19 Jul Ohio Governor Mike DeWine Vetoes Healthcare Provisions Added to Budget (and other changes)

The Ohio Legislature passed the 2-year budget bill that contained numerous healthcare policy provisions that would have negatively impacted Ohio physicians.  Ohio law provides line-item veto authority to the Governor for appropriation bills.  Governor DeWine applied this authority to veto twenty-five provisions including a number of the most problematic healthcare provisions.

Price Transparency and Surprise Billing  

The Ohio Radiological Society applauds Governor DeWine’s decision to veto an unworkable price transparency provision and language that tried to address “surprise billing” or unanticipated out-of-network fees, but did not provide physicians with any ability to negotiate with insurance providers.  In his veto message, Governor DeWine encouraged stakeholders to continue working towards a practical solution to these issues as well as monitoring efforts at the federal level as to not place duplicative or burdensome regulations on health care providers.  He also released an Executive Order that requires every agency to “seek to adopt or implement the rules regulations and recommendations which result from the Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States and which address surprise medical billing, transparency in health care costs, and access to de-identified claims data.”

Ohio Breast and Cervical Cancer Project Income Tax Contribution Fund

The bill also made changes to the Ohio Breast and Cervical Cancer Project Income Tax Contribution Fund and specifically added mammography services providers and radiology services providers to the list of those eligible to receive payments from the fund.  Changes were also made to the eligibility requirements for screening and diagnostic services through the Ohio Breast and Cervical Cancer Project as follows:

• Specifies that a woman seeking breast and cervical cancer screening and diagnostic services
  must have a countable family income not exceeding 300% of the federal poverty line, rather than
  250% as under current law;
• In the case of women seeking breast cancer screening and diagnostic services generally,
  eliminates the requirement that women be less than 65 years of age; and
• In the case of women seeking breast cancer screening and diagnostic services because of family
  history, clinical examination results, or other factors, lowers to 21 (from 25) the age at which
  women become eligible for such services.

Continuing Education Requirements Cut in Half

Physicians will need only 50 hours of continuing education — instead of 100 — to renew their licenses every two years.

Radiation Technology Professionals

The bill revises the law governing Ohio Department of Health regulation of radiation technology professionals. First, it authorizes nuclear medicine technologists and radiation therapy technologists who are certified in computed tomography, or CT, to perform CT procedures. The bill also requires the ODH Director to adopt rules establishing standards for the performance of CT procedures and for the approval of national organizations that certify nuclear medicine and radiation therapy technologists in CT.

Second, the bill modifies the definitions of radiation technology professionals in the following ways:

• By adding to the definitions of general x-ray machine operator, radiation therapy technologist, and radiographer references to radiation-generating equipment;
• By specifying that radiation therapy technologists are the same as radiation therapists;
• By removing from the definitions of general x-ray machine operator and radiographer references to determining the site of radiation and replacing them with references to determining procedure positioning.

The bill also clarifies that a general x-ray machine operator does not determine procedure positioning, while a radiographer does and changes references from “radiography” to “radiology.”

Pharmacy Benefit Managers

The Governor also vetoed a provision that would have required the state to establish a single statewide pharmacy benefit manager (PBM) rather than deal indirectly with five different PBMs through each managed-care plan.

In his veto message on this provision, Governor DeWine stated he is willing to proceed with a single Medicaid pharmacy benefit manager, but wanted to provide his Department of Medicaid with the flexibility to implement it successfully.  He also vetoed a requirement that Medicaid Director Maureen Corcoran work in conjunction with the PBM to establish a single drug formulary list stating that such a list is already being worked on by the department.

DeWine also vetoed a July 1, 2020, deadline for the Medicaid department to finalize new contracts with private managed care plans hired to oversee the tax-funded health-care program. DeWine, who ordered that contracts be rebid earlier this year in response to concerns about PBMs, said in his veto message “the provision creates an artificial deadline for a necessarily complex process.” A new setup is now expected by January 2021.

Find more information on the Ohio Biennial Budget (HB 166) at this link.