Resolution 15-2022 – Opposing the Criminalization of Self-Managed Medication Abortion

1. The OSMA amends Policy 07-2020, Legislative or Regulatory Interference in the Practice of Medicine in the State of Ohio, by addition as follows:

Legislative or Regulatory Interference in the Practice of Medicine in the State of Ohio, OSMA Policy 07 – 2020

1. The OSMA actively works to ensure that the sanctity of the physician-patient relationship is protected in all legislative and regulatory matters.
2. Current OSMA Policy 18 - 2012 (Criminalization of Medical Care) is amended to read as follows:

The OSMA opposes any portion of proposed legislation or rule that criminalizes clinical practice that is the standard of care.

That current OSMA Policy 10 – 1990 (Policy on Abortion) be amended as follows:

1. It is the position of the OSMA that the issue of support of or opposition to abortion is a matter for members of the OSMA to decide individually, based on personal values or beliefs.
2. The OSMA shall take no action which may be construed as an attempt to alter or influence the personal views of individual physicians regarding abortion procedures.
3. Items 1 and 2 notwithstanding, the OSMA shall take a position of opposition to any proposed Ohio legislation or rule that would:

• Require or compel Ohio physicians to perform treatment actions, investigative tests, or questioning of a patient which are not consistent with the medical standard of care; or,
• Require or compel Ohio physicians to discuss treatment options that are not within the standard of care and/or omit discussion of treatment options that are within the standard of care.

---

Policy 07-2020 – Legislative or Regulatory Interference in the Practice of Medicine in the State of Ohio

1. The OSMA actively works to ensure that the sanctity of the physician-patient relationship is protected in all legislative and regulatory matters.
2. Current OSMA Policy 18 - 2012 (Criminalization of Medical Care) be amended to read as follows:

The OSMA opposes any portion of proposed legislation OR RULE that criminalizes clinical practice that is the standard of care.

That current OSMA Policy 10 – 1990 (Policy on Abortion) be amended as follows:

1. It is the position of the OSMA that the issue of support of or opposition to abortion is a matter for members of the OSMA to decide individually, based on personal values or beliefs.
2. The OSMA shall take no action which may be construed as an attempt to alter or influence the personal views of individual physicians regarding abortion procedures.
3. Items 1 and 2 notwithstanding, the OSMA shall take a position of opposition to any proposed OSMA legislation or rule that would:

• Require or compel Ohio physicians to perform treatment actions which are not consistent with the standard of care; or,
• Require or compel Ohio physicians to discuss treatment options that are not within the standard of care and/or omit discussion of treatment options that are within the standard of care.

---

Policy 10-1990 – Policy on Abortion

1. It is the position of the OSMA that the issue of support of or opposition to abortion is a matter for members of the OSMA to decide individually, based on personal values or beliefs. 

2. The OSMA shall take no action which may be construed as an attempt to alter or influence the personal views of individual physicians regarding abortion procedures. 

3. Items 1 and 2 notwithstanding, the OSMA shall take a position of opposition to any proposed Ohio legislation or rule that would: 

   • Require or compel Ohio physicians to perform treatment actions which are not consistent with the standard of care; or, 

   • Require or compel Ohio physicians to discuss treatment options that are not within the standard of care and/or omit discussion of treatment options that are within the standard of care. 

---

Policy 36-1985 – Abortion Clinic Violence

1. The OSMA opposes acts of violence against abortion clinics and other health care facilities as a violation of the right to the access of health care.

---

Policy 13-1973 – Abortion as a Medical Procedure

1. The House of Delegates of the OSMA adopts as its policy the statement of abortion issued by the OSMA's Committee on Maternal Health, with the exception that abortion upon request, like any other medical procedure, should be performed only in the maternal patient's best interests, and the standards of sound clinical judgment, which together with informed maternal patient consent, should be determinative according to the merits of each individual case.

Statement on Abortion of OSMA Committee on Maternal Health

In view of the recent decision of the United States Supreme Court on abortion the following statement is issued by the OSMA's Committee on Maternal Health.

Abortion shall mean an operation to intentionally terminate a pregnancy with a live or stillborn fetus weighing 500 grams or less, or under 20 completed weeks of gestation. For its performance, adequate facilities, equipment and personnel are required to assure the highest standards of patient care.

First trimester abortions (up to 12 weeks since conception) should be performed in a hospital or in a facility that offers the basic safeguards provided by hospital admission and has immediate hospital back-up. Such a facility should be accredited by the Joint Commission on Accreditation of Hospitals or licensed by the State of Ohio.

Abortions beyond the first trimester should be performed in a hospital.

Facilities for the performance of first trimester abortions should include appropriate surgical, anesthetic and resuscitation equipment. In addition, the following should be provided:

1. Verification of the diagnosis and duration of pregnancy.
2. Pre-operative instructions and counseling.
3. Recorded pre-operative history and physical examination, particularly directed to identification of pre-existing or concurrent illnesses or drug sensitivities that may have a bearing on the operative procedures or the anesthesia.
4. Laboratory procedures as usually required for a hospital admission, including blood type and Rh factor.
5. Prevention of Rh sensitization.
6. A receiving facility where the patient may be prepared and receive necessary pre-operative medication and observation prior to the procedure.
7. A recovery facility in which the patient can be observed until she has sufficiently recovered from the procedure and the anesthesia and can be safely discharged by the physician.
8. Post-operative instructions and arrangements for follow-up including family planning advice.
9. Adequate permanent records.

It is recognized that abortion may be performed at a patient's request or upon a physician's recommendation. No physician should be required to perform, nor should any patient be forced to accept, an abortion.

The usual informed consent, including operative permit, should be obtained. The same indications for consultation should apply to abortions as to other medical-surgical procedures.

Abortions should be performed only by licensed physicians who are qualified to identify and manage those complications that may arise from the procedure. 

 

Policy 18-2022 – Establish Collaborations with the American Medical Association, Liaison Committee on Medical Education, and Ohio Medical Schools, to Create Formal Training in Telemedicine

1. The Ohio State Medical Association encourages Ohio medical schools to integrate telemedical education into medical school curricula.

---

Policy 20-2022 – Appropriate Physician Reimbursement to Cover Rising Expenses of Office Practice 

1. The Ohio State Medical Association (OSMA) advocates that physician reimbursement for all activities be increased to cover the expenses of running an office practice.
2. The OSMA will work with our Ohio State Legislature and Ohio Congressional delegation to improve physician reimbursement.
3. The OSMA Delegation to the American Medical Association (AMA) shall take this resolution regarding improved physician reimbursement to the AMA House of Delegates for action.

---

Policy 22-2022 – Medicare and Medicaid Reimbursement

1. The Ohio State Medical Association will seek to introduce legislation which will bring Ohio Medicaid reimbursement up to parity with Medicare reimbursements.
2. The Ohio delegation to our American Medical Association shall carry a resolution which calls for education of beneficiaries particularly in regard to the scope of benefit coverage within Medicare Advantage Plans.
3. The Ohio Delegation will bring to the AMA a resolution seeking an increase in Medicare reimbursement.

---

Policy 23-2022 – Prohibit Reversal of Prior Authorization

1. The Ohio State Medical Association (OSMA) supports legislation to prohibit retroactive denial of a previously approved medication, procedure, or test unless the patient is no longer insured by that company at the time of service.
2. The OSMA delegation to the AMA will take this topic regarding reversal of prior authorization to the AMA House of Delegates to advocate for this change as a part of their greater effort to eliminate prior authorization all together.

---

Policy 24-2022 – Review of Health Insurance Companies and Their Subsidiaries’ Business Practices

1. The Ohio State Medical Association requests that our AMA delegation carry a request for AMA review of health insurance companies’ business practices for potential fraudulent and unfair activities.

---

Policy 12-1998 – Transmittal of OSMA Policies to the AMA

1. The Ohio Delegation to the AMA may submit and/or co-sponsor policies to the AMA, with approval of Council, only if the timing reasonably precludes OSMA House of Delegates approval and provided no provision of such policy/policies advocate(s) a position contrary to current OSMA House of Delegates policy. In all instances where such a policy is to be submitted or co-sponsored, that action must be approved by the OSMA Council and reported to the OSMA House of Delegates at the next meeting of the full House.

---

Policy 13-1998 – Sponsorship of AMA Policies

1. The Ohio Delegation to the AMA be entrusted to revise (without change of essential substance) when necessary the policy/policies forwarded to the AMA with the intent of crafting each policy to optimally promote its intent at the AMA.
2. The Ohio Delegation to the AMA, unless specifically instructed otherwise, be permitted to hold, when deemed advisable, a policy until the AMA Interim meeting in order to allow a more thoughtful and appropriate revision and to allow gathering and submission of pertinent supporting documentation.

Policy 25-2022 –Support for Expansion of Anti-discrimination Definition to Include Sexual Orientation and Gender Identity or Expression

1. The OSMA supports legislative actions to extend the definition of discrimination on the basis of sex to include sexual orientation and gender identity or expression.
2. The OSMA reaffirms OSMA Policy 10-2016.

---

Policy 30-2021 – Condemning Forced Sterilization

1. The OSMA condemns and opposes the practice of forced sterilization as defined by the World Health Organization; or comparable practices such as the forced use of birth control.
2. The OSMA supports the education of physicians on the history and current practice of forced sterilization, particularly against marginalized communities, and the implications these practices have had on the persistent distrust of reproductive health services among marginalized patient populations.

---

Policy 15-2020 – Supporting Gender-Affirming Care for Transgender and Gender Minority Patients

1. The OSMA reaffirms existing Policy 23-2016 - Expanding Gender Identity Options on Physician Intake Forms.
2. The OSMA supports individualized, gender-affirming, evidence-based treatment and clinical practices in caring for transgender and gender minority patients.
3. The OSMA supports educational training to further educate healthcare providers on how to provide competent, respectful, evidence-based care to transgender and gender minority patients.

---

Policy 07-2019 – Female Genital Mutilation Ban

1. The OSMA condemns the practice of female genital mutilation as defined by the World Health Organization and considers female genital mutilation a form of child abuse
2. The OSMA encourages physicians to engage in culturally competent counseling to individuals at risk of female genital mutilation.

---

Policy 05-2019 – Advancing Gender Equity in Medicine

The OSMA adopts the following, which is adapted from American Medical Association policy/directives:

1) That the OSMA supports gender and pay equity in medicine consistent with the American Medical Association Principles for Advancing Gender Equity in Medicine (see below AMA Policy H-65.961 as adopted at the 2019 AMA Annual Meeting);

2) That the OSMA:

(a) Promote institutional, departmental, and practice policies, consistent with federal and Ohio law, that offer transparent criteria for initial and subsequent physician compensation;

(b) Continue to advocate for pay structures based on objective, gender-neutral criteria;

(c) Encourages training to identify and mitigate implicit bias in compensation decision making for those in positions to determine physician salary and bonuses, with a focus on how subtle differences in the further evaluation of physicians of different genders may impede compensation and career advancement;

3) That the OSMA recommends as immediate actions to reduce gender bias to:

(a) Inform physicians about their rights under the Lilly Ledbetter Fair Pay Act, which restores protection against pay discrimination;

(b) Promote educational programs to help empower physicians of all genders to negotiate equitable compensation; and

(c) Work with relevant stakeholders to advance women in medicine;

4) That the OSMA collaborate with the American Medical Association initiatives to advance gender and pay equity;

5) That the OSMA commit to the principles of pay equity across the organization and take steps aligned with this commitment.

Principles for Advancing Gender Equity in Medicine H-65.961: Our AMA: 1. declares it is opposed to any exploitation and discrimination in the workplace based on personal characteristics (i.e., gender); 2. affirms the concept of equal rights for all physicians and that the concept of equality of rights

under the law shall not be denied or abridged by the U.S. Government or by any state on account of gender; 3. endorses the principle of equal opportunity of employment and practice in the medical field; 4. affirms its commitment to the full involvement of women in leadership roles throughout the federation, and encourages all components of the federation to vigorously continue their efforts to recruit women members into organized medicine; 5. acknowledges that mentorship and sponsorship are integral components of one’s career advancement, and encourages physicians to engage in such activities; 6. declares that compensation should be equitable and based on demonstrated competencies/expertise and not based on personal characteristics; 7. recognizes the importance of part-time work options, job sharing, flexible scheduling, re-entry, and contract negotiations as options for physicians to support work-life balance; 8. affirms that transparency in pay scale and promotion criteria is necessary to promote gender equity, and as such academic medical centers, medical schools, hospitals, group practices and other physician employers should conduct periodic reviews of compensation and promotion rates by gender and evaluate protocols for advancement to determine whether the criteria are discriminatory; and 9. affirms that medical schools, institutions and professional associations should provide training on leadership development, contract and salary negotiations and career advancement strategies that include an analysis of the influence of gender in these skill areas.

Our AMA encourages: (1) state and specialty societies, academic medical centers, medical schools, hospitals, group practices and other physician employers to adopt the AMA Principles for Advancing Gender Equity in Medicine; and (2) academic medical centers, medical schools, hospitals, group practices and other physician employers to: (a) adopt policies that prohibit harassment, discrimination and retaliation; (b) provide anti-harassment training; and (c) prescribe disciplinary and/or corrective action should violation of such policies occur.

