On July 10, the Ohio Academy of Family Physicians joined other members of the Medical Association Coalition (MAC) in expressing concerns with recently altered implementation of the Ohio Department of Medicaid (ODM) rule regarding Medicaid provider agreements.
The comment letter states: “….we find it imperative and relevant to mention our concerns about the recent changes to Ohio Administrative Code section 5160-1-17.6(I)(1). This rule requires ODM to terminate the provider agreement with any provider whose license is suspended, revoked, or otherwise limited. It is our understanding that prior to this rule change, ODM had been using an elevated screening process for individuals whose licenses were disciplined based upon the provider’s personal impairment due to mental illness or substance use disorder. We are greatly concerned with ODM’s decision to discontinue the use of the elevated screening process and strictly apply Rule 5160-1-17.6 to all providers.”
The comment letter continues, “Ohio’s licensing boards are granted statutory authority to define and regulate the professional practices of various healthcare professionals. The boards protect the public by assuring board licensed individuals have the necessary education and training, meet established standards, and ensure that licensees are mentally and physically fit to practice. We believe that the ODM rule conflicts with a licensing board’s authority and further believe that the licensing board should determine when a practitioner is able to practice safely.”
The comment letter concludes, “Physicians and other medical professionals who have never had a history of criminal action, but are under a consent decree for addiction, mental health, or even a physical disability, should also be able to provide care to Medicaid recipients. As stated above, if the regulatory agency has determined that the practitioner is safe to practice, ODM should not impede the practitioner’s ability to provide needed care to a population of patients who often find it difficult to locate a physician who participates in Medicaid. Any rules that create a conflict between ODM and the licensing boards have the potential to limit a licensee’s employment opportunities and may result in patient access issues.”
The OAFP has requested a meeting with ODM Director Barbara Sears to discuss its concerns with Medicaid’s decision to strictly apply Rule 5160-1-17.6 to all Medicaid providers.