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March Advocacy Update—The Issues on OSMA’s Agenda


OSMA’s Government Relations team serves as the voice of Ohio’s physicians—advising state departments and influencing state policy on health issues. The 134th General Assembly has kicked off – and this year, OSMA will be working on a variety of familiar issues, as well as laying the groundwork and progressing with several reform initiatives.

Priorities we’re working on:

Scope of Practice

OSMA will continue to advocate for the physician-led, team-based care model and expects to work on several scope issues this year:

  • Advanced Practice Registered Nurses (APRNs) – Independent, Unsupervised Practice 
    Legislation that would allow Ohio APRNs to practice independently will return this general assembly. Along with other physician groups, and much like we have historically, we will continue to advocate against this, stressing the importance of patient safety and maintaining physician oversight.

  • Psychologists – Prescriptive Authority
    OSMA expects that a proposal that would allow certain psychologists in Ohio to prescribe medications for treatment of mental illness and substance use disorder will be reintroduced. The physician community has significant patient safety concerns about this legislation and will continue to work to inform legislators about the potential risks. 

  • Physician Assistants (PAs) – Expanded Scope
    Another issue we expect to resurface is the expansion of the scope of practice of PAs. Previously, this legislation sought to change the way PAs and physicians work together in a way that the physician community found troubling. These changes included reclassifying the supervision agreement as a “collaborative agreement,” giving PAs the ability to “pink slip” patients and conduct drug and alcohol assessments, and removing the PA’s initial onsite supervision prescriptive authority requirement, among other provisions.

Insurer Reforms

Our members continue to be concerned about the administrative burden that insurer policies and processes create for them and their practices, along with certain roadblocks to care that their patients encounter. Some of the issues we are exploring and pursuing this year include:

  • Prior Authorization/Healthcare Simplification
    Our members continue to be concerned about the administrative burden that insurer policies and processes create for them and their practices, along with certain roadblocks to care that their patients encounter. We are exploring potential legislation and researching paths forward to relieve some of the problems that persist.

  • Network Adequacy
    OSMA is examining and conducting research into the issue of network adequacy. We hope to advocate for meaningful reforms that holds insurers accountable for providing promised benefits by giving beneficiaries reasonable access to a sufficient number of in-network primary care and specialty physicians and all health care services included in the plan.

  • Non-medical switching
    OSMA will join the Ohio Association of Rheumatology in supporting legislation that would prohibit insurers from engaging in the practice of non-medical switching. This occurs when patients are forced to switch to a less expensive treatment in the middle of a plan year for no medical reason. This disrupts a physician’s ability to exercise their medical expertise and help their patients.

  • Copay accumulator
    Health plans and pharmacy benefit managers (PBMs) may apply co-pay accumulator adjustment policies when patients attempt to use copay assistance programs. These prohibit a patient’s copay assistance amount from count toward their deductible and maximum out-of-pocket cap. OSMA is supporting a bill that would require insurers and PBMs to count all payments made by patients directly or on their behalf toward their deductibles and out-of-pocket costs, increasing predictability as vulnerable patients face high out-of-pocket costs for their prescriptions.

Public Health

Along with continuing to be highly engaged with the state’s response to the COVID-19 pandemic, OSMA anticipates working on the following public health matters:

  • Tanning Ban for Minors
    OSMA will join the Ohio Dermatological Association again in support of a measure that would prohibit individuals under age 18 from using tanning beds. If enacted, this proposal would protect the youth in our state from exposure to dangerous ultraviolet radiation that drastically increases the chance of developing skin cancer, particularly when exposure occurs before adulthood.

  • Health Equity
    The pandemic and elevated conversations about racial justice have brought the issue of healthcare equity to the forefront. OSMA is dedicated making sure health care is fully inclusive and attainable so that everyone has access to necessary medical services regardless of race, ethnicity, sexual orientation, or any other defining characteristic.

  • Mental Health
    OSMA will continue our advocacy for increased access to mental health and substance use disorder care, including access to medication-assisted treatment.

  • Telemedicine
    OSMA is a long-time telehealth advocate and expects to work with legislators on issues relating to telehealth again this general assembly. The pandemic has demonstrated that making usage of telehealth easier for both physicians and patients is a valuable tool in increasing access to high quality care, particularly for underserved populations.

Medicaid Reimbursement

OSMA will keep supporting an increase in rate of reimbursement given to physicians by the Medicaid program for health care services delivered to Medicaid recipients.

Tort Reform

OSMA will monitor the medical liability climate in Ohio and continue to support stability for Ohio physicians. Additional liability protections for the COVID-19 pandemic were signed into law in September 2020 after the passage of OSMA-supported legislation HB 606. Our advocacy efforts were critical to this becoming law, and those on the front lines of the healthcare system can rest assured that they will be given additional protections for their heroism during unprecedented times.


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