Policy Timeline
BOT Rep. 27, A-19

---

Policy 06-2019 – Increase Awareness of Disparities in Medical Access and Treatment in Ohio

1. The OSMA shall work with appropriate stakeholders to increase awareness of Ohio physicians, residents, and medical students of disparities in medical access and treatment in Ohio based on disability, race, ethnicity, geography, and other social and demographic factors through the utilization of existing resources.

---

Policy 22-2017 – Opposition to the Practice of LGBTQ “Conversion Therapy” or “Reparative Therapy”

1. The OSMA affirms that individuals who identify as homosexual, bisexual, transgender, or are otherwise not heteronormative are not inherently suffering from a mental disorder.
2. The OSMA strongly opposes the practice of “Conversion Therapy,” “Reparative Therapy” or other techniques aimed at changing a person’s sexual orientation or gender identity.

---

Policy 23-2017 – Advocating for Increased Awareness and Education of Human Trafficking

1. The OSMA shall advocate against human trafficking.
2. The OSMA will encourage the education of physicians on how to identify and assist victims of human trafficking.

---

Policy 22-2016 – Lesbian Gay Bisexual Transgender Queer (LGBTQ) Protection Laws

1. The OSMA supports the protection of Lesbian Gay Bisexual Transgender Queer (LGBTQ) individuals from discriminating practices and harassment.
2. The OSMA advocates for equal rights protections to all patient populations.

---

Policy 23-2016 – Expanding Gender Identity Options on Physician Intake Forms

1. The OSMA supports non-mandatory patient intake forms that allows for sex (assigned at birth) and gender identification that are more inclusive than the binary male/female traditionally asked. 

Policy 12 – 2009 – Organized Medical Staff Section and OSMA Annual Meeting Educational Programs

1. The Organized Medical Staff Section (OMSS) CME program shall be integrated into the OSMA educational symposium schedule to support increased membership and participation in the OSMA educational symposium.

---

Policy 28 – 1997 – Mandatory Topic-Specific Continuing Medical Education (CME)

1. The OSMA opposes those portions of proposed legislation that include mandatory topic-specific CME requirements for Ohio physicians.

---

Policy 57 – 1990 – Health Promotion and Disease Prevention Education

1. The OSMA supports the implementation of effective health promotion/disease prevention curricula in medical schools, residency programs and CME programs.

Policy 13-2019 – Hospital Closures and Physician Credentialing Repository

1. The OSMA shall take whatever legislative and/or administrative steps necessary to initiate action by the Ohio Department of Health to create and maintain a repository of credentialing files of those physicians affected by hospital closures, so that such records will be easily accessible for future needs.

---

Policy 31-2004 – Oppose Economic Credentialing

1. The OSMA opposes the use of economic criteria by hospital boards and healthcare delivery systems in the granting of hospital medical staff membership and privileges for licensed physicians to practice medicine.

---

Policy 13-2002 – Maintain Privacy of Unfiled Lawsuits

1. The OSMA opposes the collection and use of information concerning threatened and unfiled malpractice complaints about physicians by health insurance companies for credentialing purposes.

---

Policy 75-1991 – Economic Credentialing

1. The OSMA opposes the use of economic criteria not related to quality to determine an individual physician's qualifications for the granting or renewal of medical staff membership or privileges. 

Policy 13-2022 - Curbing Opioid-Related Deaths in Ohio Through Medication-Assisted Treatment and Harm Reduction Services

1. The Ohio State Medical Association (OSMA) advocates for the use of medication-assisted treatment, including but not limited to methadone or buprenorphine, and harm reduction methods without penalty when clinically appropriate.
2. The OSMA supports public awareness campaigns to increase education of evidence-based services for opioid addiction, including but not limited to medication-assisted treatment, harm reduction, and recovery services.
3. The OSMA supports existing and pilot programs for the distribution of fentanyl test strips in at-risk communities in Ohio.

---

Policy 31-2021 – Dietary Supplements and Herbal Remedies

1. The OSMA rescinds policy 12-2018 Dietary Supplements.
2. The OSMA adopt new policy regarding dietary supplements and herbal remedies to read as follows:

(1) The OSMA supports AMA efforts to enhance U.S. Food and Drug Administration (FDA) resources, particularly to the Office of Dietary Supplement Programs, to appropriately oversee the

growing dietary supplement sector and adequately increase inspections of dietary supplement manufacturing facilities.

(2) The OSMA supports the FDA having appropriate enforcement tools and policies related to dietary supplements, which may include mandatory recall and related authorities over products that are marketed as dietary supplements but contain drugs or drug analogues, the utilization of risk-based inspections for dietary supplement manufacturing facilities, and the strengthening of adverse event reporting systems.

(3) The OSMA supports continued research related to the efficacy, safety, and long-term effects of dietary supplement products.

(4) The OSMA encourages the AMA to work with the FDA to educate physicians and the public about FDA's Safety Reporting Portal (SRP) and to strongly encourage physicians and the public to report potential adverse events associated with dietary supplements and herbal remedies to help support FDA's efforts to create a database of adverse event information on these forms of alternative/complementary therapies.

(5) The OSMA strongly urges physicians to inquire about patients’ use of dietary supplements and engage in risk-based conversations with them about dietary supplement product use.

(6) The OSMA encourages that the AMA continue to strongly urge Congress to modify and modernize the Dietary Supplement Health and Education Act to require that:

(a) dietary supplements and herbal remedies including the products already in the marketplace undergo FDA approval for evidence of safety and efficacy;

(b) dietary supplements meet standards established by the United States Pharmacopeia for identity, strength, quality, purity, packaging, and labeling;

(c) FDA establish a mandatory product listing regime that includes a unique identifier for each product (such as a QR code), the ability to identify and track all products produced by manufacturers who have received warning letters from the FDA, and FDA authorities to decline to add labels to the database if the label lists a prohibited ingredient or new dietary ingredient for which no evidence of safety exists or for products which have reports of undisclosed ingredients; and

(d) regulations related to new dietary ingredients (NDI) are clarified to foster the timely submission of NDI notifications and compliance regarding NDIs by manufacturers; and

(7) The OSMA encourages the AMA to support FDA postmarketing requirements for manufacturers to report adverse events, including drug interactions; and legislation that declares metabolites and precursors of anabolic steroids to be drug substances that may not be used in a dietary supplement

(8) The OSMA encourages the AMA to work with the Federal Trade Commission (FTC) to support enforcement efforts based on the FTC Act and current FTC policy on expert endorsements and supports adequate funding and resources for FTC enforcement of violations of the FTC Act.

(9) The OSMA strongly urges that criteria for the rigor of scientific evidence needed to support a structure/function claim on a dietary supplement be established by the FDA and minimally include requirements for robust human studies supporting the claim.

(10) The OSMA encourages the AMA to strongly urge dietary supplement manufacturers and distributors to clearly label all products with truthful and not misleading information and for supports that the product labeling of dietary supplements and herbal remedies to: (a) not include structure/function claims that are not supported by evidence from robust human studies; (b) not contain prohibited

disease claims.; (c) eliminate “proprietary blends” and list and accurately quantify all ingredients contained in the product; (d) require advisory statements regarding potential supplement-drug and supplement-laboratory interactions and risks associated with overuse and special populations; and (e) include accurate and useful disclosure of ingredient measurement.

(11) The OSMA encourages the AMA to support the FDA's regulation and enforcement of labeling violations and FTC's regulation and enforcement of advertisement violations of prohibited disease claims made on dietary supplements and herbal remedies.

(12) The OSMA urges that in order to protect the public, manufacturers be required to investigate and obtain data under conditions of normal use on adverse effects, contraindications, and possible drug interactions, and that such information be included on the label.

(13) The OSMA will continue its efforts to educate patients and physicians about the risks associated with the use of dietary supplements and herbal remedies and supports efforts to increase patient, healthcare practitioner, and retailer awareness of resources to help patients select quality supplements, including educational efforts to build label literacy.

---

Policy 29-2021 – Cash for Diabetic Test Strips

1. The OSMA continues to support efforts banning the resale of diabetic testing supplies provided by Medicare and Medicaid.
2. The OSMA, in a continued effort to reduce healthcare costs, waste and overprescribing recommends complete banning of the resale of diabetic testing supplies from both government and private insurance plans.

---

Policy 28-2021 - Acknowledging and Supporting Research Involving Schedule I Drugs

1. The OSMA supports efforts enabling clinical research on schedule I drugs to help elicit possible medical benefit.

---

Policy 25-2021 – Recognizing Durable Mobility Equipment in Ohio State Medical Association (OSMA) Advocacy

1. The OSMA formally recognizes durable mobility equipment (DMoE) as an essential part of patient care and includes DMoE in its existing policies including but not limited to those which pertain to medical necessity, cost reduction, increasing coverage and disability.

---

Policy 23-2021 – OSMA Letter of Support for Full Resident Access to OARRS

1. The OSMA is directed to write a letter of intent to the Ohio Board of Pharmacy recommending that MD/DO Physicians in Training be granted direct access to OARRS.
2. The OSMA recommends that, as a matter of public safety and in the name of waste reduction, any prescriber in Ohio, regardless of DEA-registration status, be eligible to register with OARRS. 

---

Policy 25-2020 – Co-Pay Accumulators

1. The OSMA takes legislative actions to mandate that the value of any vouchers provided to patients by pharmaceutical and durable medical equipment companies and submitted by patients, be counted towards patient’s deductibles or out of pocket maximum (Co-Pay Accumulators).

---

Policy 16-2020 – Strengthen Awareness of the Importance of Good-Faith Prescription Donations to the Ohio Drug Donation Repository and the Free Clinics It Serves

1. The OSMA supports efforts to increase public and private sector awareness of the importance of good-faith prescription donation to the Ohio Drug Donation Repository Program, and the free clinics it serves.

---

Policy 13-2018 – Support of Competitive, Transparent Pricing Models by Pharmacy Benefit Managers

1. The OSMA supports competitive, transparent drug pricing by Pharmacy Benefit Managers.

---

Policy 12-2018 – Dietary Supplements (rescinded and replaced by Policy 31–2021)

---

Policy 11-2018 – On-Line Controlled Drugs

1. The OSMA encourage the American Medical Association to work to change the laws to help the Drug Enforcement Administration and the Food and Drug Administration to better regulate and control the online sales and distribution of controlled substances that lack a valid prescription.

---

Policy 10-2018 – Terminal Distributor License

1. Physician practices are and must remain under the authority of the State Medical Board of Ohio and never under the Ohio Board of Pharmacy.
2. The OSMA is opposed to the requirement in the Ohio Revised Code requiring physicians to obtain the Category II License for the Terminal Distributor of Dangerous and will actively lobby for its elimination.

---

Policy 28-2017 – OSMA to Lobby to Amend the Ohio Revised Code to Read that The Ohio State Board of Pharmacy Will Regulate the Compounding by Pharmacists of Dangerous Drugs, but Not Such Compounding by Licensed Physicians

1. The OSMA will lobby to amend the Ohio Revised Code to read that The Ohio State Board of Pharmacy may regulate compounding of dangerous drugs by pharmacists, but not such compounding by licensed physicians.

---

Policy 24-2017 – Advocating for Needle Exchange Programs

1. The OSMA shall advocate for the adoption of standardized and holistic needle exchange programs in Ohio, particularly in underserved areas.
2. The OSMA shall advocate for educational programs regarding the safe disposal of used needles and syringes.
3. The OSMA encourages physicians to refer their patients to Needle Exchange Programs.

---

Policy 20-2017 – Ohio Physicians and the Opioid Problem

1. That it is the Official Policy of the OSMA that all physicians should have the ability to prescribe all medications, including controlled substances, using the highest standards of care and professionalism, providing the best possible care to each patient. All physicians should work diligently to help find solutions to the problems of abuse of prescription medications, use and overdose of illegal substances, and opioid overdose. Physicians acknowledge that substance abuse has many factors and that physicians have contributed to overuse of opioids. However, other causes of misuse of controlled substances should be the significant focus of remedial action.

---

Policy 19-2017 – Opioid Harm Reduction in Undergraduate Medical Education

1. The OSMA shall support inclusion of harm reduction strategies in pain management, including, but not limited to, prescribing and discontinuation of opioid medications in medical school curricula.

---

Policy 09-2017 – Change OARRS requirements for Medications Which Can Be Prescribed with Refills for 6 Months

1. The OSMA shall work on decreasing the requirement for physicians to check OARRS every 90 days to every 6 months for benzodiazepines.

---

Policy 26-2016 – AMA to Ensure Adequate and Reasonably-Priced Generic Drugs

1. The OSMA requests that the American Medical Association consider all options for reasonably priced generic drugs

---

Policy 19-2016 – Weight Loss Medications - Phentermine

1. The OSMA shall request that the State Medical Board of Ohio review Ohio Administrative Code Rule 4731-11-04 in order to update and simplify the process of prescribing weight loss medications.
2. The OSMA advocates that the 12-week limitation for prescriptions of phentermine be modified to allow for prescription by qualified physicians for the time necessary to treat the chronic medical condition of obesity.

