Ohio Counseling Conversations
Ohio Counseling Conversations
Couch to Capitol: June 2026 Legislative Updates
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Surprise insurance clawbacks, fast-moving Medicaid rule changes, and a growing stack of bills that reshape client access can make it feel like the ground is shifting under counselors’ feet. We lay out what’s changing in Ohio right now and translate policy language into practical realities for counseling practices, community agencies, and the people we serve.
SB 162 (SUPPORT) Third party payments are considered final one year after the payment is made and providers are given 60-days to appeal a claw back. Awaiting signature from Gov DeWine
HB 718 (SUPPORT) - Expands certification pathways for Qualified Mental Health Specialists (QMHS) and renames the Chemical Dependency Professionals Board to the Behavioral Health Professionals Board. In Committee; watching for updates.
EO 2026-01D (UPDATE) - New Ohio Medicaid rules that moderate provider credentialing and attempt to mitigate fraud: 5160-1-17.4 - Length and type of provider agreements; 5160-1-17.6 - Termination and denial of provider agreement; 5160-1-42 - Provider credentialing.
SB 315 (UPDATE) - Medicaid Fraud, Waste, and Abuse Bill impacting Medicaid providers, managed care organizations (MCOs), and other stakeholders in Ohio’s Medicaid program; Legal Analysis Shumaker
->The Ohio Council of Behavioral Health & Family Services Providers - Updated Guidance & ODM Provider Office Hours
HB 718 (SUPPORT) - Could create a formal path for Qualified Mental Health Professionals and rename the Chemical Dependency Professional Board to the Behavioral Health Professionals Board.
HB 346 (WATCH) - Creates redundant law that healthcare providers must report suspected child abuse.
SJR 10 (OPPOSE): Constitutional amendment that would enshrine the states' existing photo ID requirements into the state constitution; on the Ohio ballot in November.
HB 472 (OPPOSE): Waives ID and birth certificate fees for houseless individuals and includes a provision requiring absentee voters to present ID.
SB 276; SUB-SB 156 (OPPOSE): SUB-BILL which includes creating a requirement that 6-12 grade schools teach "Success Sequence.”
HB 347; HB 324 (OPPOSE) - Increased barriers to accessing timely abortions/abortion medication.
SB 274 (OPPOSE) - Removing a minor’s ability to access services in crisis without parental consent.
Justice Department Settles With Cleveland Clinic (UPDATE)
H.R.2616 (OPPOSE) - Restrictions in Education around LGBTQIA+ topics
Regulation for Federal Assistance (OPPOSE) - A sweeping overhaul of federal assistance rules; includes prohibitions on diversity, equity, inclusion policies or gender affirming practices.
American Counseling Association: Hill Day (ACTION) - Collaborate with ACA to meet up in Washington DC and engage in legislative advocacy.
->Article: A Counselor's Most Powerful Advocacy Tool
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- OCA Link Tree: https://linktr.ee/ohiocounseling
Created by the OCA's Media, Public Relations, and Membership (MPRM) Committee & its Podcast Subcommittee
·Hosted by Mariah Payne
·Pre-Production & Coordination by Marisa Cargill, Lauren Collins-Knight, Victoria Frazier, and Mariah Payne
·Editing by Marisa Cargill
Welcome to Ohio Counseling Conversations Couch to Capital, your quick connection from the counseling office to where laws meet lives. In this segment, we break down the latest legislative and judicial updates, policy changes, and advocacy efforts that impact counselors across Ohio. Whether you're licensed in training or just passionate about the field of counseling, we've got what you need to stay informed and empowered.
