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Updated Guidance on Ohio Department of Medicaid Telehealth Rules During the Covid-19 Public Health Emergency

Client Alert
April 15, 2020

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. 

Ohio Department of MedicaidCOVID-19 Telehealth ProgramTelehealth
Client Alert

OSHA COVID-19 EMERGENCY TEMPORARY STANDARD (ETS) Vaccination, Testing, Recordkeeping, and Reporting

November 5, 2021The Occupational Safety and Health Administration has issued its long-awaited COVID-19 Emergency Temporary Standard (ETS). Note that the ETS does not apply to employers covered under the Safer Federal Workforce Task Force COVID-19 Workplace Safety: Guidance for Federal Contractors or Subcontractors (see here), or to settings where employees provide healthcare services subject to OSHA’s ETS for the healthcare industry (see here).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

Changes to Physician Assistant Statutes in Florida

October 22, 2021In the last year, there have been many changes to the scope of practice and collaboration/supervision requirements for advanced practice providers such as APRNs and physician assistants in the state of Florida. In a previous Client Alert we discussed House Bill 607, which expanded the autonomous practice of APRNs providing primary care services in Florida.Client Alert

Ohio Senate Bill 49 – Ohio Expands Lien Rights for Design Professionals

October 20, 2021Effective September 30, 2021, Ohio granted limited lien rights to design professionals, including architects, landscape architects, engineers, and surveyors. Ohio Governor Mike DeWine signed Senate Bill 49 into law on July 1, 2021. This new law established a statutory right to lien commercial real estate by Ohio design professionals who, until now, could not file a lien for non-payment of professional services. Senator Vernon Sykes, a primary sponsor of Senate Bill 49, stated that the “legislation ensures that architects, engineers and other designers will get paid for their work, regardless of the outcome of their projects . . . It will support hardworking Ohioans by protecting the value of their labor . . ..”Client Alert

Primary Care Practice Officially Defined in Florida for APRNs Practicing Autonomously

October 12, 2021As many providers in Florida are aware, House Bill 607 (the “Bill”), which was passed in February of last year, gives certain APRNs in Florida the ability to practice autonomously. The only catch is that they must work in primary practice. When the Bill was initially passed, there was question as to what was exactly considered primary care, absent a definition from the Florida Board of Nursing. However, as of February 25, 2021, “primary care practice” has officially been defined.
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