Relationships. Commitment. Results.

icon Careers

Category: Healthcare & Dental

Ohio Department of Medicaid Starts Process to Make Telehealth Services Permanent

and
September 17, 2020

September 17, 2020

On September 1, 2020, the Ohio Department of Medicaid (“ODM”) announced it has started the process to make a current temporary rule related to telehealth services permanent. In March 2020, ODM implemented a temporary rule designed to expand the use of telehealth services in response to the COVID-19 pandemic.  Based on a significant increase in the usage of telehealth services, ODM now wishes to make the expansion permanent, and has submitted a proposed permanent rule for review and approval.

Prior to the COVID-19 pandemic, ODM providers submitted less than 1,000 telehealth claims per month for physical health services, and around 4,000 telehealth claims per month for mental health and addiction services.  Since the implementation of the temporary rule, ODM providers have submitted 1.3 million claims for physical health services, and 1.28 million claims for mental health and addiction services.

The proposed rule includes a change in the definition of telehealth.  Formerly, telehealth consisted of health care services provided by secure, synchronous, interactive, real-time electronic communication between the patient and the practitioner with both audio and video elements.  Under the proposed rule, telehealth would now include health care services that are provided via a communication that is asynchronous or that does not have both audio and video elements, including telephone calls, remote patient monitoring, and communication through secure e-mail and patient portals.  Under the previous rule, these activities were not considered telehealth.

The proposed rule also increases the types of practitioners eligible to render telehealth services to ODM patients. Additional eligible practitioners include dentists, optometrists, audiologists, and occupational and physical therapists.  The proposed rule also adds to the types of telehealth services that may be paid for by ODM.  Some of the additional covered telehealth services include:

  1. Remote evaluation of recorded video or images submitted by an established patient;
  2. Virtual check-in by a physician or other qualified health care professional who can report evaluation and management services, when provided to an established patient;
  3. Online digital evaluation and management services, when provided to an established patient;
  4. Remote patient monitoring;
  5. Audiology, speech-language pathology, physical therapy, and occupational therapy services;
  6. Limited or periodic oral evaluation; and
  7. Optometry services.

The proposed rule is currently under review by the Joint Committee on Agency Rule Review, with a hearing scheduled for October 1, 2020.  ODM anticipates the review being completed and the rule being approved before the current temporary rule expires on November 14, 2020.

The significant increase in the amount of ODM patients utilizing telehealth cannot be ignored.  Many healthcare professionals are taking steps to permanently modify their practice operations in order to accommodate the increased demand for telehealth services.

Kari Heinze is an associate in Walter | Haverfield’s Columbus office. She focuses her practice on business services within the healthcare and dental practice arena. Kari can be reached at kheinze@walterhav.com or at 614-246-2266.  

Vince Nardone is Partner-in-Charge of Walter | Haverfield’s Columbus office. He serves as a business advisor to owners and executives of closely-held businesses, counseling them on business planning, tax planning and controversy, cash-flow analysis, succession planning, and legal issues that may arise in business operations. Vince can be reached at 614-246-2264 or vnardone@walterhav.com.

Updated CDC Guidelines for Aerosol-Generating Procedures in Dental Practice Settings


June 3, 2020

June 3, 2020 

Ohio’s dental practices reopened for non-emergency services on May 1, 2020. The Ohio State Dental Board implemented several guidelines for dental practices to follow upon reopening, including a requirement to adhere strictly to infection control protocols and personal protection equipment (“PPE”) guidelines set forth by the American Dental Association’s Return to Work Toolkit and the Centers for Disease Control and Prevention (“CDC”). On May 19, 2020, the CDC updated its infection prevention and control guidelines with respect to dental practice settings during the COVID-19 pandemic.  The updated CDC guidelines included new recommendations for the use of PPE during aerosol-generating procedures.

The CDC continues to recommend that aerosol-generating procedures be avoided if possible. But, there are many situations in which aerosol-generating procedures must be performed. Prior to May 19, 2020, the CDC advised that aerosol-generating procedures should be performed only with the use of a n95 respirator mask. If a n95 respirator mask was not available, the CDC previously recommended that the aerosol-generating procedure not be performed. The CDC’s updated guidelines have revised this recommendation. The CDC still recommends that aerosol-generating procedures should be performed with the use of a n95 respirator mask, if available. But, if a n95 respirator mask is not available, the CDC now recommends that the aerosol-generating procedure should be performed with the use of a FDA-approved surgical mask and a full face shield. If a n95 respirator mask, or a FDA-approved surgical mask and full face shield are not available, the CDC advises that the aerosol-generating procedure should not be performed.

In addition to a n95 respirator mask or a FDA-approved surgical mask and full face shield, dental professionals should wear gloves, eye protection, and a gown or other protective clothing when performing an aerosol-generating procedure. Further, the CDC guidelines also call for the use of four-handed dentistry, high evacuation suction, and dental dams to minimize droplet spatter and aerosol release. The CDC also indicates that the number of dental professionals present during the aerosol-generating procedure should be limited to only those essential for patient care and procedure support.

The CDC continues to remind dental practices of the importance of ensuring that the dental practice has the appropriate amount of PPE and supplies to support its patient volume. If PPE and supplies are limited, the CDC advises dental practices to prioritize dental care for the highest need, most vulnerable patients first. To review the CDC’s updated guidelines, please visit the CDC’s website.

For more information on the new infection prevention and control guidelines set by the CDC for dental practices in response to COVID-19, or if you have questions regarding the application of these guidelines, please contact Kari Heinze.

Kari Heinze is an associate at Walter | Haverfield who focuses her practice on business services within the healthcare and dental practice arena. She can be reached at kheinze@walterhav.com or at 614-246-2266.