SPEAKER_01Hello, and welcome back to Couch2Capital. My name is Mariah Paint, and happy pride. Today we're going to be discussing Ohio's insurance clawbacks, Medicaid provider revalidation,
Welcome And Pride Month Context
SPEAKER_01the behavioral health professional boards, mandated reporting, and legislation that impacts voting access, funding, as well as more broadly, our communities. So to start us off today, we are looking at Senate Bill 162, which is related to insurance clawbacks. Senate Bill 162, also known as the insurance recoupment payment bills, changes how and when health insurers can claw back payments from providers. Under Senate Bill 162, a payment becomes final after one year instead of the current two years. Insurers must give written or electronic notice before they can recoup an overpayment, and providers will now have 60 days to appeal a recoupement instead of the previous 30 days. Once signed into
SB 162 Ends Surprise Clawbacks
SPEAKER_01a law, Senate Bill 162 is a direct counselor win. There's less exposure to surprise clawbacks, a shorter window where insurers can recoup payments, and more solid time for how a provider can respond when a clawback does happen. Movement on Senate Bill 162 is especially relevant following CareSource's attempt to initiate a very broad two-year retroactive clawback in April of this year. The predictability that's created by Senate Bill 162 benefits our clients indirectly. When providers have fewer arbitrary financial disruption, they're more likely to stay in network, which ultimately supports continuity of care. Senate Bill 162 passed the Senate in April 15th of this year, and it passed the House on June 10th of this month. It is now sitting on Governor Dewine's desk waiting for his signature to be officially enacted as a law. Speaking of Governor Dewine's desk, next we're talking about Medicaid provider revalidation. Governor DeWine signed Executive Order 2026-01D, which allows the Ohio Department of Medicaid to implement emergency rules requiring more frequent revalidation of providers who are flagged as higher risk for fraud. These emergency rules touch three sections of Medicaid provider policy: the length and type of provider agreements, the termination and denial of provider agreements, and provider credentialing. Broadly, these rules permit Ohio Medicaid to terminate
Medicaid Revalidation Rules And Fraud Flags
SPEAKER_01provider agreements if that provider has not provided a Medicaid service or has not billed a Medicaid program in more than one year. Additionally, it permits the denial of a provider's enrollment application when a federally approved pause is in effect, even if the enrollment application was received and waiting for approval before a formal moratorium. This order is part of Governor DeWine's broader anti-fraud push that includes a six-month mormatorium or a temporary pause on new provider enrollments in high-risk categories. Additionally, these emergency orders have accelerated the rollout of GPS-based electronic visit verifications for in-home services. Because of these emergency rules, they're already reshaping revalidation and credentialing timelines for Medicaid providers, faster than standard rulemaking would typically allow. If you bill Medicaid especially for in-home and personal care categories, it's worth reading the actual language now in the Ohio Administrative Codes. We've attached links to these rules in our show notes. We highly encourage you to give them a look. Following on the Medicaid fraud, waste and abuse, we are next talking about Senate Bill 315. Senate Bill 315 has been one of the biggest stories of this session. It started as House Bill 795, sponsored by Representative Josh Williams, and it went through several versions, touching on home and community-based services, electronic visit verification, Medicaid provider enrollment, and personal care services. Senate Bill 315, officially named the Ohio Medicaid Program Integrity and Fraud Prevention Act, ended up becoming the final vehicle for these changes.
SB 315 Medicaid Integrity Changes
SPEAKER_01In this alert, we're going to summarize the key provisions of Senate Bill 315 that affect Medicaid providers, managed care organizations, and other major stakeholders in Ohio's Medicaid program. The first version of this bill was controversial, drawing over 70 opposing testimonies because it would have barred family members from providing personal care services under the home and community-based services waiver. If this version had stuck, it would have been a real access problem for families who are relying on a relative to be a paid caregiver, especially in underserved areas. Thankfully, the final version of Senate Bill 315 that has passed did restore family caregiver eligibility with some added oversights. This legislation authorizes regulatory bodies such as the Ohio Department of Medicaid and the Ohio Attorney General to take swift action and issue subpoenas if they believe there is a Medicaid fraud case. It raises criminal penalties for Medicaid fraud, upgrading this from a first-degree misdemeanor to at least a fifth-degree felony. Additionally, Senate Bill 315 mandates electronic visit verification for in-home care, requiring providers to clock in and out at the service location. Senate Bill 315 currently includes requiring prior authorization for Medicaid therapeutic behavioral services. Counselors, social workers, and those providing behavioral health services in-home or through Medicaid programs may want to directly assess how this piece of legislation will impact their services. Senate Bill 315 cleared the House and passed the Senate on June 10th with bipartisan support overall. Senate Bill 315 now waits for Governor DeWine's signature. Assuming that it is signed into law, Medicaid providers may need to assess the impacts, ensure that they understand the electronic visit verification, potentially update their credentials, and prepare for new prior authorization rules. Ultimately, business owners and private practices should be looking at their fraud detection, their readiness for disruptions, as well as monitoring the Ohio Department of Medicaid for any updates on rules and timelines. If you're unsure how this might impact you, please refer to the links in our show notes so that you might be able to read over the analysis of Senate Bill 315. The next piece of legislation we're discussing today is House Bill 718, which directly impacts behavioral health care providers and integrated healthcare systems. House Bill 718, sponsored by Representatives Karen Brown Lee and Jodie Salvo, would create a certification for qualified mental health specialists, or QMHS. People who currently would work as case managers and peer coordinators in behavioral health without having a formal license. As Representative Brownlee has put it, these specialists are often the ones pooling together the resources and supports that families need for good mental health outcomes.
