3/23/20

Health Care Alert: The Impact of Emergency Telehealth Rules on OMHAS Certified Behavioral Healthcare Providers

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In our previous alert, we provided a comprehensive overview of the Ohio Department of Medicaid (ODM) emergency rule which expanded Medicaid coverage for services rendered via telehealth by eligible Medicaid providers. 

With respect to Medicaid community behavioral healthcare services provided by Ohio Department of Mental Health and Addiction Services (OMHAS) certified providers, these emergency rules (1) provide additional modalities by which such agencies may provide Medicaid reimbursable services; (2) relax current rules regarding telehealth; and (3) expand the types of services that may be provided by telehealth. Importantly, these rules do not restrict current requirements regarding which types of practitioners may provide Medicaid community behavioral healthcare services.

Although the ODM rule contains numerous provisions, it is critical to understand that only paragraph (C) applies to OMHAS certified providers. Moreover, except as expressly stated in this paragraph, the rules that typically govern OMHAS providers’ Medicaid billing continue to apply.[1]

As a result, the emergency rule’s general prohibition on billing for Medicaid services for supervised, dependent practitioners (e.g., LPCs, LSWs, LCDCs) and supervised trainees does not apply to OMHAS certified providers. Rather, we understand this language to prohibit these types of practitioners from independently seeking Medicaid reimbursement for services. This means that OMHAS certified providers may continue to bill for Medicaid community behavioral healthcare services of supervised or dependent licensees.

In addition to permitting supervised, dependent practitioners and supervised trainees to continue to provide services via telehealth, the following changes impact OMHAS certified providers: 

We encourage all providers to thoroughly read both rules in their entirety. In addition, ODM has issued a telehealth FAQ document and the state has published a MITS Bits on these emergency rules. If you have questions about the new Medicaid or OMHAS rules, or their impact on your organization, please contact Suzanne Scrutton, Liam Gruzs, or Mairi Mull.

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[1] See O.A.C. §§ 5160-27-02 and 5160-8-05.

[2] As discussed in our previous alert, OMHAS released a revised version of O.A.C. § 5122-29-31 in conjunction with the publication of the new Medicaid rule.