10/07/2025
OSMA Testifies in Support of Non-Medical Switching Legislation
For the hearing of the Ohio Senate Financial Institutions, Insurance, and Technology Committee last week, several legislative proposals supported by OSMA regarding insurance reform were on the agenda.
SB 207 and SB 162 each received their first hearing, dedicated to sponsor testimonies. For SB 160, it was the second hearing, during which witnesses are given the opportunity to provide proponent testimony.
SB 160: Non-Medical Switching
Monica Hueckel, OSMA’s VP of Advocacy, provided supportive testimony on behalf of OSMA for the proponent hearing of SB 160, which is sponsored by Senators (and physicians) Dr. Terry Johnson (R-McDermott) and Dr. Beth Liston (D-Dublin).
As a reminder, this legislation prohibits the practice of “non-medical switching” in the middle of a plan year. Non-medical switching is when the insurer requires a patient to switch from their current medication to a different medication for reasons unrelated to the patients’ health, or for “non-medical” reasons. Non-medical switching is an unfortunate and dangerous interruption in continuity of care, and often causes adverse events which require hospitalizations, emergency room visits, or other additional care needs. OSMA strongly believes that treatment decisions should come from the doctor-patient relationship, and that patients, particularly those with chronic and complex medical conditions, need and deserve individualized, patient-centered treatment plans.
Dr. Stephanie Ott gave the Committee powerful testimony from the clinical perspective on behalf of the Ohio Association of Rheumatology as a physician, detailing the negative impacts of non-medical switching on her patients.
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SB 207: Copay Accumulators
For the first hearing of SB 207, sponsors Sen. Susan Manchester (R-Waynesfield) and Sen. Beth Liston (D-Dublin) each gave Committee members introductory testimony about this legislation, which like SB 160, is reintroduced from the previous general assembly. OSMA is also supporting SB 207 as part of a coalition of several medical organizations.
SB 207 addresses what is known as copay accumulator policies, and would require health insurers to count amounts paid by or on behalf of covered individuals toward deductibles and cost-sharing requirements.
SB 162: Takebacks
It was also the first hearing of SB 207, and sponsor Sen. Bill Blessing (R-Colerain Twp.) provided sponsor testimony to formally introduce this legislation to the Committee. SB 162 would limit insurer takebacks, which occur when an insurance company retroactively denies or reclaims payments made to healthcare providers, often months or years after the claim was processed.
Specifically, SB 162 would change Ohio’s current 24-month insurer takeback timeframe, decreasing it to the same timeframe given to a provider to submit a claim, and also prohibit insurers from changing these timeframes during a contract period.
Providers already jump through numerous hoops to get reimbursed for services provided to patients. From prior authorizations, denied claims, requests for massive amounts of documentation and health plans having their own definitions of medical necessity, healthcare providers are struggling to keep their doors open.
OSMA is thrilled to be supporting SB 162 as part of our slate of insurance reform legislation this general assembly. Limiting the time frame to do a clawback of a payment to the same time frame a health plan gives a provider to submit a claim will level the playing field and allow the same rules to apply to health plans that they give to practices and providers. This will create stability and ensure practices can continue providing the care their patients need.
Please stay tuned as the fall session of the 136th General Assembly gets into full swing. OSMA anticipates that there will be a flurry of activity on many issues on our advocacy agenda, and we will continue to provide timely updates over the next couple months.