Page 8 - OPTA Access Spring 2017

Legislative & Payment Policy Report
Legislative Report: Updates & Insights
Amanda Sines and Mikayla Pollitt – Government Advantage Group
Board Consolidation Doesn’t Pass in Lame Duck
In November and December of 2016 OPTA spent a great deal of time on proposals to consolidate several licensure boards Two pieces of legislation were introduced, House
Bill 617 and Senate Bill 366 Senate Bill 366 and House Bill 617, if enacted, would have consolidated several healthcare professional boards Under this proposal, physical therapists would be licensed by a newly created Physical Health Services Board and would only have one seat on the board
The bills also contained a provision that was intended to resolve any perceived anti-trust vulnerabilities to the Boards This would have created a new review process through the Department of Administrative Services
The Ohio Physical Therapy Association was able to act quickly on this proposal Action Alerts were sent to OPTA members The OPTA worked with numerous other effected professions to coordinate efforts A letter was sent to all members of the General Assembly, signed by 16 organizations, stating opposition to the board consolidation This letter also expressed that the groups did not object to the anti-trust review process
HB 617 was referred to House Government Accountability and Oversight Committee where it ultimately had one hearing
The legislation did not pass during the Lame Duck session in 2016 because of the grassroots efforts by professional associations Thank you to all OPTA members who took
the time to call and email their representatives! Your efforts
did not go unnoticed However, we expect the issue to be considered again in 2017 Government Advantage Group will be monitoring this issue
Legislation Would Require Coverage for Autism Services – Passes in Lame Duck
Former Representative Cheryl Grossman (R – Grove City) and Representative Lou Terhar (R – Cincinnati) introduced legislation that would require insurance coverage for autism treatment Health insurance coverage for Applied Behavior Analysis (ABA) and other medically necessary treatments for autism is currently available in state employee health bene t plans and non-grandfathered plans in the individual and
small group markets This coverage is required as a result of administrative action taken by Governor Kasich in 2012
According to the bill proponents, insurers in Ohio have continued to deny coverage for this treatment if the affected individual is covered by a fully insured large group plan or a grandfathered plan in the small group or individual markets Litigation was led against the Ohio Department of Medicaid for non-compliance with Federal Employee Health Bene t Plans (EPSDT)
HB 350 proposed that the same coverage currently required by the 2012 administrative action also be required in fully insured large group plans and grandfathered small group and individual plans
Under the act, bene ts provided shall cover at a minimum:
1. 20 visits per year for speech and language therapy or occupational therapy for an enrollee under the age of 14 that is performed by a licensed therapist;
2. 20 hours per week of clinical therapeutic intervention for an enrollee under the age of 14
that is provided by or under the supervision of a professional who is licensed, certi ed, or registered by an appropriate agency of this state to perform such services in accordance with a health treatment plan; and
3. 30 visits per year for mental or behavioral health outpatient services for an enrollee under the age
of 14 that are performed by a licensed psychologist, psychiatrist, or physician providing consultation, assessment, development, or oversight of treatment plans
Under the bill “Therapeutic care” means services provided by a speech therapist, occupational therapist, or physical therapist licensed or certi ed in the state in which the person practices
In the last days of the 131st General Assembly, House Bill 350 was amended into House Bill 463 HB 463 was ultimately signed into law by the Governor on January 4, 2017
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Legislative & Payment Policy Report