Regulatory Affairs

 

Actively Monitoring the Activities
of State & Federal Regulatory Agencies

OSMA takes a very active role in advocating for physicians not just in the Ohio Legislature, but also in the regulatory arena—specifically at state agencies and state boards. We constantly monitor administrative rules at the Ohio Departments of Health, Medicaid, Insurance, Mental Health, along with state Boards such as Medical, Pharmacy, and Nursing to name a few. When one of these agencies propose changing these regulations, we work directly with our member committees to analyze how these regulations will affect our members, and when appropriate, we advocate to improve and protect the regulatory climate of our member practices. With evolving regulations such as telehealth and cross-state licensing, it is now more important than ever to participate in advocating for the medical profession.


How to get involved in advocating on these regulations
for your profession:

OSMA maintains advocacy subcommittees to review and discuss legislative and regulatory issues facing medicine. We highly value the participation of our members in these subcommittees and we encourage anyone interested in participating to do so.

 

Get Involved >
Or call OSMA at 614-527-6762.



Latest News:

Find updates below on the activities of relevant state boards and OSMA's active engagements.

02/21/2024

February Legislative Update

January 21, 2024 – This month, your OSMA Advocacy team has been working extensively behind the scenes with legislators and other interested parties on several key issues, preparing for upcoming legislative sessions next week and later this spring after the primary election.


02/15/2024

Medical Board Update

February 15, 2024 – On February 14, the State Medical Board of Ohio accepted review of two potential additional qualifying conditions for a medical marijuana recommendation. Those conditions are (1) Female Orgasmic Difficulty Disorder and (2) Autism Spectrum Disorder.


02/12/2024

HHS Updates Opioid Treatment Program Regulations for First Time in 20 Years

February 12, 2024 – Last week the Department of Health and Human Services (HHS) published new rules related to opioid treatment and issued the following statement.


01/25/2024

Recent Override of Two Gubernatorial Vetoes

January 25, 2024 – An update on: Governor DeWine’s veto of House Bill 68, the gender-affirming care legislation, being overridden by a vote in the Ohio House, as well as information about the regulatory process surrounding the development of new administrative rules regarding gender transition care for Ohioans under the age of 21.


01/18/2024

Ohio Legislative Update!

January 18, 2024 – Last week, despite strong and consistent advocacy efforts by OSMA and a large coalition of medical organizations, members of the Ohio House of Representatives returned to Columbus in order to vote to overturn Governor DeWine’s veto of House Bill 68. As a reminder, HB 68 would ban gender-affirming care – including use of hormones, puberty blockers, and surgeries – for patients in Ohio under the age of 18. Also, members of the Ohio House have unanimously voted to pass House Bill 179—on vicarious liability in tort actions, and provides that the tolling of the limitations period during the defendant's absence or concealment does not apply to statutes of repose.


01/18/2024

Legal Update: Physician Wrongful Death Liability Claim Protections Upheld

January 18, 2024 – The Ohio Supreme Court confirmed limits on physician liability in wrongful death cases late in 2023.


01/17/2024

CMS Announces Final Rules Regulation Medicare Advantage Prior Authorization

January 17, 2024 – We are pleased to report that earlier this week, CMS announced its final rule package that will address some of the challenges physicians face with the prior authorization system.


01/03/2024

New Year Brings Medicaid Rate Increase for Ohio Physicians

January 3, 2024 – On January 1, the majority of the codes in the Ohio Medicaid fee schedule for non-institutional providers (this includes physicians) increased by 5% or more—thus resulting in $415 million in additional funding this year. Additionally, fee schedules for ambulatory surgery centers, vision services, and others have also increased. Securing the Medicaid rate increase was OSMA’s top legislative priority in 2023!


12/19/2023

Thank You for Your Support in 2023!

December 19, 2023 – We're looking forward to 2024... I want to thank every OSMA member for their support and for being a passionate advocate for our profession. During the past year, OSMA staff and leadership were involved in a wide variety of activities that I hope have benefitted every physician in Ohio—and will continue to do so. 2023 highlights include... 


