Posted by Behavioral Health Billing Solutions, LLC.

Today, the Ohio Senate held an off-season session to vote on a number of Governor Kasich’s veto items for budget bill 49. 

To see the historic vote, click on this link 

For the portion pertaining to Behavioral Health Redesign, go to 27.54 in the recording to hear two specific Senators speak as to why the Managed Care Carve-in needs to be delayed from the BH Redesign for 6 months, moving it to July 1st. 2018.

The first Senator to speak was Senator Oelslager from District 29. He is also the chair of the Senate Finance Committee, before whom I had the honor of providing testimony. He stressed the need to separate the BH Redesign from the carve-in of Managed Care, which is the piece Governor Kasich vetoed. 


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The next Senator to speak on this issue was Senator Ecklund from District 18 and he is also a member of the Senate Finance Committee. He stated that he originally opposed the override, but after meeting with colleagues and others, he now understands that although some agencies in his district state they are ready, many across Ohio are not.

He also stressed the part of the legislation that REQUIRES adequate testing and demonstrate successful results across behavioral health agencies. 


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The Columbus Dispatch was the first to announce this late summer action by our Ohio Senate. Voted items and the results are listed below, take note that the vote on overriding item #31 was 33-0.

For the complete story from the Dispatch, click here. 

‒ Nursing homes. Voted 32-1 to override a provision that changes the formula for Medicaid payments to nursing homes, providing an additional $237 million. This continues an ongoing struggle over Kasich’s efforts to curtail payments to nursing homes.

‒ Controlling Board. Voted 23-10 to override a provision limiting the amount of unanticipated revenue that the Controlling Board can approve to 0.5 percent of general revenue funds for that year. Kasich argued it could impede the ability of state agencies to respond to urgent situations.

‒ Medicaid coverage. Voted 23-10 to override a provision prohibiting the state from covering any new or optional Medicaid groups unless lawmakers have approved it in law. Kasich said it imposes on the Medicaid director’s authority to manage the program.

‒ Neonatal rates. Voted 33-0 to override a provision that requires Medicaid rates for certain neonatal and newborn services equal 75 percent of rates paid by Medicare.

‒ Behavioral health. Voted 33-0 to override a provision that delays the addition of behavioral health services into Medicaid managed care until July 1, 2018. Kasich argued this care coordination has been under development since 2014, and a delay would impose additional costs and hurt those benefiting from the services.

‒ Medicaid spending. Voted 23-10 to override a provision that requires the administration to get Controlling Board permission to spend about $227 million of state-share Medicaid expansion funding, and blocks such approval if the federal matching rate is changed.

‒ Medicaid rates. Declined to vote on a provision that would have required the Department of Medicaid to submit rate payment increases to the legislative Joint Medicaid Oversight Committee for approval. Kasich said it obstructs the director’s authority to manage the Medicaid program.

‒ Managed care. Declined to vote on a provision that would have prohibited nursing homes and most community-based waiver services from being added to Medicaid managed care unless authorized by lawmakers.

‒ Money for counties. Declined to vote on a provision that would have asked the federal government for approval ton increase franchise fees on Medicaid managed care services to make up for the $207 million per year that counties and transit authorities are losing from no longer being able to apply sales tax to those services. Lawmakers are still looking for solutions to this lost funding, and could bring up this override again in early September if county commissioners and Kasich cannot reach a deal.

‒ Healthy Ohio program. Declined to vote on a provision that would have required the administration to request a federal Medicaid waiver requiring certain Medicaid enrollees to pay into a modified health savings account.

Stay tuned for the reaction from ODM and the Governor’s office.