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05/15/2020

This Week’s Advocacy Round Up and COVID-19 Announcements

There continues to be a lot of activity at the state and federal level in response to COVID-19, and OSMA was involved in a variety of advocacy initiatives this week. Below is an overview of advocacy efforts and new policy information both in Ohio and at the federal level.

As always, if you have questions about our advocacy efforts or want to learn more about how to get involved, contact our government affairs department.



State Updates

For the second consecutive week, the Ohio Legislature was at work downtown, picking up where they left off on several outstanding issues active the week prior.

Through a series of socially-distanced hearings, the Legislature considered legislation on liability, and the House Finance Committee accepted a substitute version of HB 388 regarding surprise medical billings. OSMA continued our involvement in these and other proceedings, advocating for critical physician and patient needs as the COVID-19 pandemic continues to impact our state.


Liability

Last week, Ohio Senate legislation HB 308 regarding liability of service providers and medical professionals during a declared disaster, had its first hearing in the Senate Judiciary Committee. This issue has been of serious concern to many of our members during the temporary postponement of a broad swath of elective medical procedures pursuant to an emergency order issued by the Department of Health during the early stages of the COVID-19 crisis. And now, as many healthcare practices have begun to resume certain care under the Department and Governor’s direction, this continues to be a prominent issue.

This Wednesday, OSMA had the opportunity to provide testimony in support of this bill, and joined the Ohio Hospital Association and the Ohio Health Care Association representing the medical community. The legislative process continues, and OSMA will be on-hand to monitor the progress of SB 308.

In addition, OSMA is also supporting a House bill concerning liability introduced by Rep. Diane Grendell (R-Chesterland). The bill, HB 606, would grant a person providing services for “essential businesses and operations” civil immunity for injury, death, or loss to person or property caused by the transmission of COVID-19, provided that such services are not conducted in a wanton or reckless manner. Similar to SB 308, it also includes liability coverage specific to physicians.

We will continue to provide updates as this issue progresses.


Surprise Billing

In last week’s email round-up, we gave an update on HB 388, which is the current surprise out-of-network billing legislation in the Ohio House, and summarized OSMA’s in-person testimony in the House Finance Committee.

This Wednesday, the Committee accepted a substitute version of HB 388, which contained several changes from the prior proposal. The substitute bill comes partially as the result of comments and concerns expressed by OSMA about the structure of the arbitration system the bill would set up if enacted. As a reminder, organizations representing physicians and the provider community, including OSMA, have argued against the proposal as introduced, with concerns that it overly favors the health insurers and upsets the balance of the contracting process.

The OSMA advocacy team is currently reviewing the substitute bill, and the advocacy team will continue to work with the sponsor and committee members on HB 388 and provide updates as more information is available.


Regulatory Activity

The State Medical Board of Ohio held its monthly meeting virtually on Wednesday, May 13. The board worked through a condensed agenda as many of the board’s committees are not formally meeting at this time.

Highlights from this meeting include:

    • The board’s sexual misconduct committee reported they are working through a historical case review of over 1,000 cases spanning the last 25 years, and they expect to have that review completed by fall 2020. The board was directed to conduct the historical case reviews after information surfaced that medical board investigations involving a 1996 case regarding allegations against former Ohio State University physician Richard Strauss were dropped without explanation.
    • The board’s licensure staff indicated that, despite the challenges of working remotely, there have been no delays in licensure processing times.
    • The board discussed the petitions that are pending regarding the addition of certain conditions that may be treated with medical marijuana. The board is currently considering the addition of cachexia, anxiety and autism and will likely vote to approve or deny those conditions in July.

State Budget - Medicaid Cuts Update

Last week, the governor announced a $210 million cut to Medicaid for the last two months (May and June) of the state fiscal year. While specific details have yet to be announced, OSMA believes these cuts will not impact physician rates or eligibility. Rather, it appears they will be focused primarily on reducing per member per month payments to Medicaid managed care organizations (MCOs).

This is being done to reflect reduced medical expenditure volumes seen in late March and April due to the Order banning non-essential medical services. As more details emerge, we will provide them to you.


Industry Restart Ohio Announcements

Several other Ohio industries will be re-opening today, including restaurants, bars, barber shops, salons, etc. Additionally, yesterday the governor announced day care centers, day camps, gyms and some other sporting facilities will be opening later in the month. As you may be getting questions from patients about the reopening of various facilities, you can direct them to www.coronavirus.ohio.gov for up-to-date information about what’s open and the latest safety guidelines and recommendations.


First Federal Shipment of Remdesivir Sent to Ohio

This week, the Ohio Department of Health announced it was receiving its first shipment of Remdesivir from the federal government, and will be working with the Ohio Hospital Association (OHA) to distribute it to hospitals around the state. It is believed the first shipment is enough to cover at least 100 patients. Ohio is expecting additional supplies soon. If you are a hospital system and have questions about the distribution of this drug supply, contact the Ohio Department of Health.



Federal Updates

HEROES Act

On Tuesday, May 12, House Democrats introduced the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act – H.R. 6800. This proposal creates new funding totaling almost $3 trillion to help fund the COVID-19 related impact on state, local and territorial and tribal governments, specifically covering the costs of front-line workers such as first responders, health workers and teachers.

The act also creates a $200 billion Heroes Fund to provide hazard pay for essential workers. Additionally, there are a variety of other business-related relief provisions as well as another round of economic stimulus payments for individuals.

We anticipate the legislation will be revised significantly before, or if, it ends up passing the Senate and ultimately is signed by the President. We will provide updates to you as they become available.


Guidance Released on "Good-faith Certification" for PPP Loans

Two weeks ago, we provided an overview of the PPP loan program with our partner at Blue and Company. As new information about these loans has been released, our partners wanted to share the following updated information:

In recent weeks, borrowers have been concerned over the SBA’s “good-faith certification” concerning the necessity of the loan request. Today, May 13, the Small Business Administration (SBA), in consultation with the Department of the Treasury, provided further guidance on this matter. Specifically, the SBA and Department of the Treasury states:

"Any borrower that, together with its affiliates, received PPP loans with an original principal amount of less than $2 million will be deemed to have made the required certification concerning the necessity of the loan request in good faith.”

Read more.



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