12/15/2023

OSMA December Legislative Update

December 15, 2023 – The Ohio Legislature has completed its activities and recessed until the New Year, and the past several weeks at the Statehouse have been a whirlwind of hearings, meetings, and legislative sessions as legislators prepared to wind down for the holidays. Here’s a review of important and recent updates on issues your OSMA advocacy team has been involved in this year, and a brief peek at what these developments mean for our advocacy agenda in 2024.


12/14/2023

Take Action Now: New Medicare Payment Fix Bill Introduced

December 14, 2023 – As we have informed OSMA members over the last two months, unless Congress takes action, the 2024 Medicare physician fee schedule includes a 3.37% payment cut for physicians.


12/14/2023

State Medical Board and Ohio Legal Update

December 14, 2023 – The State Medical Board of Ohio (SMBO) met on December 13 to finalize the election of Board members, while the Supreme Court of Ohio has ordered the parties in Preterm Cleveland v Yost to submit briefs in the wake of the passage of Issue 2.


12/13/2023

Attention Medical Students: 2024 Fellowship Opportunity

December 13, 2023 – Have free time this upcoming summer?  Want to get a hands-on advocacy experience? The Ohio State Medical Association (OSMA) is looking for a driven and personable medical student for a 6-8 week internship in summer 2024!


12/06/2023

Advocacy Update: Help Avert the Medicare Payment Cut!

November 28, 2023 – In addition to our direct advocacy efforts, we’re asking members to contact Congress to help fix Medicare now. We need everyone’s help to avert the cut.


12/06/2023

OSMA Advocacy Leads to More Than $400 Million in Increased Medicaid Reimbursement

November 28, 2023 – OSMA’s top legislative priority for 2023 was to increase Medicaid reimbursement for physicians. Working with the administration, a provision to increase the Medicaid fee schedule was included in the initial budget proposal and remained in the version passed by both the House and Senate—and ultimately signed by the governor at the end of June.


11/27/2023

Medicaid Fee-for-Service Claim Denials & Reprocessing

November 27, 2023 – Ohio Department of Medicaid (ODM) and its Ohio Medicaid Enterprise System vendors are diligently focused on providing transparency and visibility regarding care and services.


11/09/2023

No Surprises Act Update & Medical Board Meeting Summary

November 9, 2023 – As Congress enacted the No Surprises Act in 2020 to address the issue of “surprise medical bills” for patients and provider payment issues, the Biden administration has proposed a recent rule specifically addressing the Independent Dispute Resolution (IDR) process. And as a reminder, this summer the Board eliminated the previous One Bite Program addressing physician substance use impairment in favor of a vastly more appropriate program structure.


11/09/2023

Election Recap: Ohio Voters Pass Issues 1 & 2

November 9, 2023 – After weeks of early in-person and absentee mail-in voting, the 2023 general election culminated in this week’s Election Day, with many Ohioans heading out to the polls to cast their votes on Tuesday. Numerous local races all over the state were decided by Ohio voters, and in the evening after the polls closed, all eyes were on the incoming results, particularly concerning statewide ballot issues 1 and 2.


11/08/2023

Upcoming Trainings: Ohio Medical Board’s New Confidential Monitoring Program

November 8, 2023 – The State Medical Board of Ohio (SMBO) developed a Confidential Monitoring Program in partnership with the Ohio Professionals Health Program (OhioPHP) for all licensees and applicants. This program is a confidential path for individuals to seek help for burnout, mental health, substance use disorders, and a therapeutic alternative to regulatory awareness.


10/26/2023

Report from OSMA Delegation to the AMA

October 26, 2023 – The OSMA Delegation to the American Medical Association (AMA) had the privilege of representing our association at the 2023 Annual Meeting of the AMA House of Delegates (HOD), from June 9 to 14 in Chicago, Illinois. The business of this Annual Meeting is robust and diverse in both range and topic. There were several hundred items of business (reports and resolutions) considered at the meeting. The Delegation worked throughout the summer to summarize our activities at the meeting for review by the OSMA Council and membership.


10/19/2023

Advocacy Update: OSMA Advocates for Physicians on Numerous Major Issues

October 19, 2023 –Over the past few weeks, the Ohio Statehouse has been bustling with hearings, interested party meetings, and other activity, and your OSMA advocacy team, along with several OSMA physician members, have been busy in downtown Columbus to make physician voices heard.


