The Ohio Academy of Family Physicians (OAFP) advocacy team monitors healthcare related legislation, rule changes, and legislative updates for Ohio’s family physicians.
To access the OAFP Bill Tracker, visit the OAFP Public Policy webpage and click on the Bill Tracker icon.
Read on for this week’s updates and contact Advocacy Coordinator Kaela Springhetti with questions or for ways to get involved.
Speak Out: Tell Governor DeWine to Ensure CMS Stays Within the Bounds of H.R. 1
Last year, Congress enacted the One Big Beautiful Bill Act (H.R.1), which imposed significant changes to Medicaid, including new community engagement requirements and massive cuts to state-directed payments (SDPs).
- an interim final rule on implementing the community engagement requirements, and
- proposed regulation on SDPs.
In both cases, CMS went far beyond what Congress approved in legislation.
Speak Out now and let Governor Mike DeWine know that family physicians and patients will suffer from improper statutory implementation that further strips away access to care and restricts state-level autonomy in healthcare administration.
Community Engagement Requirements
While Congress established the framework for these policies, CMS’s rule includes several provisions that extend beyond the law’s requirements and could create unnecessary administrative burdens for patients, physicians, and state Medicaid programs.
Among other concerns, CMS has proposed restrictive policies related to medical frailty determinations, verification requirements, and ongoing documentation processes that may make it more difficult for eligible patients to maintain coverage and increase administrative complexity for family physicians and states.
State Directed Payments
H.R.1 specifically sets out only four types of services that are subject to new SDP caps (inpatient hospital services, outpatient hospital services, nursing facility services, or qualified practitioner services at academic medical centers). In its proposed regulation, CMS chose to apply the SDP caps to all service types.
The proposed regulation also eliminates SDPs for all services for which a Medicare rate is not currently available, contradictory to what Congress agreed to in H.R.1.
These are only a few examples of other egregious attempts by CMS to institute even more draconian cuts to state Medicaid programs, physicians, and beneficiaries.
Take action today by telling Gov. DeWine to urge CMS to reconsider these actions and to instead implement H.R. 1 policy requirements that are consistent with legislative intent and without creating unnecessary barriers for patients or physicians.
Medicaid Fraud Concerns Drive Ohio Lawmakers to Tighten Oversight
Source: The Columbus Dispatch
Amid conservative uproar over Medicaid fraud allegations, Ohio lawmakers are tightening requirements for personal care services, increasing GPS tracking, and upping penalties for unscrupulous actors.
The changes were added to an unrelated bill fighting food stamp fraud, passed the Ohio House, 85-10.
“Auditing and accountability are not ideological. These are the minimum safeguards our citizens deserve,” Representative Mike Dovilla (R-Berea, OH) said. “This is not about denying services. It’s about ensuring that services are real, legitimate, and delivered to those who truly need them.”
The final version did not include a ban on Medicaid paying relatives to care for their loved ones after swift, strong backlash killed that idea.
Representative Brian Stewart (R-Ashville, OH) said Ohio lawmakers started by casting a wide net to prevent “paying a nephew to go cook soup for his aunt.” But “we’ve never wanted to really touch family caregivers in the Medicaid or DD (developmentally disabled) space.”
The fast-tracked bill is Ohio lawmakers’ response to a conservative publication’s report alleging impropriety in the home healthcare sector, particularly in central Ohio. State and federal officials are investigating the claims.
Read the full article in The Columbus Dispatch.
Ohio Doctors Push Back Against 24-Hour Abortion Waiting Period Proposal
Source: Ohio Capital Journal
Ohio doctors asked lawmakers this week to back off of a bill that would require a 24-hour wait before abortion procedures.
In a hearing before the Ohio Senate Health Committee, physicians emphasized the informed consent that’s already part of the standard of care under they were trained to use.
They said Ohio House Bill 347 not only bars patients from getting timely care, but creates disparate treatment for those who treat individuals who can get pregnant.
“Requiring physicians who perform abortions to do this, without similar requirements for all other procedures, is discriminatory and frankly, it is patronizing to people seeking abortion that they would need extra rules and time to decide about abortion,” said Elise Berlan, MD, MPH, an Ohio physician who treats pediatric and adolescent patients.
Dr. Berlan and other opponents of the bill spoke at the last expected hearing of the committee before legislators head for a break that may last until after the November election.
The committee didn’t vote to advance the bill before the break, but heard from several Ohioans about their feelings on the bill.
Read the dull article in The Ohio Capital Journal.