OSMA recently testified at a hearing held in the Ohio House Health Provider Services Committee regarding HB 73, which adds protections to prescribers who prescribe an off-label drug OSMA is a long-time advocate for the physician’s ability to exercise their professional, clinical judgment (including consideration of potential risks on a case-by-case basis) in the assessment and management of the medical needs of their patients. In our continued advocacy for the medical profession and the patients served by our members, we stressed to members of the committee that this is a critical facet of health care delivery and the physician-patient relationship.
OSMA also has longstanding policy supporting that FDA-approved drugs prescribed off-label are reimbursed by third-party payers. In our testimony, we highly encouraged the sponsors of this legislation to consider adding a provision to the bill that would require this coverage in order to make more positive impact for Ohio patients.
OSMA recently provided supportive testimony regarding HB 99, which is currently under consideration by the Ohio House Insurance Committee. This legislation would strengthen Ohio’s prudent layperson standard. Ohio’s prudent layperson standard law essentially means that if a person with the average amount of medical knowledge believes that they are experiencing a medical emergency, their emergency room visit should be considered a medical emergency.
HB 99 would require insurers to conduct a comprehensive and robust emergency physician review of a claim before issuing a denial of the claim or a reduction in reimbursement, and also require insurers to inform their enrollees of their emergency services coverage. This legislation would not prohibit insurers from ever denying a claim, but it would ensure that the claim could not be denied merely on the basis of the final diagnosis, and require insurers to take all other relevant medical information into account, including the symptoms the patient presented with at the time of seeking emergency care.
OSMA encouraged members of the committee to support HB 99 to help Ohioans feel financially protected in the event of a potential medical emergency, and help combat worries associated with costs that might discourage someone who may be experiencing a life-threatening emergency from seeking emergency medical care.
OSMA also recently testified in support of HB 152, which would require health plan issuers to cover hearing aids and related services for persons under 22 years of age. For many private insurance plans, hearing aids are defined as “elective” or “cosmetic” devices, and parents are forced to pay entirely out-of-pocket for their child’s hearing aids. This can be difficult and unmanageable for many families to afford. Since Ohio already requires that newborns be screened for hearing loss, HB 152 is a logical next step, helping more children access appropriate intervention. The early stage detection and intervention of hearing loss in children is critical to ensuring better speech, language, social, behavioral, and cognitive outcomes.
By making hearing aids more affordable through insurance coverage and thus accessible to more Ohio children, this legislation would profoundly impact many Ohio families for the better.
Please stay tuned for further updates on advocacy activity at the Ohio Statehouse, including the final outcomes of the state budget bill, before the elected officials recess for the summer!