10/19/2023

State Medical Board Confidential Monitoring Program Replaces One-Bite Program – What to Know

October 19, 2023 –The new program provides individual treatment plans and confidential (non-disciplinary) programming, along with the inclusion of physical and mental health related impairment in addition to substance abuse.


10/18/2023

GOP Doctors Caucus Releases Draft Reforms to the Medicare Physician Fee Schedule

October 18, 2023 – Earlier this month the GOP Doctors Caucus released a discussion draft of legislation seeking to reform the Medicare Physician Fee Schedule (MPFS).  In the press release, the Caucus outlined three main areas it hoped to address.


10/04/2023

Ohio Medicaid Releases 2024 Fee Schedule Draft

October 4, 2023 – Earlier this year, OSMA was successful in advocating for a Medicaid rate increase in the state budget. A top priority for OSMA, in its entirety, for the 18-month period starting in January, estimates are that the increase should result in more than $200 million in new funding for physician professional services.


09/29/2023

OSMA Statement on Ohio Issues 1 and 2

September 29, 2023 – Press release: Columbus, Ohio – Ohio State Medical Association (OSMA), the state’s largest and oldest physician-led organization, issues the following statement on Ohio’s November ballot initiatives.


09/26/2023

Important Reminders on Ohio Medicaid Claim Submissions

September 26, 2023 – The Ohio Department of Medicaid (ODM) recently provided the following update on claims submissions for all Ohio physician practices.


09/20/2023

Ohio Legislature Returns for the Fall: What’s on OSMA’s Agenda?

September 20, 2023 – Along with monitoring dozens of pieces of legislation so far this year, there are several items we will be focusing our advocacy efforts on heading into late September, October, and beyond.


08/24/2023

2024 OSMA Annual Meeting – Key Dates & Deadlines

August 24, 2023 – OSMA's Annual Meeting will take place April 5-7, 2024 at the Renaissance Polaris Hotel in Columbus. We look forward to seeing everyone—and in the meantime, here is what to plan for...


08/23/2023

CMS Seeking Comments on Quality Payment Program in 2024 Physician Fee Schedule Changes

August 23, 2023 – Provide your feedback on the proposed changes to the Quality Payment Program by September 11. CMS recently sent out the following request to all physicians...


08/17/2023

Save these Dates to Connect with OSMA's Leadership Team

August 17, 2023 – Join our live updates on the following dates for a brief audio interaction on how your OSMA team is working to advance important state legislative and regulatory issues that protect you and your patients.


08/17/2023

OSMA Collaborates to Reform Medicare’s Payment System

August 17, 2023 – OSMA has joined with the AMA and other state and national medical association to reform Medicare’s broken physician payment system. The AMA sent the below alert to physicians across the country to contact members of congress when their home for the August recess. We encourage all OSMA members to contact congress and stress the importance of fixing Medicare now.


08/04/2023

OSMA Advocacy Priorities for Physician & Patient Mental Health Passed in Ohio Budget

August 4, 2023 – During the spring state budget process, OSMA advocated for funding to secure the 988 Suicide & Crisis Lifeline in Ohio, and changes to how to better protect physicians' personal data on the medical board's website.


08/02/2023

OSMA Advocacy Delivers: Medicaid Physician Fee Schedule Increase Coming in 2024

August 2, 2023 – During the spring state budget process, OSMA advocated for an increase in the Medicaid physician fee schedule. The final passed and signed version included language for a 5% increase.


07/20/2023

Monthly Advocacy Update from Monica Hueckel

July 20, 2023 – Hear firsthand from OSMA's advocacy leadership on current issues we're working on in the legislative space, including state budget wins for physicians and the practice of medicine, insurance and prior auth issues, public health topics, and some recent scope of practice activity.


07/05/2023

State Budget Bill Passed, Signed by Governor

OSMA Champions New Medicaid Physician Payment Increase Included in Budget Legislation

July 5, 2023 – 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.


06/15/2023

OSMA Provides Key Supportive Testimony for Ohio Prior Authorization “Gold Card” Bill

June 15, 2023 – HB 130 was introduced in the Ohio House in March by Rep. Kevin Miller (R-Newark), and is one of OSMA’s major legislative advocacy priorities this year. The bill, if enacted, would create an exemption system that rewards Ohio healthcare providers who consistently receive a prior authorization approval rate of 80% or more for a specific service, device, or drug in the prior 12-month period.


