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.

11/07/2024

OSMA Legislative “Lame Duck” Preview

Nov. 7, 2024 - OSMA’s Advocacy team is prepared to be all hands on deck through the last day of session in December. Lame duck can be an unpredictable time, but we do have a general idea of what issues may be in focus, and where our priorities will be in the coming weeks.


11/06/2024

OSMA's Election Takeaways – 2024 Recap & Results

Nov. 6, 2024 – Get our overview of what happened and how the OSMAPAC’s endorsed candidates fared in this week’s elections. And stay tuned for advocacy updates as the Ohio Legislature moves into its lame duck session!


10/31/2024

Take Action Now: Medicare Physician Payment Reform Bill Introduced

Oct. 31, 2024 - Your action is needed to help pass bill HR 10073 to eliminate the proposed Medicare cut and include an actual payment increase to support physicians.


10/17/2024

Medicare Physician Payment - Physician Advocacy Effort Helps Generate Significant Response from Congress

Oct. 17, 2024 – As you may recall, we recently put out a call for physicians to contact their representatives in Congress and encourage them to urge House leadership to expeditiously replace the 2.8% Medicare physician payment cut with a payment update reflective of inflationary pressures before January 1, 2025.


10/16/2024

OSMA Joins Court Brief to Protect Children from Flavored Tobacco

Oct. 16, 2024 – OSMA recently signed on to an amicus (“friend of the court”) brief in a case concerning the State of Ohio’s authority to prohibit municipalities from banning flavored tobacco products.


09/17/2024

We Need Your Help! OSMA Continues Advocacy Efforts for Medicare Payment Reform

Sept 17, 2024 – Our goal is to get House leadership to take immediate action to not only stop the 2.8 percent cut to physician Medicare payments, but also to provide physicians with a much-needed payment update that reflects the inflationary pressure they're facing while running a medical practice.


09/05/2024

OSMA Comments on Proposed 2025 Medicare Physician Fee Schedule Rules

Sept 5, 2024 – Today, OSMA submitted comments to CMS on the proposed 2025 Medicare physician fee schedule rules.


09/05/2024

UnitedHealthcare® Announces Details of Prior Authorization Gold Card to Start

Sept 5, 2024 – For the last year, OSMA has been advocating for HB 130 that would create a prior authorization gold card program for physicians in Ohio. As these efforts continue, one of the biggest payers in Ohio, UnitedHealthcare (UHC), has announced the details of a gold card program they will implement in Ohio and across the nation starting October 1.


08/29/2024

Franklin County Judge Issues Temporary Injunction Against Various Abortion-Related Statutes

Aug 29, 2024 – A judge in Franklin County has temporarily blocked a few abortion related statutes in Ohio, citing Ohio’s recently passed constitutional amendment language.


08/21/2024

Federal District Court Blocks FTC Non-Compete Ban

Aug 21, 2024 – The Federal Trade Commission’s (FTC’s) recently finalized rule banning non-compete agreements across the country will not be going into effect on September 4, as a Texas Federal District Court Judge has struck down the rule.


08/15/2024

OSMA Files Brief Defending Physicians from Broadening Exposure in Medical Malpractice Claims

Aug 15, 2024 – OSMA's advocacy team is constantly reviewing cases both at the state and federal level for any impact on our members. Of all of the issues we handle, medical malpractice laws protecting providers are the ones almost continuously under attack in litigation.


08/14/2024

Legal Update: What is Impacting Healthcare in Ohio?

Aug 15, 2024 – Litigation and legislation concerning gender-affirming care have both exploded over the past few years. In particular, many states have enacted laws that prohibit gender-affirming care for minors.


08/12/2024

Support the OSMAPAC in this Critical Election Year!

Aug 14, 2024 – OSMA is always there for you to help make your voice heard on the issues that matter most – and the Ohio State Medical Association Political Action Committee (OSMAPAC) is crucial to our continued success.


08/07/2024

No Surprises Act Court Decision Supports Physician Practices

Aug 7, 2024 – Recently, the US Fifth Circuit Court upheld a lower court surprise billing decision in favor of healthcare providers. The court held that a federal rule concerning the arbitration process in payment disputes of surprise billing claims conflicts with the Administrative Procedures Act and that the federal departments exceeded their rulemaking authority.


07/25/2024

Summer Regulatory & Legal Update

July 25, 2024 – Compliance Reminder: HIPAA Reproductive Privacy Rule implementation has essentially updated HIPAA for providers in three ways. Also, read the latest on gender-affirming care cases, i.e. the Supreme Court case United States v. Skrmetti, and how a Franklin County judge issued a temporarily injunction for the enforcement of the House Bill 68 legislation, which would prevent transgender youth from receiving gender-affirming care.


07/18/2024

OSMA Mid-Year Advocacy Wrap Up

July 18, 2024 – The legislative sessions have been extremely hectic, with both chambers of the Statehouse moving a record number of bills through committee hearings and floor votes. Your OSMA Advocacy team was actively involved as many of our priority advocacy issues were among those experiencing activity.


07/11/2024

HHS Releases 2025 Medicare Physician Fee Schedule Proposed Rules—Reductions Continue

July 11, 2024 – On July 10, the U.S. Department of Health and Human Services (HHS) released the 2025 Medicare Physician Fee Schedule Proposed Rules. In the press release, HHS stated the following related to 2025 rates...


06/19/2024

Legislative Advocacy Update – June

June 19, 2024 – The OSMA advocacy team has had an action-packed several weeks at the Statehouse in Columbus as legislators prepare to wrap up their sessions for the summer recess before the upcoming fall elections.


