07/05/2023

State Budget Bill Passed, Signed by Governor

OSMA Champions New Medicaid Physician Payment Increase Included in Budget Legislation

This spring, the Ohio Legislature embarked on the biennial state budget process, tasked with passing legislation creating the budget for fiscal years 2024-2025. The Ohio State Medical Association (OSMA)’s Government Relations team engaged with legislators on many health care budget items from the start, when the governor’s initial proposal for the budget was released.

In the months following, the OSMA was on hand each week to follow and participate in the ongoing debates about a number of health policy issues that were in the House and Senate versions of the budget bill. With a constitutional deadline on June 30, legislators raced against the clock this past week to get the legislation (House Bill 33) successfully through both chambers of the Statehouse and to the governor’s desk for review and signature.

After several days of negotiations and deliberations over the final version, the House and Senate came to a compromise with just hours to spare on Friday.

Early this week, Governor DeWine signed the final budget bill, but issued 44 line-item vetoes for specific items included in the legislation.

Key points from the Budget Bill:

• Medicaid Physician Payment Increase
  
  
• Protecting Physician Personal Data
  
  
• Scope of Practice Expansions Fail
  
  
• Protecting Public Health – Vaccines and Limiting Tobacco Sales
  
  
  

Ohio Medicaid Physician Payment Increase

The most significant victory for physicians included in this general assembly’s budget legislation is the inclusion of provisions in the bill which will increase Medicaid physician payment rates. OSMA strongly advocated for and supported the inclusion and retention of this language in the budget during its journey through the legislative process, and thankfully, our collective voice representing physicians all over the state helped keep this payment increase in the final version of the budget.

OSMA is thrilled to have this language passed in HB 33. The issue of Medicaid physician reimbursement has been a priority on our advocacy agenda for years and we know how much meaningful impact this change will bring to Ohio’s physicians and their patients. In a healthcare environment that continues to experience cost increases, stagnated Medicaid physician reimbursement has made treating Ohio Medicaid patients very difficult for our physicians.

We believe that the rate increase for the Ohio Medicaid Physician Fee Schedule will help Ohio continue to be a healthcare leader and help physicians all over the state to make a difference for Medicaid patients and their health and well-being. Implementing this change can also help encourage participation in the Medicaid system by Ohio physicians moving forward, which will greatly benefit our communities.

Provision Protecting Physicians’ Private Information

Thanks to advocacy by OSMA and others in the medical community, the budget bill contains language that will protect Ohio physicians by ensuring that physicians’ private addresses are not posted on the medical board’s website.

Certified Mental Health Assistant Scope of Practice Language Removed

During the legislative process, language from legislation that would create a new type of mental health care provider in Ohio – the Certified Mental Health Assistant (CMHA) – was added to HB 33. OSMA has testified in opposition to the original legislation in the Senate regarding the creation of CMHAs, and advocated for removal of these provisions from the budget bill.

The medical community has significant concerns with this concept, particularly because this would be an entirely new allied practitioner designation that does not exist elsewhere in any other state, and the CMHA would have prescriptive authority, including for controlled substances.

Thankfully, our advocacy and the work the OSMA team accomplished alongside other health care organizations, such as the Ohio Psychiatric Physicians Association, helped legislators to understand that passing this language in the budget was inappropriate and that the issue warrants more robust vetting and deliberation through the legislative process. We will continue to be active in advocacy regarding our serious concerns with the CMHA scope of practice legislation moving forward. Currently, it is pending as companion bills in the House (HB 97) and Senate (SB 60).

Pharmacist Scope of Practice Language Removed

Late in the legislative process, a measure was added to the budget bill which would have allowed Ohio pharmacists to give immunizations to children ages 5 and older without a prescription. The Ohio Chapter of the American Academy of Pediatrics testified in opposition to this language, and OSMA echoed their concerns to numerous elected officials. This scope of practice language was then removed from the bill.

Line-Item Vetoes

Governor DeWine issued over 40 vetoes to remove provisions passed by the legislature in the budget bill. OSMA supported the veto of several provisions struck out by the governor, including:

• Language which would have allowed a student to decline vaccines required for enrollment or residence in university dorms at a private college or state college or university. In a statement issued with the vetoes, Gov. DeWine said, “university and college dormitories and student housing are congregate settings where such policy may be of great importance to ensure resident safety. This item is overly broad and may compromise the overall health and safety of students, residents, staff, and faculty at the institution.”

• A provision which would have prohibited local governments from being able to pass ordinances regulating tobacco and alternative nicotine products. The governor already vetoed a similar measure when it was passed in a separate bill earlier this year. In both vetoes, he cited concerns about youth nicotine use and addiction as well as negative public health impact.
  
  
  

Other Budget Provisions

Additional items passed in the final version of the budget legislation include:

• Nearly $3 billion in income tax cuts;

• Funding for universal school vouchers; and,

• An overhaul of the Ohio Department of Education, which shifts oversight from the state board of education to an official that will be appointed by the governor.

Elected officials will recess for the summer until around September now that the budget process is complete. OSMA will continue to work hard on groundwork for our legislative priorities in order to gear up for the fall session, including important grassroots efforts regarding House Bill 130, the prior authorization gold card legislation we are currently supporting in the House.

Please stay tuned for important updates!