OHA State Advocacy Center

State Health Care Issues

BWC Payment Restructure
The Bureau of Workers' Compensation worked with various stakeholders – representatives of business, labor and manufacturing as well as the health care provider community – to cap fee increases to hospitals through 2006. But after labor union claims in July that alleged Ohio hospitals are overpaid for care to injured workers and a flurry of criticism surrounding the bureau's investment policies and performance, BWC abruptly backed away from the existing payment plan and implemented a payment structure that meant $50 million in cuts to hospitals, jeopardizing their ability to provide necessary care for injured workers.

OHA and a member hospital sued BWC Sept. 30 on claims the state did not follow required legal processes in instituting the $50 million cut in payments. The suit requested a temporary restraining order to block payment cuts, and the judge suggested the claims merited a hearing but declined to issue the restraining order.

These cuts come on the heels of the Taft administration's plans to drain another $310 million from hospitals’ Medicaid reimbursements through June 2007. A Medicaid payment freeze in the current state budget will cost hospitals $142 million while another $168 million will be cut by recalibrating rates paid for certain services. OHA and Ohio's hospitals will continue working to ensure the funding needed to continue providing quality health care services to their communities.

Letters
BWC Announces January 1 Start of New Inpatient Payment Plan - 12.14.06

BWC Postpones Implementation of DRG Reimbursement Methodology for Hospital In-patient Services

Testimony
OHIO ADMINISTRATIVE CODE 4123-6-37.1 “PAYMENT OF HOSPITAL SERVICES" July 24, 2006
Attachment: True Medicare DRG Payment
Charles Cataline, Senior Director, Health Policy, Ohio Hospital Association

Resources
Court decision: Appeals Court Upholds Hospitals' Victory in BWC Challenge - 3.30.07
OHA comments to BWC on Proposed Hospital Reimbursement and Provider Credentialing Changes

Court decision: Judge grants permanent injunction to stop use of rates - 5.08.06

Court decision: BWC must follow rule-making process - 12.09.05

OHA Motion for Temporary Restraining Order, Preliminary Injunction

Complaint for Declaratory Judgment and Injunctive Relief

OHA News Releases
OHA Won’t Oppose BWC Payment Plan - 7.24.06
Hospitals Win Suit Challenging BWC Cuts - 12.09.05
Hospitals Challenge Cuts for Care to Injured Workers; Suit Argues Failure to Follow Rules - 9.30.05
Judge Suggests Hearing on Hospitals' Challenge of BWC Cuts - 9.30.05

Contacts
Charles Cataline, Senior Director of Health Policy, charlesc@ohanet.org
Mary Gallagher, Vice President and General Counsel, maryg@ohanet.org

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