---

Policy 13-2016 – Insurance Coverage of Non-Narcotic Treatments Used in Pain Management

1. The OSMA shall work with the insurance companies and the Ohio Department of Insurance to stress the need for the cooperation of the insurance companies in physicians’ efforts to treat chronic pain with appropriate medications and all appropriate treatment modalities.
2. The OSMA shall encourage reasonable insurance coverage with affordable patient out-of-pocket costs for non-narcotic treatments that are useful in pain management.
3. The OSMA will support our physician members and stress that the current drug problem is a multifactorial problem not exclusively due to improper prescribing by physicians.

---

Policy 07-2016 – Cannabinoids

1. The OSMA opposes recreational use of cannabis.
2. The OSMA supports Institutional Review Board (IRB) approved clinical research to explore the potential risks versus benefits of using cannabinoids to treat specific medical conditions.
3. The OSMA supports focused and controlled medical use of pharmaceutical grade cannabinoids for treatment of those conditions which have been evaluated through Institutional Review Board (IRB) approved clinical research studies and have been shown to be efficacious.
4. The OSMA recommends that marijuana’s status as a federal Schedule I controlled substance be reviewed with the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines and alternate delivery methods.
5. The OSMA supports limiting cannabinoids prescribing rights, if permitted, to physicians (MDs and DOs).
6. The OSMA opposes legalization of any presently illegal drugs of substance abuse including, but not limited to, cannabis and cocaine, except in the instance of appropriate evidence-based use approved by the FDA.
7. The OSMA encourages physician participation in future legislative and regulatory discussions regarding the legal use of cannabinoids.
8. This policy replaces OSMA Policy 65-1991 (DELETED FROM POLICY COMPENDIUM).

---

Policy 07-2015 – Electronic Prescribing of Controlled Substances

1. The OSMA shall work with the Ohio State Board of Pharmacy and other interested parties to facilitate transmission of electronic prescriptions directly to pharmacies for controlled substances.

---

Policy 15-2014 – Medication Coverage

1. The OSMA encourages third party payers to provide free real-time electronic information to physicians about medication coverage and required co-pays so that physicians and patients can determine the best medication treatments as appropriate and affordable at the time of service. 

---

Policy 12-2012 – Pharmacy Scope of Practice

1. The OSMA shall work with the Ohio State Board of Pharmacy to require that a disclosure be made to the prescribing physician and to the patient if a medication is changed from what is ordered by the physician and how it differs, if it is not a generic equivalent.

---

Policy 03-2011 – Legislation to Compel Health Insurance Companies to Approve Dispensing Medically Appropriate Quantities of Formulary Medications

1. The OSMA encourages the development and support of state legislation to require health insurance companies offering pharmacy benefits to cover medication on their formulary at the dose prescribed by an appropriately licensed clinician at a quantity deemed medically appropriate.
2. Ohio legislation shall not permit health insurance companies to bill policyholders more than a single co-pay per month for the same medication, dose, and strength prescribed for that 30-day period by their clinician.
3. The OSMA requests that our AMA work with other state medical societies and with national health insurance companies to approve dispensing medically appropriate quantities of formulary medications.

---

Policy 04-2011 – Evaluation of the Expanding Scope of Pharmacists’ Practice and Interference of Pharmacy Benefit Managers in the Practice of Medicine

1. The OSMA shall evaluate and develop new policy addressing the expanding scope of practice of pharmacists in the practice of medicine.
2. The OSMA shall evaluate and develop policy addressing the interference of pharmacy benefit managers in the practice of medicine.

---

Policy 15-2010 – Support for Physicians to Submit Claims and Prescribe by Any Medium

1. The OSMA supports the physician’s ability to submit claims directly to payers, by mailing paper claims.
2. The OSMA opposes payers mandating physicians bear the costs associated with payer sponsored clearinghouses or intermediaries.
3. The OSMA supports physicians’ ability to continue prescribing via paper or phone, without being subjected to mandatory e-prescribing.

---

Policy 17-2008 – OARRS (Ohio Automated Rx Reporting System)

1. The OSMA shall work with the Ohio State Board of Pharmacy to further enhance and simplify OARRS (Ohio Automated Rx Reporting System) for the benefit of our physicians and patients.
2. The OSMA supports ongoing state funding for OARRS (Ohio Automated Rx Reporting System).

---

Policy 11-2007 – Compounding Pharmacies and “Bioidentical” Hormone Therapy

1. The OSMA adopts existing AMA policy on bioidentical hormone therapy (D-120.969).

---

Policy 16-2000 – Opposition to Mandatory Pill Splitting

1. The OSMA opposes mandatory policies requiring patients to cut or break pills. 

---

Policy 11-1998 – Prescription Equity for Contraceptives

1. The OSMA supports efforts to ensure that, notwithstanding any provision of law to the contrary, each employer group health policy, contract, plan or agreement issued or renewed in the state of Ohio that provides prescription drug coverage, shall provide coverage for any FDA-approved prescriptive contraceptive drug or device, nor shall they impose any unusual co-payment, charge or waiting requirement for such drug or device.

---

Policy 26-1992 – Long-Term Prescriptions

1. The OSMA encourages insurance companies and other third-party payers to inform their policyholders, enrollees, or beneficiaries that long-term prescribing may not be appropriate for some medical conditions and is solely at the discretion of the prescribing physician.

---

Policy 43-1990 – Prohibiting Therapeutic Substitution in Ohio

1. The OSMA opposes therapeutic substitution (the process by which a pharmacist replaces a drug prescribed for a given patient with a different chemical compound from the same drug category without the prior consent of the prescribing physician). 

---

Policy 52-1989 – Education Regarding Prescribing Controlled Substances

1. The OSMA in cooperation with appropriate agencies develops and makes available educational programs and information to ensure proper prescribing and dispensing of controlled substances.

---

Policy 60-1989 – Anabolic Steroids

1. The OSMA opposes prescribing, dispensing or sale of anabolic steroids for improving athletic performance. 

---

Policy 45-1985 – Generic Drugs

1. The OSMA supports the prescribing of generic drugs for their patients whenever it is deemed by a physician that a biologically equivalent generic is available.

---

Policy 31-1983 – Drug Availability

1. Every patient should have available any drug approved by the FDA that his or her physician thinks is needed and helpful.
2. The FDA-approved drugs should be reimbursed by third party payers.

---

Policy 18-1983 – Prescription Abuse

1. The OSMA intensifies its efforts at educating its members regarding prescription abuse, and in the ways in which physicians can reduce the opportunities for misuse of prescriptions.
2. The OSMA continues and increases its cooperation with other agencies and organizations in monitoring prescription abuse, and in developing solutions to the problem of prescription abuse.

Policy 10-2021 – Physician Communications in the Media

1. The OSMA adopts the following AMA Code of Medical Ethics Opinion 8.1.2:

Physicians who participate in the media can offer effective and accessible medical perspectives leading to a healthier and better informed society. However, ethical challenges present themselves when the worlds of medicine, journalism, and entertainment intersect. In the context of the media marketplace, understanding the role as a physician being distinct from a journalist, commentator, or media personality is imperative.

Physicians involved in the media environment should be aware of their ethical obligations to patients, the public, and the medical profession; and that their conduct can affect their medical colleagues, other health care professionals, as well as institutions with which they are affiliated. They should also recognize that members of the audience might not understand the unidirectional nature of the relationship and might think of themselves as patients. Physicians should:

1. A) always remember that they are physicians first and foremost, and must uphold the values, norms, and integrity of the medical profession.
2. B) encourage audience members to seek out qualified physicians to address the unique questions and concerns they have about their respective care when providing general medical advice.
3. C) be aware of how their medical training, qualifications, experience, and advice are being used by media forums and how this information is being communicated to the viewing public.
4. D) understand that as physicians, they will be taken as authorities when they engage with the media and therefore should ensure that the medical information they provide is:
5. I) accurate
6. Ii) inclusive of known risks and benefits
7. Iii) commensurate with their medical expertise
8. Iv) based on valid scientific evidence and insight gained from professional experience
9. E) confine their medical advice to their area(s) of expertise, and should clearly distinguish the limits of their medical knowledge where appropriate.
10. F) refrain from making clinical diagnoses about individuals (e.g., public officials, celebrities, persons in the news) they have not had the opportunity to personally examine.
11. G) protect patient privacy and confidentiality by refraining from the discussion of identifiable information, unless given specific permission by the patient to do so.
12. H) fully disclose any conflicts of interest and avoid situations that may lead to potential conflicts.

---

Policy 10-2016 – Preventing Harassment of Physicians

1. The OSMA opposes attempts to deter or intimidate physicians who practice in accordance with their conscience and consistent with the AMA Code of Medical Ethics.

---

Policy 48-1994 – Preservation of the Physician's Role as Patient Advocate

1. The OSMA supports physician freedom to act as the patient's advocate. The physician must be able to advise his or her patients to seek any potentially meaningful medical treatment, independently of whether the physician will thereby benefit or lose financially.

---

Policy 57-1993 – Preservation of Patient/Physician Relationship and Role of Physician as Patient Advocate

1. The OSMA reaffirms the principles embodied in the Hippocratic Oath and Code of Medical Ethics that the physician sustains his/her role of patient advocate.

---

Policy 75-1993 – Biomedical Research

1. The OSMA is committed to the humane treatment of animals used in biomedical research and the pursuit of alternative methods of research when appropriate.

---

Policy 19-1991 – Quality of Life Issues Considered in Life Prolonging Therapy

1. The OSMA reaffirms the physician's primary role in guiding the patient, family and other members of the health care team to consider both the quality of life, as well as the longevity of life, when making medical treatment decisions.

---

Policy 35-1987 – OSMA Policy on Advertising

1. The OSMA encourages its members who wish to market their services to adopt marketing practices:

1) which are not false, fraudulent, deceptive or misleading; and

2) which are designed to give the public adequate information regarding the nature and scope of the various medical specialties to permit individuals to make informed choices regarding their selection of physicians.

---

Policy 8-1985 – Unethical Aspects of Certain Medical Care Plans

1. The OSMA’s position is that it is unethical for an attending physician for personal financial gain to withhold appropriate medical care services from his patient and, further, that referral of a patient by an attending physician to a consultant should be based on the consultant's individual competence and ability to perform the services needed by the patient. 

---

Policy 36-1984 – Physician Criticism of Colleagues

1. The OSMA encourages all physicians to make a sincere and conscientious effort to be constructive and positive in criticism of their peers.

---

Policy 37-1984 – Hospital Ethics Committees

1. The OSMA supports hospital ethics committees, which should include representation from both the medical staff and non-medical fields.

---

Policy 43-1983 – Sexual Harassment

1. The OSMA encourages its members to work toward the eradication of sexual harassment where it exists in their institutions and offices, and in all other workplaces. 

---

Policy 01-2022 – Create Guidelines for Sections and Create an International Medical Graduate Section

The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2022 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 02-2022 – Change the Ratio of Representation for Medical Specialties in the House of Delegates

The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2021 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 03-2022 – Meeting Code of Conduct

OSMA adopts the following Meeting Code of Conduct:

Policy 03-2020 of the Ohio State Medical Association (OSMA) directs all attendees of OSMA hosted or sponsored meetings, events and other activities to exhibit respectful, professional, and collegial behavior during such meetings, events and activities, including but not limited to dinners, receptions and social gatherings held in conjunction with such OSMA hosted or sponsored meetings, events and other activities. Attendees should exercise consideration and respect in their speech and actions, including while making formal presentations to other attendees, and should be mindful of their surroundings and fellow participants and should disclose any conflicts of interest related to an issue under consideration.

Any type of harassment of any attendee of an OSMA hosted sponsored meeting, event or other activity, including but not limited to dinners, receptions and social gatherings held in conjunction with an OSMA hosted meeting, event or activity, is prohibited conduct and is not tolerated. The OSMA is committed to a zero tolerance policy for harassing conduct at all locations where OSMA business is conducted. This zero tolerance policy also applies to meetings of all OSMA sections, committees, and task forces. The purpose of the policy is to protect participants from harm.

Harassment

Harassment consists of unwelcome conduct whether verbal, written, physical or visual that denigrates or shows hostility or aversion toward an individual because of his/her race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, citizenship or otherwise, and that: (1) has the purpose or effect of creating an intimidating, hostile or offensive environment; (2) has the purpose or effect of interfering with an individual’s participation in meetings or proceedings of the HOD or any OSMA hosted or sponsored event; or (3) otherwise adversely affects an individual’s participation in such meetings or proceedings.

Harassing conduct includes, but is not limited to: epithets, slurs or negative stereotyping; threatening, intimidating or hostile acts; denigrating jokes; and written, electronic, or graphic material that denigrates or shows hostility or aversion toward an individual or group and that is placed at the site of any OSMA meeting or circulated in connection with any OSMA meeting.

Sexual Harassment

Sexual harassment also constitutes discrimination, and is unlawful and is absolutely prohibited. For the purposes of this policy, sexual harassment includes: 1. making unwelcome sexual advances or requests for sexual favors or other verbal, written, physical, or visual conduct of a sexual nature; and 2. creating an intimidating, hostile or offensive environment or otherwise interfering with an individual’s participation in meetings or proceedings of the HOD or any OSMA hosted or sponsored meeting.

