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Judge Temporarily Blocks Ohio Ban on Gender-Affirming Care for Trans Youth

A Columbus judge on Tuesday, April 16th temporarily blocked a controversial bill banning gender-affirming care for transgender youth and prohibiting trans students from participating in athletics on teams that align with their identity.

Judge Michael Holbrook issued a temporary restraining order on House Bill 68, which would have prevented minors from accessing care such as hormone blockers, hormone replacement therapy and some mental health services.

It would have also prohibited trans athletes from taking part in middle and high school sports. The TRO is for two weeks, but it is renewable. The law was expected to go into effect next week.

Earlier in the week, a Joint Committee on state rules declined to invalidate a rule developed by the Ohio Department of Health that would ban gender transition surgeries for youth and referrals for such interventions. 

Several other rules related developed by the departments of Health and Mental Health & Addiction Services were delayed and put into a refiled status.

 

OhioMHAS Virtual Data Forum — April 24

The Ohio Department of Mental Health and Addiction Services (OhioMHAS) is pleased to announce our next Data Forum on April 24, 2023, from 3:00 p.m. to 4:15 p.m. The purpose of the Data Forums is to:

  • highlight new data resources, share information about current and upcoming data projects;
  • facilitate opportunities for peer-to-peer learning;
  • demonstrate how data can be used in the daily practice of ADAMH Boards and Behavioral Health providers; and
  • discuss local needs related to data and data infrastructure.

The Data Forum series will convene on a quarterly basis to provide a venue for sharing timely and useful best practices, examples, and resources for ADAMH Boards and behavioral health providers that may be implementing or updating their own data systems and data analytic capabilities.

Intended Audience

This resource is intended for any stakeholders who are interested in learning about data and data resources, including ADAMH Board and Behavioral Health provider leadership and staff who work with, manage, and communicate data at all levels.

APRIL DATA FORUM AGENDA

  1. Peer-to-Peer Learning – Lessons Learned in Utilizing Local Data from Suicide Fatality Review Committee, Dallas Allen, Franklin County Coroner’s Office
  2. Peer-to-Peer Learning – Data Sharing and Analysis of Local Behavioral Health Hospital Data, Dr. Anju Mader, MD, Stark County Mental Health & Addiction Recovery
  3. New Data Product – Annual Data Brief
  4. Update – Data Modernization Project

Click Here to Register

Contact [email protected] if you have any questions. 

 

Only 8% of Medicaid and 4% of Medicare Enrollees Received Behavioral Health Services

New government findings outlined in a recently issued report add details to the lack of availability of behavioral health services for America’s poor and elderly.

The Office of Inspector General (OIG) for the U.S. Health and Human Services Department found that about one-third of behavioral health providers in selected counties serve patients in the Medicare, Medicare Advantage, or Medicaid programs.

The report focuses behavioral health services offered during 2021 -- a time before significant action was taken by the agency that oversees the three programs, the Centers for Medicare & Medicaid Services (CMS), along with the White House and Congress.

Medicare spends an estimated $27 billion a year on behavioral health services, while about 1-in-4 members are coping with a behavioral health condition. For Medicaid, the cumulative spending totals about $52 billion, while adult members experience mental health conditions at a rate of 29% and substance use disorders (SUD) at about 21%, the report states. Some of the causes of the shortage are well-known in the industry: the administrative burden of participating in certain health plans (especially the prior authorization and credentialing processes), low payment rates by payers and overall provider shortages.

 

Potential Action Required to Avoid Medicaid Termination - PNM SSN Verification 

We wanted to ensure Ohio Council member organizations are aware that the Ohio Department of Medicaid (ODM) will be validating provider organization information in the PNM against the Social Security Administration Death Master File this weekend. Several hundred organizations, including behavioral health providers, were terminated in February the last time this was conducted. ODM has contacted the previously impacted organizations that have yet to make the required updates in the PNM since February. ODM called and sent the below email to organizations that must take action TODAY or your organization will be terminated from Medicaid and you will be required to submit a new Medicaid provider enrollment application for your organization with a required site visit. This process can take up to 90 days or longer.

If your organization received a call from ODM or the email below, ACT NOW and follow the steps outlined below to avoid termination of your Medicaid provider agreement. ODM will not be reinstating terminated organizations as they did in February. Please note, if you completed the process below and your organization is in a pending or submitted status in the PNM, you will not be terminated. If your organization was not terminated in February and/or was not contacted by ODM this week, there is no action necessary. However, providers should ensure they have a process to updated information about ownership, control interest, and managing employees in the PNM for their organization as this validation will be conducted monthly.


Action Required: Update Your PNM SSN/TIN Owner Information To Avoid Termination

Attention Medicaid provider,

All Ohio Medicaid provider organizations must disclose and maintain information about ownership, control interest, and managing employees in the Provider Network Management (PNM) module as part of their Medicaid Provider Agreement. The Ohio Department of Medicaid is required to verify that individuals and organizations disclosed for this purpose are screened against several federal exclusion databases. The PNM module automatically runs these checks on a monthly basis.

If you are receiving this email, our records show that one of your organization’s disclosed owners or managing employees is triggering a match on the Social Security Death Masterfile, a federal exclusion database. You must take immediate action to avoid termination.

Required action:

  • Log into the PNM and complete an update.
  • Medicaid-only providers should choose “Begin Reapplication” or “Begin Revalidation.”
  • Providers with Department of Developmental Disabilities contracts need to choose “Begin DODD Enrollment.”
  • Check for the following common issues:
    • The person listed as an owner or managing employee is deceased and the owner or managing employee record needs to be end-dated on the provider's application.
    • A person provided an employee identification number in lieu of a social security number. State and federal regulations require that individuals disclose their social security number.
    • A person’s social security number is mistyped.

Note: If you submitted an update to this information that Ohio Medicaid is currently reviewing, you do not need to take any further action.

For more information:

Access the Updating or Adding Owner Information Quick Reference Guide for step-by-step instructions on how to update your provider information in the PNM. For technical support or assistance, contact Ohio Medicaid’s Integrated Helpdesk (IHD) at 800-686-1516 and follow the prompts for provider enrollment (option two, option two) or email [email protected]. Representatives are available Monday-Friday, 8 a.m.-4:30 p.m. Eastern time.

 

More Americans Forgoing ADHD Meds As Shortages Drag On

Shortages of commonly prescribed drugs for attention deficit hyperactivity disorder have stretched on for nearly 18 months, with no clear end in sight for many Americans who've found it difficult if not impossible to get the treatments.

Why it matters: As demand for stimulants like Adderall and Vyvanse soared, the fill rate for such prescriptions has dropped more than 10% in two years, according to a new analysis from health analytics firm Truveta.

Patients struggling to find ADHD drugs have aired their frustrations in thousands of comments filed to the Federal Trade Commission, which is studying possible factors driving shortages.

"I have not been able to fill my prescription at any pharmacy I've been to including Costco, CVS, Publix, Walmart, and local discount pharmacies," wrote a man who identified himself as a medical student in the Miami area.

One woman said she's had trouble each month filling a prescription for her son, a sixth grader. "Recently his teacher asked him to find a way to 'just stay home' until his medication becomes available again," she wrote. "Can you imagine what it feels like for a child to hear this?"

Between the lines: Likely drivers of the shortages include pandemic-driven increases in demand, caps on production of the drugs, and the threat of rolling back rules making it easier to prescribe stimulants virtually.

 
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