06/14/2023

OSMA Supports AMA “Fix Medicare Now” Initiative

June 14, 2023 – In addition to reforming prior authorization at the state and federal level, OSMA joins the AMA and organized medicine across the country to fix major flaws in the Medicare physician fee schedule.


05/31/2023

Cigna Update to Modifier 25 Policy

May 31, 2022 – Cigna has updated its modifier 25 policy to announce a delay in implementing the required submission of documentation to support the use of modifier 25 when billed with E/M CPT codes 99212 – 99215 and a minor procedure.


05/25/2023

Take Action: Contact Congress to Fix Prior Authorization

May 25, 2023 – In addition to our efforts at the state level with HB 130, OSMA is also involved with our national and state partners to reform prior authorization practices in Medicare Advantage plans.


05/25/2023

Introducing OSMA’s New President: A Q&A with Eric Drobny, MD

May 23, 2023 – We are thrilled to welcome Dr. Drobny as our new President, and we thank Dr. Brian Santin who tactfully completed his term. Read on to learn more about Dr. Drobny, his medical career, and his vision for leading OSMA.


05/17/2023

OSMA Spring Legislative Update

May 17, 2023 - The OSMA government relations team continues activity related to the state budget bill, which recently passed out of the Ohio House and is now in hearings in the Ohio Senate Finance Committee. As summer approaches, OSMA has been involved in advocacy efforts regarding several pieces of legislation in the last few weeks.


05/16/2023

Public Health Emergency Ends

May 16, 2023 - On Thursday, May 11, 2023, the federally declared Public Health Emergency (PHE) ended. As many flexibilities for physicians and practices were provided by federal regulatory agencies during the PHE, it is important to know which, if any, of those flexibilities will be going away.


05/04/2023

Medicare Annual Visits: How to make them work in your office

May 4, 2023 - Medicare annual wellness visits provide an important opportunity to promote health and to provide disease screening and advance care planning with patients who have Medicare. However, billing for the wrong visit or at the wrong time can result in denied claims.


05/04/2023

Tort Reform in Ohio: 20-Year Anniversary Reflections

May 4, 2023 – OSMA Exclusive Partner, The Doctors Company (TDC) CEO and Chairman, Dr. Richard Anderson reflects on the history of tort reform in Ohio.


05/03/2023

Are Employee Health Insurance Costs Giving You a Headache?

May 3, 2023 – OSMA can help. According to a recent survey of 1,000 employers by Forbes Advisor, employer-sponsored health coverage is the most important benefit to employees in 2023. Yet one of the biggest costs facing employers today continues to be health insurance coverage for employees.


05/03/2023

United Healthcare to Reduce Prior Authorizations

May 3, 2023 - OSMA's continued focus at the state and federal level is starting to result in individual plans announcing revisions to prior authorization practices. We’re also supporting HB 130 in Ohio that creates a prior authorization gold card and we anticipate additional legislation in Ohio related to prior authorization and billing later this year.


04/27/2023

OSMA Advocates for Medicare Physician Payment Changes

April 27, 2023 – OSMA has joined with more than 120 other state and national medical societies communicating our support to the sponsors of H.R. 2474—the Strengthening Medicare for Patients and Providers Act.


04/25/2023

Advocacy Update on Non-Compete Proposed Rule 

April 25, 2023 – In January of this year, the Federal Trade Commission issued notice of a proposed rule which would prohibit non-compete agreements between nearly every employee/employer under the FTC’s jurisdiction, including physician employment agreements.


04/24/2023

OSMA/National Response to Cigna's Re-release of Modifier 25 Policy

April 24, 2023 – Cigna is re-releasing its policy to require the submission of medical records with all Evaluation and Management (E/M) claims with CPT 99212-99215 and modifier 25 when a minor procedure is billed. Last week, OSMA joined the AMA and almost 100 other state and national medical/specialty societies in a collective letter urging Cigna to reconsider this policy.


03/30/2023

We Need Your Help to Make the Prior Authorization Gold Card a Reality in Ohio!