HB 718 And Behavioral Health Workforce
SPEAKER_01Right now, there's no formal pathway for this work. House Bill 718 would also rename the Chemical Dependency Professionals Board as the Behavioral Health Professionals Board, which would better reflect the broader scope that House Bill 718 would create. OCA worked with the sponsors of this bill to remove the term counseling, which addressed our main concern and also provided and established professional distinctions. If House Bill 718 passes, it would meaningfully change how qualified mental health specialists are reimbursed. Currently, Medicaid eligibility for these services depends on where that specialist is employed and the ability that has been. Currently, Medicaid eligibility for these services depends on where the specialist is employed, and that eligibility has to be redetermined every time someone changes jobs. A process that can take months. House Bill 718 creates a three-level formalized training pathway. For counselors, this can have a real practical impact if you work alongside qualified mental health specialists or even if you supervise them. For the broader workforce, supporters frame House Bill 718 as a way to ease a genuine behavioral health staffing shortage in Ohio. House Bill 718 had its fourth hearing on June 2nd. It's still in review by the House Committee. If HB 718 could have a positive impact on your work, I encourage you to consider contacting the Ohio House Community Revitalization Committee, those who are currently monitoring this bill, and share your insights with them about how House Bill 718 might affect you or the community-based work that you do. This covers some of the major updates around behavioral health care professional boards and Medicaid insurance reimbursement. So now we're going to be shifting into talking about some of the other pieces of news that might affect your community or those you serve. The next bill is House Bill 346. This is also known as the Child Abuse Reporting Bill. House Bill 346 would require that healthcare providers report suspected child abuse to both law enforcement and child protective services.
SPEAKER_00It did pass the House unanimously.
SPEAKER_01House Bill 346 would require healthcare providers to report suspected child abuse to both law enforcement and child protective services. It passed the House on June 9th by a unanimous vote. If enacted, House Bill
Mandated Dual Reporting HB 346
SPEAKER_01346 formalizes the already existing mandated dual reporting requirements with the intent of strengthening child protections. These requirements are also worth watching for the effect that they might have on trust and disclosure in therapeutic relationships. House Bill 346 has now moved into the Senate, and we'll keep monitoring it from there. The next piece of legislation that might affect your practice or your community is the Senate Joint Resolution 10. These pieces of legislation are related to voting rights. Ohio lawmakers have advanced voting restrictions in this past month. There's the Senate Joint Resolution 10, or SJR 10, which is a legislatively referred constitutional amendment that would write Ohio's existing photo ID requirement into the Constitution. SJR 10 has already passed both chambers and should be heading to a vote for the general population in November. Coverage of SJR 10 has noted
Voting ID Amendment SJR 10
SPEAKER_01pushback across the political spectrum, not strictly along partisan lines. If you're concerned about how Senate Joint Resolution 10 would affect your ability to vote or your community's ability to be accurately represented in voting, please contact Governor Dewine's office and express to them your concerns. Ask that Governor Dewine not sign Senate Joint Resolution 10 if these things sound like they may negatively impact your community. Following this, we're talking about Senate Bill 276. Also, we'll be talking a little bit about Senate Bill 156. This is referred to as the success sequence curriculum. It began as Senate Bill 156, which would require the Ohio Department of Education and Workforce to build a model curriculum that teaches what is referred to as the success sequence. The success sequence is defined in this bill as completing high school, getting full-time work, marrying, and having children. Senate Bill 156 required schools to incorporate
Success Sequence Added To SB 276
SPEAKER_01the teaching this model for success into grades 6 through 12 as a prerequisite for graduation. Critics of Senate Bill 156 argued that this bill promotes one version of family structure, oversimplifies poverty as personal choice, ignores systemic issues that create hardship, and doesn't account for the cases where following this exact sequence still didn't prevent hardship. Because of the critics around Senate Bill 156, it did not end up continuing to advance on its own. Instead, Senate Bill 156 and the language that it had was folded into Senate Bill 276, which is named Ratify the Interstate Compact for School Psychologists. On June 10th, the House passed amended Senate Bill 276, which does now include the success sequence requirement. The Senate concurred on this bill the same night. Senate Bill 276 now waits for Governor Dwine's signature. If passed as it is currently written, students sixth grade through twelfth grade will be