Sexual harassment may include, but is not limited to, such conduct as explicit sexual propositions, sexual innuendo, suggestive comments or gestures, descriptive comments about an individual’s physical appearance, electronic stalking or lewd messages, displays of foul or obscene printed or visual material, and any unwelcome physical contact.

Complaint process

Any attendee or participant in an OSMA hosted or sponsored event who believes they have experienced or witnessed a violation of this policy may file a complaint with the OSMA Council, the OSMA President, President-Elect, or Past President or the OSMA Chief Executive Officer who shall inform the Council. All complaints brought under this policy will be promptly and thoroughly investigated. To the fullest extent possible, the OSMA will keep complaints and the terms of their resolution confidential.

The Council may investigate, conduct a hearing and decide the matter, or refer the matter to an internal committee appointed by the President or to an external entity qualified to investigate and recommend to the OSMA Council a resolution of the matter. If the complaint implicates a member of the OSMA Council, the complaint shall be referred to a committee of Past Presidents assigned by the OSMA President on an ad hoc basis or to an external entity qualified to investigate and recommend to the Council a resolution of the matter. 

Retaliation against anyone who has reported harassment, submits a complaint, reports an incident witnessed, or participates in any way in the investigation of a harassment claim is forbidden and shall be investigated in the same manner as outlined for complaints. 

Related documents:

• OSMA Council Conflict of Interest Policy (requires annual signed disclosure statements)
• OSMA AMA Delegation Conflicts of Interest Policy
• OSMA’s Human Resources Policies: 
• Conflict of Interest Policy (requires annual signed disclosure statements)
• Harassment Prevention Policy
• Social Media Policy. 

---

Policy 04-2022 – Establish an Ohio State Medical Association Women Physicians Section

1. The OSMA will form a section of the OSMA known as the OSMA Women Physicians Section.

2. That appropriate Bylaws changes be accomplished to establish the OSMA Women Physicians Section. 
   
   

---

Policy 05-2022 – Establish an Ohio State Medical Association Senior Physician Section

1. The OSMA will form a Section of the OSMA known as the OSMA Senior Physicians Section, to include all members age 65 and above, either active or retired.
2. That appropriate Bylaws changes to establish the Senior Physicians Section be accomplished.

---

Policy 06-2022 – OSMA Focused Task Force on Pandemic Preparedness and Response    

1. The OSMA will create the Focused Task Force (FTF) on Pandemic Preparedness and Response to ensure that the organization is prepared to collaborate with other public and private bodies on the preparedness for and response to potential future pandemics.
2. The Focused Task Force (FTF) on Pandemic Preparedness and Response shall, be appointed by the OSMA President to include OSMA members from a variety of specialties and geographic areas of the state, but with a majority of the FTF members being those with special expertise in immunology/infectious diseases, public health, emergency medicine, critical care, primary care, those caring for vulnerable populations (as defined by federal regulations), emergency preparedness, public policy and other areas of emphasis critical to the assessment and implementation of pandemic preparedness and response initiatives.
3. The Focused Task Force (FTF) on Pandemic Preparedness and Response may invite non-OSMA member physicians and non-physicians with special expertise in pandemic preparedness and response to attend as non-voting participants in FTF meetings at the discretion of the FTF Chair.
4. The Focused Task Force (FTF) on Pandemic Preparedness and Response may provide recommendations to the OSMA Council and the OSMA House of Delegates regarding the following issues.

• Changes to local, state and federal public health measures to effectively prevent or reduce the impact of potential future pandemics.
• Changes to state or federal laws, regulations, administrative rules, and accreditation/certification standards to improve local, state or federal preparedness for and response to potential future pandemics.
• Changes to state or federal laws, regulations, administrative rules, and accreditation/certification standards to improve the ability of physicians, hospitals, and other healthcare entities to prepare for and maintain safe, high-quality, patient-centered, accessible, and equitable clinical practice/clinical operations during potential future pandemics.
• Local, regional and statewide efforts to improve the collaboration and coordination of clinical care in ambulatory, outpatient, inpatient, post-acute and other congregate care settings with regard to hospital capacity, nursing facility capacity, vaccination, prevention, and treatment of pandemic-related illnesses.
• Local, regional and statewide efforts to coordinate public and private entities to maintain the effective and equitable distribution of medical supplies, medications, and other scarce medical resources during potential future pandemics.
• Creation of effective networks and systems for the dissemination of accurate, evidence-based information related to preparedness for and response to potential future pandemics for physician practices, medical staffs, hospitals, nursing facilities, medical schools and GME training programs as well as the general public.
• Enhancements to CME programs related to pandemic preparedness and response.
• Programs to effectively provide professional and behavioral health support for physicians and other frontline healthcare personnel during potential future pandemics.
• Changes in the OSMA constitution, bylaws, policies and procedures to effectively maintain the operations of the organization during potential future pandemics.

---

Policy 00-2021 – 2021 OSMA Policy Sunset Report

The OSMA House of Delegates adopted the 2021 OSMA Policy Sunset Report

---

Policy 01-2021 – Constitution and Bylaws – updates and corrections

The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2021 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 02-2021 – House of Delegates Ratio of Representation

The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2021 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org. 

---

Policy 03-2021 – OSMA elections

The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2021 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 04-2021 – Constitution and Bylaws changes – membership category updates

The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2021 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 12-2021 – OSMA to Create an IMG (International Medical Graduate) Section

1. The OSMA will create a separate International Medical Graduate (IMG) Section.

---

Policy 01-2020 – OSMA Elections - Corrections

1. The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2020 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 03-2020 – Meeting Code of Conduct

1. It is the policy of the Ohio State Medical Association that all attendees of OSMA hosted meetings, events and other activities are expected to exhibit respectful, professional, and collegial behavior during such meetings, events and activities, including but not limited to dinners, receptions and social gatherings held in conjunction with such OSMA hosted meetings, events and other activities. Attendees should exercise consideration and respect in their speech and actions, including while making formal presentations to other attendees, and should be mindful of their surroundings and fellow participants.
2. The OSMA will further define inappropriate conduct and develop policy and procedures regarding this issue so that recommendations can be presented to the House of Delegates.

---

Policy 01-2019 – Membership Participation Rights

1. The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2019 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 02-2019 – OSMA Elections

1. The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2019 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 03-2019 – Increase Specialty Participation in the HOD

1. The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2019 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 01-2018 – Constitution and Bylaws Amendments

1. The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2018 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 02-2018 – Young Physicians

1. Policy 02 – 2018 created a Young Physicians Section. The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2018 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 04-2018 – Policy Finder and Bylaws

1. The OSMA maintain an up-to-date OSMA policy database, preferable in a searchable format, readily available on its website at all times.
2. That the OSMA maintain a readily accessible copy of our current Constitution and Bylaws available on its website at all time.

---

---

Policy 14-2017 – Maintain Rights of County Medical Societies

1. The OSMA will recognize and respect the independent structure, organization and domain of the actively functioning county medical societies in the state of Ohio.
2. The rights of the county medical societies to appoint their representatives to serve in the OSMA House of Delegates shall be preserved.

---

Policy 15-2017 – Maintain the House of Delegates as the Legislative Body of the OSMA

1. The OSMA House of Delegates shall remain in place as the legislative body of the OSMA, retaining all rights, privileges and authority as are now set forth in the OSMA Constitution and Bylaws.

 

---

Policy 16-2017 – Limit the OSMA Council’s Attempts to Dissolve the House of Delegates

1. The OSMA Council shall propose no action to dissolve the OSMA House of Delegates absent specific direction from the House of Delegates.

---

Policy 01-2016 – Membership List Exchange

1. The OSMA replaces Policy 09 - 2015 and 10 - 2015 (DELETED FROM POLICY COMPENDIUM) with the following: The OSMA and County Medical Societies shall exchange membership lists twice per year on or around March 31 and September 30.

---

Policy 03-2016 – Disclosure to OSMA Members

1. The officers of the OSMA and its executive staff shall make a full report to all OSMA Delegates within 30 days of the conclusion of each annual House of Delegates detailing the real estate transactions, finances and staffing levels of OSMA for the last three years.
2. Delegates are encouraged to share OSMA financial information with OSMA members in their jurisdiction.

---

Policy 04-2016 – OSMA Annual Meeting Schedule

1. The time for the business sessions of the Annual Meeting of the OSMA House of Delegates shall revert to being scheduled to take place on Saturday-Sunday, beginning Saturday morning and carried through as long as necessary on Sunday of the weekend selected for the OSMA Annual Meeting to allow for the appropriate conduct of all business as has historically been scheduled to occur at the OSMA Annual Meeting of the House of Delegates
2. Time will be allotted at the OSMA Annual Meeting for geographic caucus meetings to review the report(s) of the Policy Committee(s) before voting on the items in the report.

---

Policy 11-2015 – OSMA Annual Meeting Attendance

1. All members of the OSMA shall be invited to attend each annual meeting.
2. Members of the OSMA shall be seated with, and encouraged to participate in, their residential or practice regional caucus.

---

Policy 12-2015 – OSMA Annual Meeting Costs

1. The OSMA Council shall consider ways of making our House of Delegates meeting more efficient while allowing adequate time for deliberation and debate.
2. The OSMA shall seek a less expensive meeting venue.
3. The meeting venue chosen will be near a group of hotels for those who wish to stay in Columbus the night before or after.

---

Policy 13-2015 – Retiring OSMA Members

1. The OSMA shall create a packet of helpful information and referrals as a resource for retiring members.
2. The OSMA shall create and support a forum for retired members to meet, communicate, and perhaps grow into a meaningful organized group of wise, enthusiastic, resourceful physicians for their own benefit and that of their communities.

---

Policy 21-2015 – Evidence Based Organized Medicine

1. This OSMA organizational quality improvement committee is charged with identifying measures of success by which we can judge the impact of changes.
2. All members of the OSMA shall be invited to attend and participate in House of Delegates deliberations.
3. The OSMA shall proceed with changes to minimize the cost of the OSMA annual House of Delegates meeting.

---

Policy 24-2015 – Continue OSMA House of Delegates Annual Meeting

1. The OSMA shall continue with an annual meeting including a House of Delegates for policy making with Delegates representing county medical societies and state specialty societies to guide the direction of the organization and establish policy.
2. The OSMA staff shall investigates other venues for the OSMA annual meeting with the goal of decreasing costs.

---

---

Policy 12-1998 – Transmittal of OSMA Policies to the AMA

1. The Ohio Delegation to the AMA may submit and/or co-sponsor policies to the AMA, with approval of Council, only if the timing reasonably precludes OSMA House of Delegates approval and provided no provision of such policy/policies advocate(s) a position contrary to current OSMA House of Delegates policy. In all instances where such a policy is to be submitted or co-sponsored, that action must be approved by the OSMA Council and reported to the OSMA House of Delegates at the next meeting of the full House.

---

Policy 13-1998 – Sponsorship of AMA Policies

1. The Ohio Delegation to the AMA be entrusted to revise (without change of essential substance) when necessary the policy/policies forwarded to the AMA with the intent of crafting each policy to optimally promote its intent at the AMA.
2. The Ohio Delegation to the AMA, unless specifically instructed otherwise, be permitted to hold, when deemed advisable, a policy until the AMA Interim meeting in order to allow a more thoughtful and appropriate revision and to allow gathering and submission of pertinent supporting documentation.

---

Policy 13-1997 – OSMA Conflict of Interest Policy

1. The OSMA utilizes a conflict of interest policy that will pertain to all members of OSMA Council, elected officers of OSMA and AMA delegates.
2. The OSMA utilizes an appropriate disclosure of potential conflicts of interest statement to be filed by all members of OSMA Council and candidates for office in the OSMA or AMA delegation.

---

Policy 41-1994 – OSMA Reporting Practices

1. The OSMA provides members of the House of Delegates and separate county societies/districts with a report on actions referred to Council at the previous OSMA meeting 90 days prior to the opening of the House of Delegates.

---

Policy 44-1991 – Women in Medicine

1. The House of Delegates recognizes and supports women members of this association in their efforts to participate at the operational levels in the formulation of policy for all OSMA programs and projects. 

---

Policy 20-1989 – Encouragement of OSMAPAC Membership

1. The OSMA encourages all OSMA delegates and alternate delegates to be members of OSMAPAC.

---

Policy 32-1988 – Young Physicians as Delegates and Alternate Delegates

1. The OSMA urges each of its county medical societies to encourage and select qualified young physicians to serve as delegates or alternate delegates to the OSMA as a means of getting these physicians more involved in the process which will affect their future and the future of all physicians.

---

Policy 9-1982 – Parliamentarian

1. The OSMA will provide an accomplished and competent parliamentarian to insure orderly procedure for each session of the House of Delegates.

---

Policy 51-1980 – Reaffirmation of Existing Policy

1. The House of Delegates of OSMA allows Policy Committees to submit all policies for reaffirmation of existing policy to the House under a separate category similar to the Consent Calendar and entitled, "Reaffirmation of Existing Policy."

---

Policy 37-1980 – Participation in Organized Medicine

1. We preserve the present federation system of County Society, State Association and the AMA, maintaining direct representation from local grass roots to the national forum.
2. Our elected leaders in these organizations will act in ways not only to inspire more participation by their members, but also to encourage nonmembers to be proud to join together in each level of representation.
3. Each of us as individual members of these organizations will undertake a more positive role in encouraging our nonmember peers to join us in the collective effort to preserve the free enterprise, privately responsible practice of medicine.

