DeWine Signs HB 244

On Wednesday, Gov. Mike DeWine signed HB 244, which prohibits public universities from mandating COVID-19 vaccinations. The last-minute provision was added to HB 244, legislation that originally dealt with school enrollment for military children. The bill specifies vaccinations under emergency use authorization, which is the current status of all three COVID-19 vaccines. It also prohibits schools and universities from placing requirements, such as mask-wearing or social distancing, on unvaccinated students.

On Tuesday, DeWine said the FDA should grant full approval to the COVID vaccines as soon as possible. While he did not comment on HB 244 upon signing, his spokesperson said “We are confident that these vaccines, proven repeatedly to be very safe and very effective, will be approved by the FDA, thus rendering this issue moot.”

The bill takes effect October 11.

Ohio Sees Uptick in COVID Cases due to Delta Variant

The state is experiencing an increase in COVID-19 cases caused by the delta variant. The Ohio Department of Health reported more than 400 daily cases of coronavirus this week, the second highest amount recorded in the last three weeks.

In May, the delta variant made up about 1.9% of all Ohio cases, according to ODH Chief Medical Officer Bruce Vanderhoff, MD. That statistic increased to 15% for June 6-19, and will likely be twice that when data becomes available for June 20-July 3. Nationwide, cases are rising in every state with the average of new cases at least 10% higher than a week ago—and 38 states are seeing at least a 50% increase, according to data from Johns Hopkins University

Vanderhoff said vaccination trends in the state have led to “two Ohios,” one that is vaccinated and protected, and one that is unvaccinated and vulnerable to the delta variant.

As of this afternoon, 48.36% in Ohio have started the vaccine process. That equates to more than 5.65 million Ohioans. Over 5.29 million, or 45.31%, have completed the vaccination series. On Wednesday, ODH officials said Ohio is close to 60% vaccination rate among those who are eligible. The rate is about 70% for those over 60, and is about 85% for those over 70.

Earlier this week, Gov. Mike DeWine said the state will soon begin another incentive program in an effort to boost the vaccination rate.

House of Delegates Convenes

The AOA House of Delegates convened this morning. The virtual meeting will run through Sunday. The OOA is well represented with 32 members serving as delegates.

The Ohio delegation is led by Chair George Thomas, DO, of Cleveland; Vice Chair Paul A. Martin, DO, of Dayton, and President Henry L. Wehrum, DO, of Columbus, who will chair the Ad Hoc Reference Committee.

Other OOA members who were appointed to reference committees include:

• Jennifer L. Gwilym, DO
  Educational Affairs
• Sean D. Stiltner, DO 
  Professional Affairs
• Chelsea A. Nickolson, DO
  Public Affairs
• Michael E. Dietz, DO
  Constitution & Bylaws
• Katherine H. Eilenfeld, DO
  Rules & Order of Business

The annual meeting brings together more than 500 osteopathic physicians and medical students from across the country to enact AOA policy and consider proposed resolutions, including five from Ohio.

Three Ohioans, Robert W. Hostoffer, Jr., DO, of Cleveland; Jennifer J. Hauler, DO, of Dayton; and Chelsea Nickolson, DO, of Dayton, serve on the AOA Board of Trustees. Nickolson, who holds the new physician in practice seat, was nominated for another one-year term.

State Board Seeks Nominations

The State Board of Emergency Medical, Fire, and Transportation Services (EMFTS) is seeking nominations for seat #2. It is designated for a physician who is active in the practice of trauma surgery and emergency medical services.

The 21-member Board represent fire and emergency medical services, private medical transportation services, mobile intensive care providers, air medical providers, trauma programs, hospitals, emergency physicians, EMS training programs, and the Ohio Department of Public Safety. Appointments are made by the Governor.

The Board generally meets every other month. Candidates should contact OOA Executive Director Matt Harney at mattharney@OhioDO.org for details about the nomination process.

Medicare Increases Payment for Cognitive Care

Alzheimer’s dementia affects one in nine people age 65 and older and kills more than breast and prostate cancer combined. The Centers for Medicare & Medicaid Services (CMS) has taken steps to address this public health crisis by increasing payment for and expanding access to cognitive assessment and care plan services.

Effective January 1, 2021, Medicare increased payment for these services to $282 (may be geographically adjusted) when provided in an office setting; added these services to the definition of primary care services in the Medicare Shared Savings Program; and permanently covered these services via telehealth.

The Cognitive Assessment & Care Plan Services (CPT code 99483) typically start with a 50-minute face-to-face visit that includes a detailed history and patient exam, resulting in a written care plan. If your patient shows signs of cognitive impairment at an Annual Wellness Visit (AWV) or other routine visit, you may perform a more detailed cognitive assessment and develop a care plan. Use CPT code 99483 to bill for this service. Part B coinsurance and deductible apply. You may bill this code separately from the AWV.

For more information on billing, go to www.cms.gov/cognitive. For more information on assessing cognitive impairment, go here.

Medical Board Issues Telemedicine Guidance

The State Medical Board of Ohio has a new FAQ about telehealth, as approved at the Board’s meeting this week. The eight-page document provides guidance on telemedicine in Ohio and SMBO’s resumption of enforcement on September 17, 2021, of its laws and rules requiring in-person visits in certain situations.