required to complete a portion of this curriculum that teaches them success is about graduating high school, getting a job, getting married, and having children. And that that is the way these individuals will obtain success. Senate Bill 276 isn't completely about the success sequence. However, as it's been added in, this does change the educational requirements for schools across Ohio. Should this be a concern to you, please contact Governor Dewine again. Express to him that you would like a line veto to remove the success sequence from Senate Bill 276. If you would like to review the bill in its entirety, please review our show notes as we will include the link to Senate Bill 276. Following this, we're going to talk about another bill impacting our communities at large. This is House Bill 347, which refers to reproductive waiting periods for abortions. House Bill 347 would create a new 24-hour state-imposed waiting period for any abortion within Ohio. It would also require scripts that testifying physicians described as containing medical misinformation, and the doctors providing these abortions would be required to give these scripts to those who are now pressing that service. There's a related measure, House
Abortion Waiting Period And Telehealth Ban
SPEAKER_01Bill 324, which would ban the use of telemedicine for mephopristone, one of the two medications that are used for medication-related abortions. It's worth tracking both of these bills, House Bill 347 and House Bill 324, since they are both restricting access to the same category of care. If either of these bills pass, the impact for our clients includes real access barriers such as transportation, childcare, scheduling conflicts, all of these related to mandatory waiting periods, as well as lack of access to telemedicine for Mephopristone. These can be significant impacts for clients in rural areas, clients with financial barriers, as well as clients navigating an already difficult and complex healthcare system. For those of us providing counseling, the waiting periods and how that intersects with our clients' mental health can be a really significant impact to their mental wellness. Delaying access to care is associated with increased stress and increased mental health difficulties. Senate committee testimony has already occurred for these bills on June 3rd and June 10th. If you would like to influence whether or not House Bill 347 and House Bill 324 move forward and how the Ohioans can access abortion care, it's important that you contact the Senate Health Committee. We'll keep you updated as more things happen. Following on this discussion of access to care, the next piece of legislation I'll be reviewing is Senate Bill 274, which discusses restrictions to services without parental consent. Senate Bill 274, which has been named Prohibit Minor Health Services Without Parental Consent, would repeal a current provision in Ohio law. This provision allows minors ages 14 to 17 to access up to six outpatient mental health sessions or 30 days of care without parental consent when there is a substantial probability of harm to that minor or to others.
SB 274 Limits Minor Consent
SPEAKER_01If this current law is repealed, providers would need parental consent before they can offer any mental health services to a minor, with no exception for the more narrow safety-related circumstances. For clients, the impact falls hardest on minors whose home situation is part of why they were seeking care without parental knowledge or consent in the first place. A population that the existing exception was specifically designed to reach. Senate Bill 274 would remove this provision that we created to allow minors who are in dire situations to access care without undue barriers. Senate Bill 274 has recently been introduced, so we are still waiting to hear about testimony. Now is a great time to review the bill's language. And if you are a provider who does utilize services without parental consent for clients who are experiencing an emergency, please know that your voice is crucial in understanding how Senate Bill 274 will affect Ohioans. The next topic that we're going to discuss today is one you've likely already heard about, which is the Department of Justice settlement with Cleveland Clinic. The Justice Department announced this settlement with the Cleveland Clinic on June 5th. The settlement resolved a 2025 investigation into allegations that Cleveland Clinic improperly billed insurance for gender-related medical procedures provided to minors. Under their agreement with the JOD. Under the agreement with the DOJ, Cleveland Clinic will pay to resolve the billing allegations, commit $2 million towards care for patients who
DOJ Settlement With Cleveland Clinic