---

Policy 17-1979 – Consent Calendar

1. The OSMA adopts the House procedure rule called a Consent Calendar for use by its Policy Committees.
2. This Consent Calendar will be placed at the beginning of a Policy Committee Report for approval as a group.
3. Any delegate may request that a policy or policies on the Consent Calendar be removed and be considered separately prior to the vote for the policies on the Consent Calendar.

---

Policy 21- 1979 – Reduction of Dues for Physicians in Their First Year of Practice

1. OSMA dues for Active Members will be reduced by 50% for one year for physicians in their first year of practice after training is completed.

---

Policy 16-1976 – Official Representative of Organized Medicine

1. The OSMA reaffirms its position that the most effective representation of organized medicine, as well as of the individual physician, is through a strong relationship of the AMA, the State Medical Societies and their component societies.

Policy 14-2022 – Eliminating Parking Costs for Patients

1. The Ohio State Medical Association will work with relevant stakeholders to recognize parking fees as a burden of care for patients and to implement mechanisms for eliminating parking costs.

---

Policy 23-2020 – Government Pay for Government Mandates

1. The OSMA advocates for policies that allow for physician judgment and documented medical decision-making to supersede government regulation – including the utilization of Augmented Intelligence – in instances of disputes in patient care.
2. The OSMA advocates for policies that require “proof of concept,” in the form of independently demonstrated quality improvement, prior to the implementation of any government, insurance company or other third party mandate or regulation on patient care and the physician-patient relationship.
3. The OSMA advocates for policies requiring government, insurance company or other third party entities to fully fund any mandates or regulations imposed on patient care and the physician-patient relationship.
4. The OSMA delegation to our AMA will write a resolution for A-20 asking our AMA to advocate for similar policies

---

Policy 16-2019 – OSMA Support of Direct Primary Care

1. The OSMA shall provide a written description of the Direct Primary Care model to physicians and medical students for the purpose of educating on alternative practice models.

---

Policy 01-2017 was reaffirmed at the 2019 OSMA House of Delegates.

---

Policy 01-2017 – Supporting Changes in Health Care Policy that Increase Coverage and Expand Benefits

1. The OSMA supports the elimination of pre-existing condition exclusions from health insurance contracts and supports providing all Ohio citizens with high quality health care.
2. The OSMA opposes changes to healthcare policy that would decrease access to health care coverage for the citizens of Ohio.
3. The OSMA supports the inclusion of young adults up to age 26 on their parents’/guardians’ health care plans.
4. The OSMA supports health care policies that allow states and institutions the right to explore and develop individualized models for covering the uninsured.

---

Policy 11-2010 – Promoting Free Market-Based Solutions to Health Care Reform

1. The OSMA promotes free market based solutions to improve access and cost effectiveness of health care delivery in the United States.

---

Policy 3-2005 – Health Care Costs

1. The OSMA continues to work with the AMA to identify and promote policies and encourage individual ownership of health insurance, including exploring the feasibility of income-based refundable federal and state tax credits to encourage Ohioans to purchase health insurance.
2. The OSMA works to identify and enact changes in Ohio law that would provide for the favorable treatment of Health Savings Accounts.
3. The OSMA works to ensure that any proposal designed to provide patients with health care quality and cost information pertaining to individual physicians, physician group practices, or hospitals includes data that is standardized, accurate, complete, easily understandable and appropriately risk adjusted.
4. The OSMA asks the AMA to work with the American Hospital Association and other interested parties to develop national standards for public reporting of health care quality and cost data pertaining to individual physicians, physician group practices, and hospitals.
5. The OSMA monitors any legislation designed to increase access to health insurance coverage and promote patient choice. 

---

Policy 74-1994 – Application of Health Plans to Elected Officials/Government Employees

1. Any health-care reform plan which excludes federal, state and local elected officials and federal, state and local employees and retirees is not acceptable to the OSMA.

---

Policy 63-1994 was reaffirmed at the 2019 OSMA House of Delegates. 

---

Policy 63-1994 – Health-System Reform

1. The OSMA supports only those proposed changes in our health-care system that are in the best interest of patients and which assure that all Americans continue to receive high quality medical care.
2. The OSMA supports the following principles: (1) All Americans shall have access to health insurance; (2) The right of patients to choose their physician freely; (3) The right of patients and their physicians to make medical decisions.
3. The OSMA supports the elimination of underwriting requirements which interfere with the establishment of small business pools.
4. The OSMA supports the elimination of pre-existing condition exclusions from health insurance contracts.
5. The OSMA supports guaranteed portability of health insurance.
6. The OSMA supports, for the medically indigent, the adoption of health insurance vouchers and/or tax credits as one of the mechanisms of providing them health-care coverage.
7. The OSMA supports both Medical Savings Accounts and Medical IRAs as acceptable methods to fund health care.
8. The OSMA supports legislative health-care plans which include fee-for-service as a method of payment for physician services.
9. The OSMA supports the position that free competition and meaningful medical professional liability reform are the more effective ways to contain health-care costs rather than global budgets and spending caps.

---

Policy 34-1993 – Health-Care Reform II

1. The confidential relationship between the physician and patient must be preserved throughout the quality assurance process.
2. The OSMA supports reform of health care to encourage making utilization review in health care standardized and objective.
3. The OSMA supports efforts to require third parties to publish their criteria for utilization review for hospitals and physicians so that these criteria may be reviewed for their validity and appropriateness not only for utilization review purposes, but also to ensure that they further the goal of quality patient care.
4. The OSMA supports efforts to make the appeals process for denials of payment independent of the payer so that the inherent conflict of interest in the present process would be eliminated and dialogue and cooperation between physicians and payers would be encouraged.

Policy 8-1986 – Physician Reimbursement for Home Health Care

1. The OSMA supports equitable remuneration consistent with services rendered by physicians when treating patients at home.

Policy 12-2020 – Improving Preventive Medicine through the Decriminalization of HIV Status

1. The OSMA reaffirms Policy 41 – 1996 (More Routine HIV Testing) which recommends more routine HIV testing.
2. The OSMA supports modernizing Ohio’s laws regarding criminalization of non-disclosure of HIV status to better reflect advances in science and medicine and to remove stigmatization associated with diagnosis of HIV.
3. The OSMA opposes any Ohio state legislation that discriminates based on an individual’s HIV status.

---

Policy 41-1996 – More Routine HIV Testing

1. The OSMA recommends more routine HIV testing especially young sexually active people.

Policy 28-1993 – Testing for Treatable Inborn Errors of Metabolism

1. The OSMA supports the elimination of the religious exemption from testing for treatable inborn errors of metabolism which can result in mental retardation or other disability.

---

Policy 42-1985 – Eye Prophylaxis in Newborns for Gonorrhea

1. Eye prophylaxis for newborns should be continued in all cases including Caesarean section.

Policy 01-2022 – Create Guidelines for Sections and Create an International Medical Graduate Section

The OSMA Constitution and Bylaws were updated to incorporate the changes adopted by the 2022 OSMA House of Delegates. The current OSMA Constitution and Bylaws are available on www.osma.org.

---

Policy 12-2021 – OSMA to Create an IMG (International Medical Graduate) Section

1. The OSMA will create a separate International Medical Graduate (IMG) Section.

---

Policy 04-2020 – Parity for International Medical Graduates with US Medical Graduates in Years of GME Requirement for Licensure

1. The Ohio State Medical Association adopts a policy supporting parity in the number of years of training required in an ACGME accredited program for IMGs and USMGs to obtain state medical licensure.

---

Policy 32-1986 – Foreign Medical Graduates

1. The OSMA supports the rights and privileges of all physicians duly licensed in the State of Ohio regardless of ethnic or educational background.

---

Policy 25-1982 – The American Student in Foreign Medical Schools

1. The OSMA encourages the Ohio Board of Regents to develop standards for the conditions under which students to foreign medical schools function in medical student clinical clerkships offered by hospitals in the State of Ohio, which will be equivalent to those offered by medical schools in the United States, and which will clearly delineate the responsibilities of the supervising physicians for the actions of the student.
2. The OSMA encourages State Medical Boards to develop standards to assure that foreign medical graduates have received a medical school education substantially equivalent to that received in a U.S. medical school prior to their examination for licensure.

Policy 25-2022 –Support for Expansion of Anti-discrimination Definition to Include Sexual Orientation and Gender Identity or Expression

1. The OSMA supports legislative actions to extend the definition of discrimination on the basis of sex to include sexual orientation and gender identity or expression.
2. The OSMA reaffirms OSMA Policy 10-2016.

---

Policy 23-2022 – Prohibit Reversal of Prior Authorization

1. The Ohio State Medical Association (OSMA) supports legislation to prohibit retroactive denial of a previously approved medication, procedure, or test unless the patient is no longer insured by that company at the time of service.
2. The OSMA delegation to the AMA will take this topic regarding reversal of prior authorization to the AMA House of Delegates to advocate for this change as a part of their greater effort to eliminate prior authorization all together.

---

Policy 22-2022 – Medicare and Medicaid Reimbursement

1. The Ohio State Medical Association will seek to introduce legislation which will bring Ohio Medicaid reimbursement up to parity with Medicare reimbursements.
2. The Ohio delegation to our American Medical Association shall carry a resolution which calls for education of beneficiaries particularly in regard to the scope of benefit coverage within Medicare Advantage Plans.
3. The Ohio Delegation will bring to the AMA a resolution seeking an increase in Medicare reimbursement.

---

Policy 20-2022 – Appropriate Physician Reimbursement to Cover Rising Expenses of Office Practice 

1. The Ohio State Medical Association (OSMA) advocates that physician reimbursement for all activities be increased to cover the expenses of running an office practice.
2. The OSMA will work with our Ohio State Legislature and Ohio Congressional delegation to improve physician reimbursement.
3. The OSMA Delegation to the American Medical Association (AMA) shall take this resolution regarding improved physician reimbursement to the AMA House of Delegates for action.

---

Resolution 15-2022 – Opposing the Criminalization of Self-Managed Medication Abortion

1. The OSMA amends Policy 07-2020, Legislative or Regulatory Interference in the Practice of Medicine in the State of Ohio, by addition as follows:

Legislative or Regulatory Interference in the Practice of Medicine in the State of Ohio, OSMA Policy 07 – 2020

1. The OSMA actively works to ensure that the sanctity of the physician-patient relationship is protected in all legislative and regulatory matters.
2. Current OSMA Policy 18 - 2012 (Criminalization of Medical Care) is amended to read as follows:

The OSMA opposes any portion of proposed legislation or rule that criminalizes clinical practice that is the standard of care.

That current OSMA Policy 10 – 1990 (Policy on Abortion) be amended as follows:

1. It is the position of the OSMA that the issue of support of or opposition to abortion is a matter for members of the OSMA to decide individually, based on personal values or beliefs.
2. The OSMA shall take no action which may be construed as an attempt to alter or influence the personal views of individual physicians regarding abortion procedures.
3. Items 1 and 2 notwithstanding, the OSMA shall take a position of opposition to any proposed Ohio legislation or rule that would:

• Require or compel Ohio physicians to perform treatment actions, investigative tests, or questioning of a patient which are not consistent with the medical standard of care; or,
• Require or compel Ohio physicians to discuss treatment options that are not within the standard of care and/or omit discussion of treatment options that are within the standard of care.

---

Policy 09-2022 – Access to Standard Care for Nonviable Pregnancy

1. The Ohio State Medical Association (OSMA) supports patients’ timely access to standard treatment of nonviable pregnancy, including but not limited to miscarriage, molar pregnancy, and ectopic pregnancy, in both emergent and non-emergent circumstances.
2. The OSMA opposes any hospital directive, policy, or legislation that may hinder patients’ timely access to the accepted standard of care in both emergent and non-emergent cases of nonviable pregnancy.

---

Policy 17-2021 – Ban Enforcement of Restrictive Covenants When Physicians are not Rehired or are Terminated for Nonclinical or “No Cause” Reasons

1. The OSMA reaffirms policy 27-2017 Ban Restrictive Covenants for Physicians Employed by Hospitals in Ohio. “The OSMA shall lobby for state legislation to ban restrictive covenants in contracts between hospitals or hospital systems and their employed physicians in Ohio.”
2. Restrictive covenants should not be able to be enforced if a hospital or hospital system terminates a physician’s contract or does not renew a physician’s contract for “no cause.”
3. The OSMA will work with the AMA to educate residents in training and physicians about review of proposed contracts for unfair language including restrictive covenants with unreasonable mileage and time restrictions and “no cause” clauses.

---

Policy 16-2021 – Amend Policy 05—2011: Universal Health Insurance Access

1. The OSMA amends Policy 05—2011 to read:

---

Policy 05-2011 – Universal Health Insurance access

1. The OSMA reaffirms support for universal health insurance access through market and public based initiatives to create incentives for the purchase of coverage.
2. OSMA will continue to support legislative and regulatory reform to achieve universal health insurance access.

