Executive Vice President Ann Spicer and Lobbyist David Paragas, JD, represented the Ohio Academy of Family Physicians at a meeting with Ohio Department of Medicaid Director John McCarthy on December 17, 2015. Medicaid holds regular meetings with physician organizations to brief them on issues.
Earlier this year a provision was inserted into the Ohio Bureau of Workers Compensation budget bill that would require providers of health care services to offer, upon request, a good-faith cost estimate for all non-emergency services. The bill (as enacted) establishes, under the Office of Health Transformation, a Health Services Price Disclosure Study Committee, which is required to study and issue a report with recommendations on the impact and feasibility of requiring physicians and other health service providers to provide cost estimates at the time the service is delivered.
The Health Services Price Disclosure Study Committee recently met and will be filing a report that states that it is the opinion of the committee that the price transparency statute is unworkable, not feasible, and the effort should be abandoned. Despite the recommendation of the committee, short of enactment of legislation to abandon the price transparency requirement, the Ohio Medicaid director is legally required to promulgate rules to implement the legislation by Friday, July 1. The OAFP will be joining other physician organizations in advocating for repeal of the price transparency requirement as recommended by the Health Services Price Disclosure Study Committee. While the requirement’s intent sounds good in theory, it is the position of physicians and other health care providers, hospitals, and insurers that the requirement, as currently constructed, is impossible to implement.
Graduate Medical Education (GME) Formula
Director McCarthy indicated that the legislatively-created GME Study Committee has met twice and made good progress in starting the process to revise the way the Ohio Department of Medicaid (ODM) funds GME. The decades-old formula unevenly distributes funding for resident training and is not distributed in ways that incentivizes production of the kinds of physicians that are most needed.
Resident Provider Registration
Beginning in December 2015, the State Medical Board of Ohio has changed how acknowledgement letters and training certificates for residents are processed in an effort to facilitate easier Medicaid provider registration. Residents will be issued a unique credential number at the time an acknowledgement letter is issued and their credential status will be displayed as “Acknowledgement Letter Issued.” When the training certificate is issued, residents will maintain the same credential number they were provided when the acknowledgement letter was issued, but their credential status will change and be displayed as “Active.”
Director McCarthy also updated the physician organizations on the State Innovations Model effort to pay for value instead of volume (see related story titled “Payment Innovation Update”) and informed meeting participants that the transition to ICD-10 had gone smoothly. Medicaid is monitoring payments made under ICD-10 closely as physicians and other health care providers may actually be receiving higher payments for services under ICD-10 as a result of the more specific coding.
The next meeting of the Physicians Associations with Director McCarthy is scheduled for Wednesday, March 16.