The COVID-19 pandemic continues to usher in new mandates and changes that are leveling a rapid and significant impact on Ohio’s healthcare system. State officials expect for the number of COVID-19 cases in Ohio to continue to rise.
Testing remains the number one priority. The state continues to have a limited supply of COVID-19 tests and has restricted testing to the most symptomatic patients and healthcare professionals.
Like other parts of the country, the Ohio Department of Health (ODH) is anticipating a shortage of ventilators and a quickly dwindling supply of personal protective equipment (PPE), which necessitated state guidance and orders, including postponing elective surgeries and procedures.
Per ODH guidance, the state has set up a few regional drive-thru testing sites at hospitals across the state. However, patients can only receive testing at these locations if they have a prescription from their physician, and the physician must have working privileges at the testing facility. This has proposed challenges as physicians who may not have privileges at the hospital appear to be left with little option for how to help patients.
These concerns have been brought to ODH’s attention and a revision of the guidance is being considered. Also, the state is not publicizing the location of the drive-thru testing sites in order to avoid a rush of people without prescriptions showing up.
Following ODH’s order earlier this week prohibiting elective surgeries and procedures that require personal protection equipment during this state emergency, many medical practices are beginning to suffer significant financial consequences. Some physicians are anticipating laying off staff or worse, temporarily closing their practices.
On Thursday, the U.S. Small Business Administration approved Ohio's request to make low-interest loans available to Ohio firms and nonprofits, which would include medical practices. Entities can apply for loans up to $2 million under the Economic Injury Disaster Loan program at disasterloan.sba.gov. The Economic Injury Disaster Loans may be used by Ohio small business owners and non-profits to pay fixed debts, payroll, accounts payable and other bills that can’t be paid because of the disaster’s impact.
The state previously announced that anyone laid off during this crisis is immediately eligible for benefits. The state continues to urge people to file using https://unemployment.ohio.gov/ if they can, while those without computer access can call 1-877-644-6562. Workers with coronavirus-related claims can use the mass-layoff number 2000180 on their applications, but those who have already submitted claims do not need to add it.
More information may be available next week.
With many physicians reporting patients cancelling appointments or medical practices seeking to limit traffic in their office due to the virus, there have been increased calls for telemedicine services so that patients still have access to their doctor.
The Ohio Department of Medicaid (ODM), the Centers for Medicare & Medicaid (CMS), and commercial payers are each revising telemedicine rules and creating directives that will allow telehealth services to be used and providers properly reimbursed during this time of crisis.
CMS has announced it is broadening access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility.
The three main types of virtual services approved by CMS include: telehealth visits, virtual check-ins, and e-visits.
The Ohio Department of Medicaid on Thursday announced similar changes, authorizing more medical and mental health services via telehealth. The patient will not be required to have a prior relationship with the physician with whom they consult. The temporary changes will apply to Ohio’s five Medicaid managed care plans.
The full order from Medicaid is expected to be released on Friday.
The Governor’s office, the Department of Insurance and the major commercial insurers remain in talks to relax telemedicine rules for private plans. We hope to have updates for you next week.
The Medical Board’s has relaxed licensure restrictions which also apply for telemedicine services in Ohio. Specifically, an in person visit will no longer be required prior to providing services via telemedicine.
The Department of Health and Human Services Office of Civil Rights announced it won’t be enforcing certain aspects of HIPAA related to telehealth during the COVID-19 crisis. Specifically it differentiates those application types that will be allowed to be used with patients and those that can’t.
The State Medical Board of Ohio held an emergency meeting on Wednesday and voted to immediately suspend enforcement of any regulations requiring in-person visits between providers and patients. This exercise of enforcement discretion includes, but is not limited to, enforcement of regulations related to providers prescribing to patients not seen in-person by the physician.
The effective date for this change is March 9, 2020, and it will remain in place until Gov. Mike DeWine lifts the state emergency.
The Medical Board voted to suspend continuing medical education required for license renewal. This order pertains to all renewals due by March 1, 2021. The Medical Board also said it was considering options for licensing out-of-state doctors to work in Ohio if needed during the COVID-19 pandemic.