---

Policy 15-2021 – OSMA Lobbying for Revision on Payment for Out-of-Network Services

1. The OSMA reaffirms policy 19-2020 out-of-network billing.
2. The OSMA will work through the regulatory bodies on both the state and federal levels on implementation of out-of-network policies, and when appropriate advocate to align the policies to the extent possible with OSMA Policy 19-2020.
3. The OSMA will actively monitor implementation of out-of-network policies by the Ohio Department of Insurance and other regulatory bodies for their impact, with particular focus on potential deleterious effects they may have on Ohio physicians, by creating a working group comprised of OSMA staff and physician members from appropriate specialties that will perform no less than semi-annual reviews and analysis of the effects of the outcomes of the Ohio out-of-network law and recommend to OSMA Council if any legislative advocacy needs to be undertaken. In addition, the working group will evaluate the text of existing federal and state laws and make recommendations for further legislative advocacy.

---

Policy 14-2021 – Network Adequacy

1. The OSMA advocates for legislation to require health insurers to submit and make publicly available, at least quarterly, reports to state regulators that provide regional data on several measures of network adequacy, including the number and type of providers that have joined or left the network; the number and type of specialists and subspecialists that have left or joined the network; the number of physicians by specialty and subspecialty that are accepting new office- based patients, efforts made to provide an in-network panel of all specialists that reduce disparities of utilization, if present, among specialties providing out-of-network service; the number and types of providers who have filed an in network claim within the calendar year; total number of claims by provider type made on an out-of-network basis; data that indicate the provision of Essential Health Benefits; and consumer complaints received.
2. The OSMA advocates for legislation that develops a mechanism by which health insurance enrollees are able to file formal complaints about network adequacy with appropriate regulatory authorities.
3. The OSMA advocates for legislation that prohibits health insurers from falsely advertising that enrollees in their plans have access to physicians of their choosing if the health insurer's network is limited.
4. The OSMA advocates for legislation that requires health plans to document to regulators that they have met requisite standards of network adequacy including hospital-based physician specialties (i.e. radiology, pathology, emergency medicine, anesthesiologists and hospitalists) at in-network facilities, and ensure in-network adequacy is both timely and geographically accessible.
5. The OSMA advocates for legislation requiring that health insurers that terminate in-network providers for reasons other than immediate loss of licensure: (a) notify providers of pending termination at least 90 days prior to removal from network; (b) give to providers, at least 60 days prior to distribution, a copy of the health insurer’s letter notifying patients of the provider’s change in network status; and (c) allow the provider 30 days to respond to and contest if necessary the letter prior to its distribution.

---

Policy 25-2020 – Co-Pay Accumulators

1. The OSMA takes legislative actions to mandate that the value of any vouchers provided to patients by pharmaceutical and durable medical equipment companies and submitted by patients, be counted towards patient’s deductibles or out of pocket maximum (Co-Pay Accumulators).

---

---

Policy 19-2020 – Out-of-Network Billing

1. The OSMA rescinds Policy 19 – 2010 (Lifting the Restrictions on Balance Billing):
2. The OSMA supports repeal of regulations currently in place that prohibit balance billing for physicians.
3. The OSMA adopts its own policy similar to AMA policy H-285.904, to read as follows:

 

1. The OSMA adopts the following principles related to unanticipated out-of-network care:

 

    A. Patients must not be financially penalized for receiving unanticipated care                    from an out-of-network provider.

    B. Insurers must meet appropriate network adequacy standards that include                    adequate patient access to care, including access to hospital-based                              physician specialties. Ohio regulators should enforce such standards                            through active regulation of health insurance company plans.

   C. Insurers must be transparent and proactive in informing enrollees about                       all deductibles, copayments and other out-of-pocket costs that enrollees                       may incur.

   D. Prior to scheduled procedures, insurers must provide enrollees with reasonable            and timely access to in-network physicians.

   E. Patients who are seeking emergency care should be protected under the                    “prudent layperson” legal standard as established in state and federal law,                     without regard to prior authorization or retrospective denial for services after                 emergency care is rendered.

   F. Out-of-network payments must not be based on a contrived percentage of the             Medicare rate or rates determined by the insurance company.

   G. Minimum coverage standards for unanticipated out-of-network services should            be identified. Minimum coverage standards should pay out-of-network providers          at the usual and customary out-of-network charges for services, with the                      definition of usual and customary based upon a percentile of all out-of-network            charges for the particular health care service performed by a provider in the                same or similar specialty and provided in the same geographical area as                      reported by a benchmarking database. Such a benchmarking database must be          independently recognized and verifiable, completely transparent, independent of          the control of either payers or providers and maintained by a non-profit                        organization. The non-profit organization shall not be affiliated with an insurer, a          municipal cooperative health benefit plan or health management organization.

    H. Mediation and/or Independent Dispute Resolution (IDR) should be permitted in             all circumstances as an option or alternative to come to payment resolution                 between insurers and providers.

2. The OSMA will advocate for the principles delineated in this policy for all health plans, including ERISA plans.
   
   
3. The OSMA will advocate that any legislation addressing surprise out of network medical bills use an independent, non-conflicted database of commercial charges.
4. The OSMA’s delegation to the AMA submit a resolution at A-20 asking for this amendment to Item H in their policy.

---

Policy 07-2020 – Legislative or Regulatory Interference in the Practice of Medicine in the State of Ohio

1. The OSMA actively works to ensure that the sanctity of the physician-patient relationship is protected in all legislative and regulatory matters.
2. Current OSMA Policy 18 - 2012 (Criminalization of Medical Care) be amended to read as follows:

The OSMA opposes any portion of proposed legislation OR RULE that criminalizes clinical practice that is the standard of care.

1. That current OSMA Policy 10 – 1990 (Policy on Abortion) be amended as follows:

 

1. It is the position of the OSMA that the issue of support of or opposition to abortion is a matter for members of the OSMA to decide individually, based on personal values or beliefs.
2. The OSMA shall take no action which may be construed as an attempt to alter or influence the personal views of individual physicians regarding abortion procedures.
3. Items 1 and 2 notwithstanding, the OSMA shall take a position of opposition to any proposed OSMA legislation or rule that would:

• Require or compel Ohio physicians to perform treatment actions which are not consistent with the standard of care; or,
• Require or compel Ohio physicians to discuss treatment options that are not within the standard of care and/or omit discussion of treatment options that are within the standard of care.

---

Policy 21-2019 – 2019 Congressional Health Care Proposals

1. The OSMA supports provisions in Federal and State legislation that:

• 1) Do not limit the choices available for Americans for health care coverage.
• 2) Support improving existing health plans.
• 3) Make any new plan voluntary.
• 4) Do not eliminate the private insurance market.

2. The OSMA reaffirms our basic principles for health care (Policy 63 - 1994 and Policy 01 - 2017).
3. The OSMA AMA Delegation take this policy to the AMA Annual meeting in Chicago for further discussion and action.

---

Policy 14-2018 – Protection of the Patient-Physician Relationship in Controversial Legislation

1. The OSMA actively oppose any legislation or rule that would negatively impact the sanctity of the physician/patient relationship.

---

Policy 27-2017 – Ban Restrictive Covenants for Physicians Employed by Hospitals in Ohio

1. The OSMA shall lobby for state legislation to ban restrictive covenants in contracts between hospitals or hospital systems and their employed physicians in Ohio. 

---

Policy 12-2017 – Medical Price Transparency

1. The OSMA supports legislative efforts to develop medical price transparency which are congruent with the principles of price transparency found in AMA policies such as D-155.987 and CMS Report 4-A-15 on price transparency.

---

Policy 01-2015 – Repeal the 2% Medicare Physician Payment Cuts Authorized by Sequestration Action

1. The OSMA shall take all necessary legislative and administrative steps to eliminate the hidden 2% “sequestration” Medicare payment cuts for physicians.

---

Policy 13-2014 – Transfer of Records in Retail Settings

1. The OSMA shall work to promote legislation that requires ambulatory clinical care providers and retail clinics to exert a reasonable effort to identify and send a copy of the care record to the patient’s primary care physician.

---

Policy 09-2013 – Abolishing Loss of Chance

1. The OSMA shall make every effort to advocate to the Ohio General Assembly to abolish the “Loss of Chance” doctrine.

---

Policy 06-2013 – Crafting Innovative Ways of Funding Graduate Medical Education

1. The OSMA supports legislation to convene a state based task force of key stakeholders to include representatives from private business enterprises such as health insurance companies, private practice physicians, members of the general public, and academic medical center employees to study current graduate medical education (GME) financing in Ohio and investigate creative alternatives for GME funding that rely less on federal resources.

---

Policy 18-2012 – Criminalization of Medical Care

1. The OSMA opposes any portion of proposed legislation or rule that criminalizes clinical practice that is the standard of care.

---

Policy 05-2012 – AMA’s Truth in Advertising Campaign

1. The OSMA shall work to enact state legislation to help provide clarity and transparency for patients when they seek out and go to a health care practitioner and that the legislation includes provisions similar to those included in the AMA’s Truth in Advertising campaign.

---

Policy 17-2011 – Creation of a Legislative and Advocacy Program for Medical Students

1. The OSMA shall develop and implement a Legislation and Advocacy Program that allows medical students to learn about and work in areas such as health care law reform and legislation, legislative process and professional advocacy on the state level.
2. The OSMA shall advertise and offer this program to Medical Students that are matriculated at medical schools in the State of Ohio.

---

Policy 03-2011 – Legislation to Compel Health Insurance Companies to Approve Dispensing Medically Appropriate Quantities of Formulary Medications

1. The OSMA encourages the development and support of state legislation to require health insurance companies offering pharmacy benefits to cover medication on their formulary at the dose prescribed by an appropriately licensed clinician at a quantity deemed medically appropriate.
2. Ohio legislation shall not permit health insurance companies to bill policyholders more than a single co-pay per month for the same medication, dose, and strength prescribed for that 30-day period by their clinician.
3. The OSMA requests that our AMA work with other state medical societies and with national health insurance companies to approve dispensing medically appropriate quantities of formulary medications.

---

Policy 21-2010 – Legislation to Change 48-Hour Signature Rule

1. The OSMA shall work with the AMA’s model state legislation, the Ohio Hospital Association and the Ohio legislature to change the time frame for the 48-hour signature for verbal and telephone orders to a longer time period, preferably 30 days.

---

Policy 13-2010 – Federal Health Care Coverage to Include Member of Congress and Their Families

1. The OSMA and the AMA encourage congress and their staffs and families, as fellow Americans, to include without exception their own health care coverage options in any proposed healthcare legislation.

---

Policy 12-2010 – Response to Patient Protection and Affordable Care Act

1. The OSMA advocates that the state of Ohio take action to modify the Patient Protection and Affordable Care Act with legislation, regulation and/or judicial action that is financially responsible and consistent with AMA policy.
2. The OSMA advocates that our AMA take action to modify the Patient Protection and Affordable Care Act with legislation, regulation and/or judicial action that is financially responsible and consistent with AMA policy.

---

Policy 19-2008 – Opposing State of Ohio Restrictions of Physician Investment

1. The OSMA opposes any inappropriate state of Ohio proposed limitations on the ability of physicians to participate in or have ownership in ancillary services such as radiology (MRI, X-ray, CT, US), physical therapy, ambulatory surgery centers or hospitals which would be more restrictive than federal government limitations on physician investment.

---

Policy 14-2006 – OSMA Support for Legislation to Improve Ohio’s Homestead Exemption Provision

1. The OSMA supports changes to improve Ohio’s homestead exemption provision to allow for a reasonable measure of asset protection in the event of a liability judgment.

---

Policy 8-2005 – Minor Statute of Repose

1. The OSMA supports a legislative effort to enact an Ohio “Minor statute of repose.”

---

Policy 6- 2000 – Strengthening of OSMAPAC

1. The OSMA encourages OSMAPAC to continue its grassroots political efforts to help those candidates who are philosophically aligned with organized medicine’s positions.
2. Members of the OSMA Alliance, OSMA physicians and concerned patients join together to participate in the OSMA’s Physician Legislative Action Network (PLAN) program to work to identify those legislators and candidates who support the health and welfare for our patients.
3. The OSMA encourages OSMAPAC to continue to identify key contact physician and alliance members in each district and assist these members in increasing electoral participation and in increasing level of financial political contributions. 

---

Policy 74-1990 – Physician Representation on Health-Care Boards and Committees of the State of Ohio

1. The OSMA urges the Ohio General Assembly, the Ohio Department of Health, the Ohio Department of Insurance and other agencies involved in the public health for the state of Ohio to select members of the medical profession for health care-related bodies so as to increase the proportion of physicians in active clinical practice serving on these boards and committees and encourage OSMA physicians to participate on the boards when asked.       

---

Policy D-1932 – Medical Legislation

1. The OSMA re-emphasizes and re-endorses the established and fundamentally-sound policies of medical organization of Ohio toward all legislation affecting public health, scientific medicine and medical practice, namely:

      a. The medical profession of Ohio is opposed to the enactment of any legislation              which would be detrimental to the health of the citizens of the State or which                would hinder or prevent effective public health administration.

      b. The medical profession of Ohio condemns and opposes those proposals which            would interfere with the advancement of scientific medicine; lower the high                  standards surrounding medical practice in Ohio, and jeopardize the health and            welfare of the people by extending legal privileges to unqualified, incompetent              and untrained individuals.

