Top Legislative Issues
The 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:
Out-of-Network Billing, or “Surprise Billing”
OSMA is working with legislators on several proposed solutions to surprise billing — that is, billing from an out-of-network provider at an in-network facility. While we agree it is important to relieve patients of the burden of surprise medical bills, we believe it is essential that an effective surprise billing solution be crafted in a way that does not have a negative ripple effect on the contracting process between physicians and insurers. To that end, OSMA is supporting Senate Bill 198 as the most comprehensive, efficient, and physician-friendly solution. The other, House Bill 388, raises significant concerns that the framework of the bill could hinder Ohio physicians’ ability to contract appropriate and fair rates with insurers. We’re working to educate legislators about this issue and encourage appropriate changes to HB 388.
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.
Scope of Practice
Going into 2020, 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 a collaborating physician or podiatrist. 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 collaborative model and stressing patient safety concerns.
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.
Expanded scope of practice – Certified Registered Nurse Anesthetists (CRNAs)
OSMA’s work with legislators has led to a solution included in House Bill 224 that ensures patient safety and sensibly fits into the care model utilized by anesthesia care teams. OSMA and the Ohio Society of Anesthesiologists (OSA) together have taken a neutral position on the latest version of this legislation, as it maintains the current team-based care model and supervisory relationship between CRNAs and physicians. We believe the bill has appropriate safety guardrails that alleviate previous patient safety concerns and do not dismantle the physician-led, team-based model of care. The physician remains at the head of the care team, overseeing critical patient treatment decisions.