06/18/2024

Recent Medical Board & Legal News

June 18, 2024 – Get an update on the Supreme Court decision on Mifepristone, what the Ohio Med Board has rejected as qualifying conditions for the recommendation of medical marijuana, and a new HIPAA privacy rule.


06/18/2024

Legislation Reintroduced to Reform Medicare Advantage Plans use of Prior Authorization 

June 18, 2024 – A bipartisan bill, Improving Seniors’ Timely Access to Care Act (S. 4532 / H.R. 8702), has been reintroduced at the federal level to reform the use of prior authorization by Medicare Advantage plans. Both Ohio Senators—Brown and Vance—have co-sponsored the bill as well as congressman Balderson, Carey, Latta and Wenstrup. In total there are 135 U.S. House of Representatives and 45 senators signed on as co-sponsors.


06/13/2024

Ohio Physician Leaders Attend AMA Annual Meeting

June 13, 2024 – Over the last week, a delegation of Ohio physicians elected by members of the OSMA attended the American Medical Association’s Annual Meeting—joining with colleagues from across the country to review and debate policy. There were also a number of physicians from Ohio elected or appointed to leadership positions.


05/15/2024

May Legislative Advocacy Update

May 15, 2024 – Our OSMA Advocacy team is currently facing the additional challenge of limited chances for movement on our priority issues, but thankfully we can report that due to our efforts, progress continues for the OSMA advocacy agenda.


05/14/2024

Feds Solicit Complaints for Anti-Competitive Behavior in Healthcare

May 14, 2024 – In late April of this year, the Federal Trade Commission, Justice Department, and Department of Health and Human Services announced a joint online portal to solicit complaints from providers and members of the public to report anti-competitive behavior in the healthcare marketplace.


05/14/2024

Ohio Medical Board Receives Expert Reports on Medical Marijuana Conditions

May 14, 2024 – At its May meeting, the State Medical Board received expert third-party reports for the petitions to add two new conditions to the Board’s list of those permissible for a medical marijuana condition.


05/13/2024

Planned Parenthood Challenges Additional Ohio Abortion Laws

May 13, 2024 – Last week, Planned Parenthood motioned the court in their case to file an amended complaint to include the recently-passed Constitutional right to abortion as support to their initial claims—which challenged an Ohio law that required any initial dose of medication-induced abortion to be consumed by the patient while physically present in the same location of their physician.


04/24/2024

State Medical Board & Regulatory Update

April 24, 2024 – The State Medical Board of Ohio's recent activity has been around topics of adopting the official licensure status of "retired," working on Board rules concerning Medication-Assisted Treatment, and a newly-hosted podcast to inform members and the general public on current Board matters.


04/18/2024

Legislative Update: Gender Affirming Care Legislation for Ohio Youth Temporarily Blocked by Judge

April 18, 2024 – This week, a Franklin County judge issued a temporary injunction for the enforcement of House Bill 68, legislation which would prevent transgender youth from receiving gender-affirming care.


04/18/2024

OSMA’s Advocacy Results in Directive from the Department of Insurance on Change Healthcare

April 18, 2024 – Last month, OSMA and OHA sent a joint letter to the Ohio Department of Insurance (ODI), requesting a directive be sent to all licensed health insurers in Ohio to create flexibility for physicians' and hospitals' interactions with payers due to the major disruption caused by the Change Healthcare cyberattack. Last week, ODI followed through on this request and sent a notice to all payers outlining the specific requests that we made.


04/17/2024

BWC Virtual Provider Forum on Physician’s Report of Work Ability is April 24—Have Your Voice Heard

April 17, 2024 – If your practice sees patients covered by worker’s compensation, you now have a chance to interact with the Bureau’s leadership and medical directors regarding the Physician’s Report of Work Ability. BWC sent out the following notice—don’t miss your chance to connect with key leaders and physicians.


04/11/2024

2024 OSMA Annual Meeting Recap

April 11, 2024 – This past weekend, OSMA members from across the state gathered together in Columbus for the OSMA Annual Meeting—an opportunity to network, share ideas, and conduct important policy work on behalf of their profession and their patients. Read on for a full summary of the event's happenings.


03/28/2024

Spring Legislative Preview

March 28, 2024 – Now that the March 19 primary elections have passed, the Ohio Legislature is expected to return to the Statehouse for a flurry of activity shortly after the upcoming holiday. The Ohio House and Senate will conduct a series of hearings and sessions from mid-April up until the legislators depart back to their districts for the summer recess and to campaign for the general election this fall.


03/26/2024

Are You Being Paid 2024 Rates? Check Your Medicaid Claims

March 26, 2024 – As a result of OSMA advocacy efforts last year, on Jan. 1 Ohio increased the Medicaid fee schedule resulting in the majority of codes increasing by 5% with a cumulative impact of about $400 million in new funding. The implementation of the increase has been challenging and it's essential that practices review their claims payment history since Jan. 1 to ensure you are receiving the appropriate increase.


03/21/2024

OSMA Seeks Ohio Department of Insurance Action on Change Healthcare Cyberattack

March 21, 2024 – OSMA and the Ohio Hospital Association (OHA) sent a joint letter to the Ohio Department of Insurance (ODI) to direct commercial health insurance plans in Ohio to provide administrative and financial relief for physician practices and hospitals impacted by the cyberattack on Change Healthcare.


03/20/2024

Partial Medicare Fee Schedule Fix Passed and Implemented

March 20, 2024 – While not erasing the entire 3.37 percent cut that went into effect on January 1, recent passage of the Consolidated Appropriation Act created a 1.68 percent update to the Medicare Physician Payment Schedule conversion factor.


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.


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.