    2. All OSMA members should take an active, personal interest in molding public             opinion in accordance with the foregoing principles, and aid in selecting for                   public office - national, state and local - persons who can be depended upon to           protect and further the best interests of the public generally, and who will look to           the medical profession for counsel and advice on those matters pertaining to               public health, medical practice and scientific medicine.

Policy 43-1994 – Ohio State Medical Board

1. The OSMA supports limits on the length of time from citation to disposition by the State Medical Board; such time to be no longer than one (1) year.
2. The OSMA supports limits on public disclosure of allegations until final disposition of the allegations by the State Medical Board.

---

Policy 81-1990 – Accountability of Third-Party Reviewers

1. The OSMA encourages the Ohio State Medical Board to recognize that those individuals (physicians or non-physicians) making decisions which determine the type and location of testing, procedures, and or admission to the hospital for patients and physicians should be held accountable in the same manner as the patient's treating physician.
2. The OSMA supports legislation that recognizes medical decisions which influence hospital-patient care through pre-certification of testing, procedures, and/or admission to the hospital are the practice of medicine and must be done under the direction and supervision of an Ohio licensed physician.

Policy 10-2022 – Enhancing Education and eliminating Inequitable Time Constraints for Contraceptive Sterilization Procedures 

1. The OSMA supports the sufficient education of physicians involved in prenatal care, obstetrics, and family planning on current Medicaid policy.
2. The OSMA encourages physicians to spend sufficient time educating and counseling patients on the Consent to Sterilization form, necessary steps for its completion, and the implications of contraceptive sterilization procedures.
3. The OSMA supports the elimination of inequitable time constraints for consent for contraceptive sterilization procedures.

---

Policy 26-2020 – Bundled Payments and Medically Necessary Care

1. The OSMA will work with Ohio Medicaid to make sure that medically necessary care is done for all patients and that Episodes of Care be carefully reviewed to make sure that the system is reasonable and fair to all, including patients and physicians.
2. The AMA Delegation will take the issue of “Bundled Payments and Medically Necessary Care” to the AMA Annual Meeting for study and report back to the AMA HOD, to make sure that our health care system is reasonable and fair to all, allows for medically appropriate and necessary care for our patients, and allows for fair reimbursement for physicians.

---

Policy 22-2019 – Opposition to Medicaid Eligibility Barriers

1. The OSMA opposes drug testing as a requirement to determine eligibility for Medicaid and applicants.
2. The OSMA opposes employment criteria for Medicaid enrollees and applicants.

---

Policy 23-2018 – Maintaining Medicaid Coverage for Group VIII Enrollees

1. The OSMA supports the ongoing coverage of those individuals defined as Medicaid group VIII eligible individuals by any program deemed to continue their coverage in a manner comparable to coverage as allowed by the Affordable Care Act, and oppose programs which would not continue commensurate coverage.

---

Policy 25-2016 – Access to Care for Medicaid and Medicaid Product Insured Patients in Ohio

1. The OSMA advocates that Ohio Medicaid and Medicaid product insurers extend coverage to their patients for thirty days beyond the date of non-coverage and reimburse physicians who provide services during this time period.

---

Policy 29-2012 – Denial of Care by Medicaid Managed Care Programs

1. The OSMA opposes any Medicaid payer’s action of requesting proof of qualifications from physicians who have already been credentialed in the program as specialists.
2. The OSMA shall continue to work with all Medicaid entities to decrease the administrative burden for physicians who agree to care for Medicaid patients.

---

Policy 7-2009 – Medicaid Reform

1. The OSMA shall work to get one set of rules for the Medicaid system.
2. The OSMA shall work to be sure that patients who are on an approved drug in one program and are switched to another program may continue the drug without another prior authorization from the physician's office (thus requiring communication between managed care programs when a patient moves from one to another).
3. The OSMA shall work to eliminate current barriers to traditional referral patterns for complicated patients who need a tertiary center regardless of which provider group they are in.
4. The OSMA shall work to eliminate needless hassles for physicians in their offices in obtaining prior authorization for medications and testing.
5. The OSMA shall encourage a statewide source of up-to-date verification of a patient’s coverage.

---

Policy 42-2008 – Reform of Medicaid Managed Care

1. The OSMA continues to work with the State of Ohio to reform the current Medicaid managed care system to make it easier for Ohio physicians to care for this group of patients.

---

Policy 14-1995 – Privatize Medicaid

1. The OSMA supports privatizing Medicaid including the use of the medical savings accounts. Reaffirmed in 1996.

Policy 8 – 1989 – Medicare Terminology

1. The OSMA opposes use of such phrases as "not reasonable and necessary" and "medically unnecessary services" and instead advocates for use of the more appropriate and accurate term "non-covered medical services."

 

---

Policy 13 – 1995 – Privatizing Medicare

1. The OSMA supports privatizing Medicare including the use of the medical savings account.

 

---

Policy 16 – 2014 – Advance Benefits Notification (ABN)

1. The OSMA requests that CMS require the use of a single, standard Advance Benefits Notification (ABN) form for all Medicare beneficiaries including all Medicare Advantage Plans.

 

---

Policy 18 – 2016 – Site of Service Charges

1. The OSMA requests that the American Medical Association continue to address the current inequity of “site of service” charges being used by hospitals and Medicare.

 

---

Policy 19 – 2019 – Investigate Medicare Part D - Insurance Company Upcharge

1. The OSMA Delegation to the AMA asks the AMA to investigate Medicare Part D rules which allow insurance providers to keep up to 5% more than their actual cost of providing pharmacy prescription services while at the same time they are eligible to get paid by CMS reinsurance rules for certain losses.

Policy 20-2022 – Appropriate Physician Reimbursement to Cover Rising Expenses of Office Practice 

1. The Ohio State Medical Association (OSMA) advocates that physician reimbursement for all activities be increased to cover the expenses of running an office practice.
2. The OSMA will work with our Ohio State Legislature and Ohio Congressional delegation to improve physician reimbursement.
3. The OSMA Delegation to the American Medical Association (AMA) shall take this resolution regarding improved physician reimbursement to the AMA House of Delegates for action.

---

Policy 19-2021 – Notification of Insurance Company Takeback Payments

1. The OSMA advocates that insurance companies including Medicaid/Medicare products notify any provider, practice, or healthcare entity in writing prior to takeback payments, when the takeback will occur, reasons for the takeback, and options for appeal with contact information.

---

Policy 18-2021 – Differential Payment

1. The OSMA reaffirms existing policies 18-2016, site of service charges, and 18-2019, practice overhead expense and the site-of-service differential.

---

Policy 15-2021 – OSMA Lobbying for Revision on Payment for Out-of-Network Services

1. The OSMA reaffirms policy 19-2020 out-of-network billing.
2. The OSMA will work through the regulatory bodies on both the state and federal levels on implementation of out-of-network policies, and when appropriate advocate to align the policies to the extent possible with OSMA Policy 19-2020.
3. The OSMA will actively monitor implementation of out-of-network policies by the Ohio Department of Insurance and other regulatory bodies for their impact, with particular focus on potential deleterious effects they may have on Ohio physicians, by creating a working group comprised of OSMA staff and physician members from appropriate specialties that will perform no less than semi-annual reviews and analysis of the effects of the outcomes of the Ohio out-of-network law and recommend to OSMA Council if any legislative advocacy needs to be undertaken. In addition, the working group will evaluate the text of existing federal and state laws and make recommendations for further legislative advocacy.

---

Policy 26-2020 – Bundled Payments and Medically Necessary Care

1. The OSMA will work with Ohio Medicaid to make sure that medically necessary care is done for all patients and that Episodes of Care be carefully reviewed to make sure that the system is reasonable and fair to all, including patients and physicians.
2. The AMA Delegation will take the issue of “Bundled Payments and Medically Necessary Care” to the AMA Annual Meeting for study and report back to the AMA HOD, to make sure that our health care system is reasonable and fair to all, allows for medically appropriate and necessary care for our patients, and allows for fair reimbursement for physicians.

---

Policy 19-2020 – Out-of-Network Billing

1. The OSMA rescinds Policy 19 – 2010 (Lifting the Restrictions on Balance Billing):
2. The OSMA supports repeal of regulations currently in place that prohibit balance billing for physicians.
3. The OSMA adopts its own policy similar to AMA policy H-285.904, to read as follows:
4. The OSMA adopts the following principles related to unanticipated out-of-network care:

   A. Patients must not be financially penalized for receiving unanticipated care from           an out-of-network provider.

   B. Insurers must meet appropriate network adequacy standards that include                     adequate patient access to care, including access to hospital-based physician             specialties. Ohio regulators should enforce such standards through active                   regulation of health insurance company plans.

   C. Insurers must be transparent and proactive in informing enrollees about all                   deductibles, copayments and other out-of-pocket costs that enrollees may incur.

   D. Prior to scheduled procedures, insurers must provide enrollees with reasonable            and timely access to in-network physicians.

   E. Patients who are seeking emergency care should be protected under the                     “prudent layperson” legal standard as established in state and federal law,                    without regard to prior authorization or retrospective denial for services after                emergency care is rendered.

   F. Out-of-network payments must not be based on a contrived percentage of the             Medicare rate or rates determined by the insurance company.

   G. Minimum coverage standards for unanticipated out-of-network services should            be identified. Minimum coverage standards should pay out-of-network providers          at the usual and customary out-of-network charges for services, with the                      definition of usual and customary based upon a percentile of all out-of-network            charges for the particular health care service performed by a provider in the                  same or similar specialty and provided in the same geographical area as                      reported by a benchmarking database. Such a benchmarking database must be          independently recognized and verifiable, completely transparent, independent of          the control of either payers or providers and maintained by a non-profit                        organization. The non-profit organization shall not be affiliated with an insurer, a          municipal cooperative health benefit plan or health management organization.

   H. Mediation and/or Independent Dispute Resolution (IDR) should be permitted in           all circumstances as an option or alternative to come to payment resolution                 between insurers and providers.

2. The OSMA will advocate for the principles delineated in this policy for all health plans, including ERISA plans.
3. The OSMA will advocate that any legislation addressing surprise out of network medical bills use an independent, non-conflicted database of commercial charges.
4. The OSMA’s delegation to the AMA submit a resolution at A-20 asking for this amendment to Item H in their policy.

---

Policy 04-2019 – Addressing the Pay Gap in Medicine

1. The OSMA supports policies that promote data collection in physician compensation that is de-identified for personal and academic research use.
2. The OSMA supports pay based on objective, gender-neutral criteria.
3. The OSMA supports pay equality to ensure equal pay for equal work.

---

Policy 12-2017 – Medical Price Transparency

1. The OSMA supports legislative efforts to develop medical price transparency which are congruent with the principles of price transparency found in AMA policies such as D-155.987 and CMS Report 4-A-15 on price transparency.

---

Policy 11-2017 – Third Party Patient Reimbursement for Out-of-Network Physicians

1. The OSMA adopts a policy and provides support to physicians and patients which requires insurers and third-party payors to properly reimburse patients and/or out-of-network physicians their usual charges, and that there be no increase in deductibles or co-payments for those patients requiring care from out-of-network physicians because of urgent and emergent treatment needed in emergency rooms and hospitals.
2. The OSMA adopts a policy which requires insurers and third-party payors to reimburse patients and/or out-of-network physicians their usual charges in non-emergent care, if insurer and third-party payor are not able to arrange participating network physician care in a reasonable time, and that there be no increase in deductible or co-payments for those patients.

---

Policy 39-2013 – Audit Overpayments

1. The OSMA shall work to ensure that insurance companies can only seek reimbursement for medical claims within one year unless fraud or misrepresentation is present.
2. The OSMA shall work to ensure that insurance companies accept claims within one year of provision of service without penalty.
3. When interest is charged to the physician on overpayment of a given claim, the OSMA shall advocate that the physician can charge and be paid an equivalent interest rate on underpayment of claims.
4. The OSMA supports health care providers who have acted in good faith in providing services with a valid contract.

---

Policy 34-2013 – Patient Satisfaction Surveys Not Valid as Reimbursement Criteria

1. When quality criteria are used as a measure to determine reimbursement for physician services, payers shall only use those quality parameters that are in the direct control of the physician, such as tests or treatment ordered, or appropriate patient education performed.
2. If or when subjective quality criteria are utilized, such as patient satisfaction surveys, such information should be used only as an adjunctive and not a determinative measure of physician quality for the purpose of physician reimbursement.

---

Policy 07-2013 – Support for Physician led Patient-Centered Medical Home

1. The OSMA encourages the formation and ongoing support of physician led patient-centered medical homes by calling for insurance providers to (1) recognize and reimburse the staffing needed for a medical home and (2) increase reimbursements for primary care physicians.

---

Policy 20-2012 – Physician Reimbursement for Coordination of Care in Medical Home

1. The OSMA shall work with Ohio insurers and the Ohio Department of Insurance to assure that physicians receive adequate reimbursement for providing coordination of care outside of the traditional patient office visit required for the successful treatment of patients in the medical home.