SPEAKER_01detransition, meaning patients who are reversing or stopping previous gender transitioning, and commit to two decades not to provide gender-related medical interventions to minors across its hospitals in Ohio and several others. The detransition care commitment includes hormonal care and endocin care, surgical revision, fertility restoration, psychological support, and was offered regardless of a patient's ability to pay and will be offered regardless of a patient's ability to pay. Cleveland Clinic has characterized the underlying issue as an unintentional bill and code matter, affecting a small number of patients. They noted they already offered detransition related. Services before this settlement, and that their care for transgender adults remain unaffected. The Cleveland Clinic is the second major U.S. hospital system to reach this kind of settlement, following a similar agreement that was made with Texas Children's Hospital the previous month. Transgender advocacy groups, including Ohio's TransOhio, have heavily criticized this settlement as lending credibility to a broader political effort in order to try and restrict transgender health care nationally. Many Ohioans have been upset and disheartened by Cleveland Clinic's decision to reach this settlement. It's hard to ignore the very real impacts that these kinds of settlements have on trans-Ohioans and trans folk all across the world. Following this, I'm going to give you the review of two active lawsuits related to healthcare access. The first is regulation for federal financial assistance. The Office of Management and Budget and Budget, along with Health and Human Services and over two dozen other federal agencies, published a 400-page proposed rule on the Federal Register this past May 29th. This rule would overhaul how federal grants are reviewed before they are awarded. Among its provisions, the rule would require a political appointee, rather than a career or a staff member, review grant applications to ensure that these grants align with federal agency
Federal Grant Rule Targets Trans Care
SPEAKER_01priorities. Federal agency priorities include screening for whether or not a recipient's organization's policies, healthcare practices, or HR procedures deny the sex binary or treat sex as changeable. Ultimately, what this section of the rule is attempting to do is ensure that federal grant recipients are not engaging in gender-affirming care or acknowledging that transgender individuals exist and that their identities are valid. Coverage in this nonprofit sector trade is noted that this rule would also affect federal awards tied to DEI programs and immigration status. The public comment period for this rule ended on July 13th this month. For counselors and the organizations that they work with, particularly nonprofits, federally qualified healthcare centers, hospitals, and universities that receive federal grant funding. This could have some real downstream effects on our institutions, our structural policies, our services, as well as the potential for moral injury. We plan to continue tracking this after the comment period has closed, and we will keep you updated on what the final rules end up being. Unfortunately, this Pride Month, there are further LGBTQIA plus restrictions that I'm going to be discussing with you today. That includes HR 2616, titled Stopping Indoctrination and Protecting Kids Act, which passed the U.S. House on May 20th. This bill would require public elementary and middle schools receiving federal education funding to obtain parental consent before they can change a student's gender markers, pronouns, preferred name on school forms, or before allowing access to sex-based
HR 2616 And School Gender Policies
SPEAKER_01accommodations like locker rooms or bathrooms that differ from the students' sex assigned at birth. This piece of legislation could also bar schools from using federal funds in order to teach or advance concepts tied to gender ideology, as it has been defined in the 2025 Executive Order from the Trump administration. This bill combines two earlier measures and amends the Elementary and Secondary Education Act of 1965. And it's not expected for it to clear that threshold. However, we are still encouraging that we monitor this bill, given how much it would directly affect LGBTQRA plus students, as well as the counselors who work with them. I know that today's topic and all of the things that we've discussed on Couch to Capital can be pretty heavy to hold on to and to carry. In these moments, when we can see so much of how these systems are currently trying to influence care, access to resources, as well as moderating who can receive funding, it's important you recognize that your voice matters and that collectively we are very strong. If you're not sure what to do, one of the options that you have is attending the American Counseling
Why Advocacy Matters Right Now
SPEAKER_01Association's Hill Day. If you're unfamiliar with the American Counseling Association's Hill Day, this is their legislative advocacy day. It runs from September 16th to September 17th, 2026. Registration closes on July 31st. This is a great opportunity for counselors to connect with each other, to meet other counselors from across the nation, and to advocate at the federal level directly to their representatives.
ACA Hill Day How To Join
SPEAKER_01The American Counseling Association and other associations may be offering scholarships and grants to those who might struggle to afford attending a CA's Hill Day.
SPEAKER_02That's it for this edition of Catch to Capital, brought to you by the Ohio Counsel Association and Ohio Counseling Conversations. In the meantime, stay tuned, stay engaged, and keep advocating for the future of counseling in Ohio. Because what happens at the Capitol doesn't stay at the Capitol. It impacts every counseling conversation.