Posted by Behavioral Health Billing Solutions, LLC

According to an article in the Columbus Dispatch,

Nine of the 11 vetoes that state representatives voted to override in the state budget last week are related to Medicaid, though not the big veto on the plan to freeze Medicaid expansion enrollment next year.

That was likely no accident, because Medicaid was in the spotlight and under the microscope this time.

These overrides of Gov. John Kasich’s vetoes were the first in 40 years

There have been occasional disagreements between Ohio’s Republican-dominated House and Senate and fellow Republican Gov. John Kasich. But he’d issued more than a hundred vetoes in his seven years in office without one being overturned.

In a day, that changed dramatically.  For the first time in 40 years, state lawmakers voted to override a budget veto. And they did it 11 times, leaving only 36 of Kasich’s 47 vetoes, which were the most he’d ever issued on a spending plan. 

Another article on July 7th, talks about the overrides and House Finance Chair Ryan Smith,a Bidwell Republican, said the overrides were an appropriate show of force by state lawmakers, who are very concerned about spending, especially in Medicaid.

The Senate still needs to agree with these overrides. The House won’t return until September, but the Medicaid expansion enrollment freeze, along with Kasich’s 35 other vetoes, could be overridden at any time before the two-year session ends in December of next year.

So the question is, if Senate still needs to approve and has potentially cancelled any sessions prior to the summer break, what does this mean for Ohio Medicaid and the BH Redesign?

Does it all go on hold pending the next session? Will testing re-open soon or stay closed “pending a new date”? I’m thinking we need to ask that question. Email your Senator todayto find out what the plan is.

I sent the email below to several including Senate President Larry Obhof and Senator Joe Schiavoni. I received a response from Senator Schiavoni this morning. Unfortunately, as I suspected, it’s not good news. 



To: State Senator Joe Schiavoni
Subject: RE: Budget and Finance

Senator Schiavoni,

My experience with politics is limited to the past 3 months so I’m trying to understand what the House veto’s mean.

The final budget was signed with 46 line item veto’s. The House overrode 11 of those veto’s but they still need approved by Senate and yet, it appears you’ve cancelled your session scheduled for July 12th. Does this put everything on hold?

My concern is both the House and the Senate have done a great thing by delaying the BH Redesign. We simply weren’t ready.

However, if a final date is not given to Medicaid, what does that mean for testing and attempting to get the numbers now written in the budget to require 50% successful testing? My guess is they will delay re-opening testing for providers which will put everything on hold again.

Any input or insight you can provide on this process would be greatly appreciated.

Thank you for your continued diligence,

Teresa Heim

Subject: RE: Budget and Finance


I hope this email finds you well. I would be happy to provide you with some information on the process. Everything that the Governor signed into law, will take effect immediately, the only aspects of the budget that are being held up are the 47 items the Governor vetoed. You are correct that Kasich did  veto the initial delay on the roll into managed care.  You are also correct that the Senate needs to address the House overrides before the vetoes can be considered truly overridden allowing those provisions can become law. The behavioral health redesign delay will not happen unless both chambers address the veto.  The Chambers do have the ability to address any of the veto items until December 2018. I am not sure when or if the Senate President Obhof, plans to try and override any veto items. The majority makes the decisions regarding session and committees. I  hope this information is helpful to you.

If you have any other questions or concerns, please let me know,

Joe Schiavoni

This afternoon, Ohio Council provided further information on this moving target.

The state budget bill for FY 2018-19 has been signed by the governor. Read on for summaries of budget provisions that affect behavioral health, family services, and addiction treatment.

Neither the House of Representatives nor the Senate have sessions scheduled until fall, though committees may continue their activities through the summer. 

BH Redesign in the Final Budget Bill

The Conference Committee maintained the six-month delay of both the Medicaid service/coding changes and integration of BH services into managed care (“carve in”) to January 1, 2018 and July 1, 2018, respectively.  However, Governor Kasich vetoed bill language moving the carve-in to managed care, leaving the implementation dates for both BH redesign and the carve in at January 1, 2018. The House overrode the governor’s carve-in date veto, but the governor’s veto stands unless the Senate also acts to override the veto.

The bill retained the IT beta testing language that requires at least 50% of providers voluntarily participating in testing to be able to submit and receive a properly adjudicated claim prior to implementation of BH Redesign.  The bill also retains the requirement for ODM and MHAS to adopt rules, finalize the BH Provider Manual, IT specifications, and all training materials to support BH Redesign by October 1, 2017.