Top Legislative Issues
OSMA's Government Relations team serves as the voice of Ohio’s physicians—advising state departments and influencing state policy on health issues. Through leadership and education, we support and advance the physician profession in the state of Ohio.
We continue to monitor the major issues affecting the practice of medicine at the state and federal level. The top priority issues impacting the practice of medicine in Ohio are detailed below.
Current advocacy priorities include the following:
House Bill 679 would modify telemedicine requirements in order to expand access for more Ohioans and make it easier for providers to use. Introduced in part due to the rapid growth in telehealth utilization during the COVID-19 pandemic, this bill was fast tracked through the House, passing just 2 weeks after introduction. OSMA, a long-time telehealth advocate, initially expressed some questions and concerns about the original version of HB 679. The sponsors were willing to consider the suggestions from OSMA, and subsequently made changes to the legislation. OSMA will continue to support HB 679 as it moves through the Senate.
Mental Health Parity
Several years of work with a coalition seeking to bring mental health insurance coverage parity to Ohio have culminated in the introduction of House Bill 443/Senate Bill 254. A recent report assigns 32 states, including Ohio, a failing grade for ensuring equal access to mental health and addiction treatment for their citizens, even though federal law requires that health insurers provide coverage for the treatment of mental health and addiction equal to the coverage for physical illnesses and conditions. We’re working to support a robust state statute as proposed in HB 443/SB 254 to give regulators a strong tool for enforcement of parity.
OSMA submitted feedback we received from our members to the Ohio Department of Medicaid in response to a request for comments on the Medicaid managed care system as part of the upcoming rebid process. Our letter focused on key issues, including:
- The need for increased transparency and plan accountability
- Reforms to the grievances and appeals processes
- Bolstered provider support
- More streamlined and efficient patient care coordination and management.
We will continue to monitor the rebid process and any changes the state administration might seek to make to the Medicaid program.
Scope of Practice
OSMA continues to advocate for a physician-led, team-based approach to care and is working on several ongoing scope-of-practice issues:
Independent, Unsupervised Practice – Advanced Practice Registered Nurses (APRNs)
House Bill 177 is an independent practice bill that would allow Ohio APRNs to practice without physician or podiatrist oversight. The most recent version adds a stipulation that in order to gain independent practice authority, an APRN must complete 2,000 hours of “clinical practice.” The term “clinical practice” is not clearly defined in the bill, which does state however that these hours are to be completed under a standard care arrangement with a licensed health care practitioner. This means that for roughly the equivalent of one year, an APRN would be required to be in a standard care arrangement, but that does not have to be with a physician. It could be with another APRN, and again, is only for a period of about one year. Along with other physician groups, we continue to advocate against this bill, reinforcing the positive impact of the current physician-led team-based model and stressing patient safety concerns.
Expanded Scope of Practice – Physician Assistants
House Bill 492 would modify the scope of practice of physician assistants (PAs) in several ways, including by reclassifying the PA/physician supervision agreement as a “collaborative agreement,” granting PAs the ability to “pink slip” patients and conduct drug and alcohol addiction assessments, and removing the PA’s initial onsite supervision prescriptive authority requirement. The physician community, including OSMA, has significant concerns about the provisions of HB 492 and is working to inform legislators of the potential negative consequences of these changes to the physician-led, team-based care model.
Prescriptive Authority – Psychologists
House Bill 323 would allow certain psychologists in Ohio to prescribe medications for the treatment of mental illness and/or substance use disorder. OSMA and the Ohio Psychiatric Physicians Association (OPPA) continue to focus on this issue out of serious about patient safety.
Medical Price Transparency
OSMA expects the Ohio legislature will continue to deliberate over price transparency, which would allow Ohio patients to anticipate costs and make more informed decisions about their care. We are supporting legislation on hospital-based price transparency for scheduled health care services, which has passed in the Senate and must now proceed through the House.
Out-of-Network Billing or “Surprise Billing”
OSMA has been working on the issue of “surprise” out-of-network medical billing for several years now with a coalition of health care groups and other interested parties. Initially, we had serious concerns about a proposal in the Ohio House (HB 388)—mainly due to its establishment of a statutory rate cap for physician reimbursements and for its potential to tip the balance too far in favor of insurers in the contracting process.OSMA raised the voices of the physician community to advocate for changes, and in May 2020, a new version of the bill was crafted with compromise language included to help alleviate physician concerns. This was accepted and it went to the House floor, where it passed with a favorable vote. The Senate will now consider the bill.
Tanning Ban for Minors
OSMA is joining the Ohio Dermatological Association in support of a measure that would prohibit individuals under age 18 from using tanning beds. If enacted, HB 329 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.