March 30, 2023 – This is an important time for healthcare in the Ohio legislature, as House Bill 130 was introduced—which, if passed, will create a Prior Authorization Gold Card Program for Ohio providers. Get involved and help us drive meaningful change in the insurance industry.


03/30/2023

Prior Authorization Gold Card Legislation Introduced in Ohio House

March 30, 2023 – Proposed HB 130 would ease regulatory burdens of prior authorization, improve healthcare system and outcomes for patients. 


03/23/2023

OSMA Comments on Federal Prior Authorization Rules

March 23, 2023 – Prior Authorization reform is OSMA’s top advocacy issue in 2023 and 2024. In addition to advocating for major legislative reforms at the state level that will impact commercial and Medicaid plans, we have also been involved in initiatives at the federal level that will impact Medicare advantage plans.


03/02/2023

OSMA Needs Your Help—New Prior Authorization Legislation to Be Introduced

March 2, 2023 – The goal of this legislation, which will be sponsored by Rep. Kevin Miller (R-Newark), is to create a “gold card” system for prior authorization, giving physicians a way to “earn” their way out of prior authorization requirements by demonstrating a high prior authorization success rate. Similar legislation was recently passed and enacted in the state of Texas.


04/26/2022

Introducing OSMA’s New President: A Q&A with Brian Santin, MD

April 26, 2022 – We are thrilled to welcome Dr. Santin as our new President, and we thank Dr. Lisa B. Egbert who tactfully completed her term. Read on to learn more about Dr. Santin, his medical career, and his vision for leading OSMA.


04/23/2021

Introducing OSMA’s New President: A Q&A with Lisa Egbert, MD

April 23, 2021 – We are thrilled to welcome Dr. Egbert as our new President, and we thank Dr. Anthony Armstrong who skillfully completed his term. Read on to learn more about Dr. Egbert, her medical career, and her vision for leading OSMA.


02/11/2021

Health Equity Q&A with OSMA President Anthony Armstrong, MD

February 11, 2021 - The COVID-19 pandemic and elevated conversations about racial justice have brought the issue of healthcare equity to the forefront for healthcare professionals everywhere. As we support members in 2021, we’re pleased to share thoughts from OSMA President Anthony Armstrong, MD on health equity and what this means for Ohio physicians.


08/01/2019

Ohio Physicians Give Feedback on Medicaid Managed Care Program

Many of our members provide daily patient care to Ohio’s Medicaid population and thus are uniquely qualified to provide meaningful information to assist the Ohio Department of Medicaid in its upcoming competitive Medicaid managed care procurement process. The comments we received from our members generally centered on areas where improvement is most desired, including plan accountability, grievances and appeals, provider support, benefits and delivery, and care coordination and management.


07/23/2019

Wrap Up: Ohio Delegation to the American Medical Association

Your OSMA Delegation to the AMA worked diligently on behalf of Ohio physicians during the recent 2019 Annual Meeting in Chicago. Ohio resolutions were carried forward and either adopted as new policy or committed the AMA to continue existing policy for another ten years.


07/18/2019

Ohio Budget Process Complete

The OSMA Government Relations team has been engaging with legislators on health care-related budget items since the governor’s initial proposal was released, and has been following and participating in the ongoing debates about a number of health policy decisions.


03/28/2019

Dollars & Sense: The State Budget

Earlier this week, the state budget became a bill on Capitol Hill—or at least on Capitol Square in Columbus, Ohio. The OSMA has completed an initial review of the bill language...


02/28/2019

OSMA Goes to Washington

Earlier this month, several OSMA members along with the OSMA Government Relations staff traveled to Washington DC to meet with members of Congress to discuss how existing laws are affecting patients and practices.


02/14/2019

What is the OSMA Doing for You?

With a new governor in office and Ohio legislators back at the Statehouse, the OSMA is putting our advocacy agenda—based on the priorities of our members—in motion.


01/08/2019

Ohio’s Lame Duck Legislative Session 2018 – What Happened & What You Should Know

The final months of 2018 were a whirlwind beyond the usual frenzied legislative activity of “lame duck” – with Ohio’s legislators staying in session until just days before the Christmas holiday, and returning for more action just days after. This scenario is extremely rare and hasn’t happened in Ohio’s legislature to this extent in decades.