On Tuesday, October 21, the Centers for Medicare & Medicaid Services (CMS) updated its Medicare claims hold guidance to Medicare Administrative Contractors, noting: “CMS instructed all Medicare Administrative Contractors (MACs) to lift the claims hold and process claims with dates of service of October 1, 2025, and later for certain services impacted by select expired Medicare legislative payment provisions passed under the Full-Year Continuing Appropriations and Extensions Act, 2025 (Pub. L. 119-4, Mar. 15, 2025). This includes claims paid under the Medicare Physician Fee Schedule, ground ambulance transport claims, and Federally Qualified Health Center (FQHC) claims. This includes telehealth claims that CMS can confirm are definitively for behavioral and mental health services."

Update on OSMA Activity with
Insurance Reform Legislation

Over the last few weeks, there has been a significant amount of activity on numerous insurance reform proposals that OSMA is supporting in the Ohio Legislature. Make sure you are caught up on all of the progress these bills are making—read on for a quick summary of the hearings thus far!

OSMA Legal & Regulatory Update:
Rural Health Funding & the Lyon Case

Two major issues are taking shape this fall that could impact physicians and patients across Ohio—one tied to new federal funding for rural health care, and another involving how Ohio courts handle damages in medical malpractice cases. Here’s what you need to know.