State Policy Issues
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OACHC'S public policy and advocacy efforts are dedicated to promoting the value of Community Health Centers to Ohio's elected and appointed officials, both on the state and federal levels. OACHC staff work closely with Ohio's Congressional Delegation, Ohio's General Assembly, the Governor's Administration and other government agencies, to provide input on legislation and policies of interest of interest to Ohio's Community Health Centers. 

 

For legislative or public policy information, contact Julie DiRossi-King, Chief Operating Officer jdirossi@ohiochc.org 

 

OHIO REGULATORY UPDATES


Payment for Long-Acting Reversible Contraception (LARC) Furnished at a Federally Qualified Health Center (FQHC)
ODM’s Medicaid Advisory Letter (MAL) on the payment of LARCs explicitly allows the billing of a medical encounter for insertion and separate payment may be made for a LARC device or implant, including FFS patients. 

Affiliation
ODM will be requiring the MCPs to use the MITS “Provider Master File” (PMF) to verify enrollment information and to determine which individual practitioners are affiliated to each clinic. As we understand it, right now, the MCPs are using their own rosters to determine who is working at each clinic.  Rosters will continue to be used for other purposes, but the PMF will be used to verify some enrollment information and to determine affiliation.  At some point, if practitioners’ enrollment and affiliation information is not up-to-date in MITS, FFS and MCP claims may deny.

In short, it will be important for FQHCs to keep their enrollment and affiliation information up-to-date in MITS.  According to ODM, everything can be done by the provider by following the Enrollment and Group Member Linkage Instructions.

ODM’s Non-Emergency Transportation
The new Non-Emergency Transportation Services resource is intended to help answer the question “Where can I call for transportation assistance to Medicaid appointments?”.  It can be used, and distributed, by health care providers, county offices, advocacy organizations, community groups, and anyone who has an interest in promoting access to health care. 

Medication Units
This new rule allows OTP Medication Units (methadone) to locate at FQHCs (among other locations), effective Jan 1, 2019. Additional resource: a map of OTPs and OBOTs in Ohio.

Memo from ODMHAS Director, Dr. Mark Hurst:  Medication-Assisted Treatment for Opioid Use Disorders is the Standard of Care 
Ohio Department of Mental Health and Addiction Services (OhioMHAS) Director Mark Hurst, M.D., today issued a memo to healthcare providers reinforcing the notion that Medication-Assisted Treatment (MAT) for opioid use disorders is the standard of care. The memo, which includes links to extensive research on MAT outcomes, notes there are currently three FDA-approved MAT options: products containing naltrexone, products containing buprenorphine, and methadone. 

“All three options have advantages and disadvantages for specific patients, and all three are demonstrated to improve treatment outcomes. There is no evidence that one form of MAT is more effective than the others,” Dr. Hurst stated in the memo. “Many providers cannot offer all forms of MAT, and some do not have the ability to offer MAT at all, but patients should be informed of the different options available and referrals made when needed,” he added.

Ohio Department of Medicaid (ODM) Website Refresh

The Ohio Department of Medicaid’s Managed Care webpage now only has items related to providers and managed care. Reports have been moved here: https://medicaid.ohio.gov/reports. Managed care contracts, addenda, FAQ, and plan guidance can be found here: https://medicaid.ohio.gov/RESOURCES/Publications/ODM-Guidance#1615214-managed-care. Lastly, the MyCare webpage reflects more current updates. 

STATE POLICY PRIORITIES

 

The overarching goal for OACHC state advocacy initiatives is to ensure that Ohio’s Community Health Centers have the resources to provide care to medically underserved Ohioans, regardless of income or insurance status.

 

Quality Coverage and Care for All Ohioans

Expanded Medicaid eligibility levels are directly associated with the enhanced ability of safety net providers like Community Health Centers to invest in capacity, increase access, and better meet the needs of patients and our communities. Thanks to a greater number of patients accessing coverage, Community Health Centers have hired more staff, established more locations and partnerships to access care, and helped more Ohioans find care for chronic conditions at the right time, and in the appropriate primary care setting. 

 

Support and Growth for Front Line Providers

Ohio’s Community Health Centers, along with the Administration and the General Assembly, created the FQHC Primary Care Workforce Initiative (PCWI). This line item, housed in the Department of Health, is the only primary care workforce strategy in the state. The funds provide a stipend to the Community Health Centers who bring on primary care students (medical and dental students, APRNs, PAs, and behavioral health) for a rotation and expose them to advanced Primary Care Medical Homes in practice, providing a standardized, high-quality educational experience. Learn more about OPCWI here.

 

Support Value Over Volume

As Ohio elevates care coordination and increasing quality outcomes through value-based payments, the Comprehensive Primary Care (CPC) Program is vital for our success. CPC is a patient-centered medical home program, which is a team-based care delivery model led by primary care practices that comprehensively manage patients’ health needs to improve population health outcomes while lowering costs. 

 

340B

The purpose of the 340B program is to provide discounted drug prices to enable certain safety net entities, including FQHCs, “to stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services." A federal requirement of participation in the 340B program is to reinvest the savings from the discounted drug prices, back into the community. Some examples of this include passing along the discounts to uninsured and underinsured patients, and expanding capacity and/or services to care for more Ohioans. A prime example in our state today would be investing the savings from 340B into Medication-Assisted Treatment (MAT) to combat opioid addiction

 

FQHC/PPS RULE PACKAGE 

 

Visit here for the “Chapter 5160-28 Cost-Based Clinic (FQHC, OHF, RHC) Services” – more commonly known as the FQHC/PPS Rule Package in the Ohio Administrative Code (OAC).

 

 



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