expects the state to continue to experience budgetary concerns for months. 

The ReasoningGovernor DeWine anchored his reasoning to future-facing concerns. He cautioned that, “[w]hile we do not know what the coming months will hold, COVID is here with us and will be here for months to come.” He hedged his possible cautionary actions by pointing to his unwillingness to draw from the Rainy Day Fund for the rest of this fiscal year (two months), but will likely need to tap the budget stabilization fund in the next fiscal year beginning in July. 

On MedicaidThe Governor said that cuts to Medicaid will not come at the cost of essential services, and that he believes they will be able to find savings within the system even as the state responds to the COVID-19 pandemic. Subsequently, the Director of the Office of Budget and Management indicated that much of the Medicaid cuts will be achieved as an adjustment to Medicaid managed care plan rates.

For more, contact Daphne L. Kackloudis 614.246.7508, dlkackloudis@bmdllc.com.


Laboratory Specimen Collection Arrangements with Contract Hospitals - OIG Advisory Opinion 22-09

On April 28, 2022, the Department of Health and Human Services, Office of Inspector General (“OIG”) published an Advisory Opinion[1] in which it evaluated a proposed arrangement where a network of clinical laboratories (the “Requestor”) would compensate hospitals (each a “Contract Hospital”) for specimen collection, processing, and handling services (“Collection Services”) for laboratory tests furnished by the Requestor (the “Proposed Arrangement”). The OIG concluded that the Proposed Arrangement would generate prohibited remuneration under the federal Anti-Kickback Statute (“AKS”) if the requisite intent were present. This is due to both the possibility that the proposed per-patient-encounter fee would be used to induce or reward referrals to Requestor and the associated risk of improperly steering patients to Requestor.

Property Owner Protection from Tax Valuation Challenges

New legislation provides significant new protections for commercial property owners against challenges to valuation primarily by local school boards and prohibiting side agreements to avoid tax valuation changes. The Ohio Legislature has approved House Bill 126 which will go into effect July 2022 but will effectively apply to the 2023 tax valuation year.

No Surprises Act Update: The IDR Portal is Open

The No Surprises Act (“NSA”) became effective January 1, 2022, and has been the subject of lawsuits and criticisms since its inception. The goals of the No Surprises Act are to shield patients from surprise medical bills, provide to uninsured and self-pay patients good faith estimates of charges, and create a process to resolve payment disputes over surprise bills, which arise most typically in emergency care settings. We have written about Part I and Part II of the NSA previously. This update concerns the Independent Dispute Resolution (“IDR”) procedure created by Part II but applicable to claims covered by Part I. The Centers for Medicare & Medicaid Services (“CMS”) finally opened the Portal for providers to submit disputes to the IDR process following some updated guidance regarding the arbitration process itself.

Updated FAQs for the No Surprises Act - Good Faith Estimates

The No Surprises Act (“NSA”) became effective January 1, 2022. Meant to protect consumers from surprise medical bills, the new law is good for consumers, but vexatious for health care providers and facilities. One particular source of frustration is the operationalization of the Good Faith Estimate (“GFE”) requirement, governed by Part II of the regulations that implement the NSA. The GFE requirements apply broadly to all healthcare providers and facilities that practice within the scope of their state-issued license.

IMPORTANT PRF UPDATE! HRSA Allows Providers the Opportunity to Correct Missed Period 1 Reporting

Late Wednesday, April 6, HRSA announced that it was going to allow providers with extenuating circumstances that prevented them from preventing a completed Period 1 Report to submit a Request to Report Late Due to Extenuating Circumstances.