---

Policy 10-2011 – Standardize Insurance Payment Policies

1. The OSMA supports a requirement that all private insurers standardize their payment policies to accept claims for at least one year after date of service and that private insurers limit their ability to retroactively require provider reimbursement for rejected claims to 6 months or less.

---

Policy 15-2010 – Support for Physicians to Submit Claims and Prescribe by Any Medium

1. The OSMA supports the physician’s ability to submit claims directly to payers, by mailing paper claims.
2. The OSMA opposes payers mandating physicians bear the costs associated with payer sponsored clearinghouses or intermediaries.
3. The OSMA supports physicians’ ability to continue prescribing via paper or phone, without being subjected to mandatory e-prescribing.

---

Policy 36-2008 – Third-Party Coding Audits

1. The OSMA advocates that third-party payers be required to reimburse involved physicians for their reasonable audit-related expenses, including for their time, if the physicians’ coding was found to be reasonably consistent with current widely accepted standards.
2. The OSMA advocates that third-party payers be required to reimburse involved physicians if the audit demonstrates undercoding.
3. The OSMA advocates that third-party payers’ staff be required to provide adequate assistance during the audit process.
4. The OSMA advocates that third-party payers be limited to record review within the previous twelve (12) months.
5. The OSMA advocates that third-party payers be required to provide sixty days for involved physicians to respond to the audit process without penalty.

---

Policy 40-2000 – Payment for All Procedures Performed During a Single Patient Session

1. The OSMA supports payment for each distinct service provided during a single patient session.

---

Policy 15-2000 – Emergency On-Call Payments to Physicians

1. The OSMA reaffirms current policy such that physicians providing care in emergency settings will be appropriately reimbursed by the managed-care organization regardless of the physician’s participation status with said managed-care organization.
2. The OSMA supports appropriate reimbursement for follow-up care by the initial treating physician for an appropriate time after the initial care, if the patient so desires.

---

Policy 71-1994 – Right to Balance Bill

1. The OSMA works diligently toward insuring that any health-care plan adopted in Ohio, in order to preserve the quality of health care for Ohio citizens, allows physicians who have not contracted to do otherwise, to balance bill their patients for fees and portions of fees not paid by third parties, including government.

---

Policy 43-1993 – Fee for Service

1. The OSMA affirms fee for service as a model for physician payment.

---

Policy 52-1992 – Organized Medicine's Role in Health Care Policy

1. The OSMA supports negotiation of reimbursement, review of quality and appropriateness of care, review of the appropriateness of fees, and establishment of overall healthcare budgetary predictability.
2. The OSMA supports a specific exemption from anti-trust action for organized medicine in negotiations regarding fees and peer review. 

---

Policy 10-1991 – Standardized Explanation of Benefits to Patients

1. The OSMA supports a standardized explanation of benefits for patients that includes the following information: 1) day of service; 2) place of service; 3) billing parties; 4) CPT code and description of service.

---

Policy 1-1991 – Third-Party Reimbursement for Telephone Time

1. The OSMA supports reimbursement to physicians for telephone calls required by third-parties.

---

Policy 8-1986 – Physician Reimbursement for Home Health Care

1. The OSMA supports equitable remuneration consistent with services rendered by physicians when treating patients at home.

---

Policy 21-1984 – Payment for Physicians' Services

1. Patients maintain the right to assign benefits to their physicians under all health insurance plans. 

---

Policy 16-1984 – Cognitive Services Reimbursement

1. The OSMA supports the concept that third party payers should provide equitable reimbursement for physician's cognitive services in comparison with their procedural services.

---

Policy 13-1984 – Third Party Reimbursement Problems

1. The OSMA opposes any language in third party reimbursement forms and other literature that implies physicians' fees above insurance benefit levels are improper and excessive.

Policy 12-1992 – Peer Review Process

1. The OSMA supports the following peer review processes: a) the peer review process eliminates the punitive aspects of the system except for the most egregious problems; b) all initial peer review decisions should allow for rebuttal and discussion; c) all review criteria including generic quality screens, and directives emanating from the peer review process should be made publicly known and sent to all practitioners of medicine for their review and response; and d) peer review should include a physician advocacy system that will diligently uphold the difference of opinion or philosophy before any assignment of quality points are determined.

Policy 17-2017 – Importance of OSMA Promoting Physician Well-Being by Addressing the Physician and Medical Student Burnout Issue

1. The OSMA shall work with medical schools, hospitals, residency programs, and physicians to address the issue of physician and medical student burnout.
2. The OSMA encourages physicians and medical students to utilize the AMA Steps Forward Program to learn more about preventing physician burnout.

---

Policy 35-1982 – Education Regarding Suicide Recognition, Prevention and Treatment

1. The OSMA encourages physicians to continue their education in the recognition, treatment, and prevention of potential suicides and the management of survivors of suicide attempts. 

Policy 20-2022 – Appropriate Physician Reimbursement to Cover Rising Expenses of Office Practice 

1. The Ohio State Medical Association (OSMA) advocates that physician reimbursement for all activities be increased to cover the expenses of running an office practice.
2. The OSMA will work with our Ohio State Legislature and Ohio Congressional delegation to improve physician reimbursement.
3. The OSMA Delegation to the American Medical Association (AMA) shall take this resolution regarding improved physician reimbursement to the AMA House of Delegates for action.

---

Policy 15-2006 – Health Insurer Interference with Practice Advisors

1. The OSMA opposes efforts by any entity to interfere with or limit the ability of physicians to obtain independent professional advice, from business advisors, accountants, attorneys, or others, related to contracts with health-insurance payors.

---

Policy 1-2006 – Practice Economics

1. The OSMA shall provide trusted practice management related information, education, resources, products and services to the appropriate segments of its members.

Policy 31-2022 – Support For Increased Education and Availability of Supplies for Bleeding Control

1. The OSMA promotes the education of both lay public and professional responders on proper bleeding control techniques within the state of Ohio; and be it further
2. The OSMA supports the increased availability of hemorrhage control supplies (including pressure bandages, hemostatic dressings, tourniquets and gloves) in schools, places of employment, and public buildings.

---

Policy 30-2022 – Patient-Centered and Evidence-Based Visitation Policies

1. The Ohio State Medical Association (OSMA) supports clear and easily accessible visitation policies that are patient-centered and evidence-based in all Ohio healthcare facilities.
2. The OSMA supports the Ohio Hospital Association and other healthcare facility associations’ adoption of policies to allow visitors for all patients, including but not limited to children, persons with disabilities, end-of-life care, and labor and delivery units.
3. The OSMA supports collaboration between hospitals and other healthcare facilities within the state of Ohio to create consistent policies.

---

Policy 29-2022 - Supporting Housing Initiatives to Improve Health of Homeless Individuals

1. The OSMA supports the development of state and local policies that protect the health of low-income and homeless individuals by promoting and funding housing initiatives.

---

Policy 28-2022 – Substance Use Disorder in Pregnant People

1. The OSMA opposes any efforts to assert that a diagnosis of substance use disorder in a pregnant person alone constitutes child abuse or inherent parental unfitness.
2. The OSMA supports prioritizing funding for the expansion of integrative mental health and substance use treatment programs explicitly for pregnant persons.
3. The OSMA opposes the removal of a child based solely on a prenatal drug screen or positive newborn toxicology screening without a full safety evaluation of newborn care upon disposition.

---

Policy 27-2022 – Recognition of Climate Change as a Threat to Ohio’s Health

1. The OSMA encourages the development of policy to combat climate change and its health effects in Ohio and to mitigate the undesirable environmental conditions that damage Ohioans’ health.
2. The OSMA encourages education of the broader Ohio medical community to the serious adverse health effects of climate change and local conditions of climate variation.

---

Policy 17-2022 – Supporting Vaccination in Ohio

1. The OSMA supports the right of public and private entities in Ohio to require vaccines for employees, staff, and students for highly communicable diseases while allowing for medical exemptions.

---

Policy 16-2022 – Allowing Mature Minors to Consent for Vaccination

1. The OSMA supports allowing the mature minor, as defined in Ohio statute or legal precedent, the ability to self-consent for vaccination.

---

Policy 14-2022 – Eliminating Parking Costs for Patients

1. The Ohio State Medical Association will work with relevant stakeholders to recognize parking fees as a burden of care for patients and to implement mechanisms for eliminating parking costs.

---

Policy 13-2022 - Curbing Opioid-Related Deaths in Ohio Through Medication-Assisted Treatment and Harm Reduction Services 

1. The Ohio State Medical Association (OSMA) advocates for the use of medication-assisted treatment, including but not limited to methadone or buprenorphine, and harm reduction methods without penalty when clinically appropriate.
2. The OSMA supports public awareness campaigns to increase education of evidence-based services for opioid addiction, including but not limited to medication-assisted treatment, harm reduction, and recovery services.
3. The OSMA supports existing and pilot programs for the distribution of fentanyl test strips in at-risk communities in Ohio.

---

Policy 11-2022 - Addressing Weight Stigma Among Healthcare Workers

1. The Ohio State Medical Association (OSMA) supports health promotion techniques that center around healthy behavior and lifestyle modifications rather than weight reduction alone.
2. The OSMA supports educational training to further educate healthcare practitioners and trainees about the multifactorial nature of body weight, the impact of weight stigma, and strategies to reduce the detrimental health effects of weight stigma on Ohioans.

---

Policy 08-2022 - Supporting Research into the Neurological and Psychological Effects of SARS-CoV-2 and the Covid-19 Pandemic

1. The Ohio State Medical Association supports efforts to address the need for research into the neurological and psychological effects of SARS-CoV-2 infection and the Covid-19 pandemic overall.

---

Policy 07-2022- Addressing the Roles of licensed Health Professionals in Preventing Public Health Misinformation

1. The OSMA opposes legislation that mandates licensed healthcare professionals provide non-evidence-based healthcare information to patients.
2. The OSMA: 1) Will continue to support the dissemination of accurate medical and public health information by public health organizations and health policy experts; and 2) will work with public health agencies and professional societies in an effort to establish relationships with journalists and news agencies to enhance the public reach in disseminating accurate medical and public health information and address misinformation that undermines public health initiatives.

---

Policy 06-2022 - OSMA Focused Task Force on Pandemic Preparedness and Response    

1. The OSMA will create the Focused Task Force (FTF) on Pandemic Preparedness and Response to ensure that the organization is prepared to collaborate with other public and private bodies on the preparedness for and response to potential future pandemics.
2. The Focused Task Force (FTF) on Pandemic Preparedness and Response shall, be appointed by the OSMA President to include OSMA members from a variety of specialties and geographic areas of the state, but with a majority of the FTF members being those with special expertise in immunology/infectious diseases, public health, emergency medicine, critical care, primary care, those caring for vulnerable populations (as defined by federal regulations), emergency preparedness, public policy and other areas of emphasis critical to the assessment and implementation of pandemic preparedness and response initiatives.
3. The Focused Task Force (FTF) on Pandemic Preparedness and Response may invite non-OSMA member physicians and non-physicians with special expertise in pandemic preparedness and response to attend as non-voting participants in FTF meetings at the discretion of the FTF Chair.
4. The Focused Task Force (FTF) on Pandemic Preparedness and Response may provide recommendations to the OSMA Council and the OSMA House of Delegates regarding the following issues.

• Changes to local, state and federal public health measures to effectively prevent or reduce the impact of potential future pandemics.
• Changes to state or federal laws, regulations, administrative rules, and accreditation/certification standards to improve local, state or federal preparedness for and response to potential future pandemics.
• Changes to state or federal laws, regulations, administrative rules, and accreditation/certification standards to improve the ability of physicians, hospitals, and other healthcare entities to prepare for and maintain safe, high-quality, patient-centered, accessible, and equitable clinical practice/clinical operations during potential future pandemics.
• Local, regional and statewide efforts to improve the collaboration and coordination of clinical care in ambulatory, outpatient, inpatient, post-acute and other congregate care settings with regard to hospital capacity, nursing facility capacity, vaccination, prevention, and treatment of pandemic-related illnesses.
• Local, regional and statewide efforts to coordinate public and private entities to maintain the effective and equitable distribution of medical supplies, medications, and other scarce medical resources during potential future pandemics.
• Creation of effective networks and systems for the dissemination of accurate, evidence-based information related to preparedness for and response to potential future pandemics for physician practices, medical staffs, hospitals, nursing facilities, medical schools and GME training programs as well as the general public.
• Enhancements to CME programs related to pandemic preparedness and response.
• Programs to effectively provide professional and behavioral health support for physicians and other frontline healthcare personnel during potential future pandemics.
• Changes in the OSMA constitution, bylaws, policies and procedures to effectively maintain the operations of the organization during potential future pandemics.

---

Policy 39-2021 – Strengthen the Minority Health Strike Force as the Groundwork for a Sustainable Entity

1. The OSMA supports preserving and broadening the recommendations of the Ohio Minority Health Strike Force 2020 report.

---

Policy 32-2021 – Implementing Free and Routine Infectious Disease Testing at Homeless Shelters Across Ohio

1. The OSMA supports efforts for access to prevention, testing and treatment of infectious diseases to patients residing in homeless shelters.

---

Policy 27-2021 – Recognition of Substance Use Disorder (SUD) as a Disease, Advocate for Expansion of Safe Treatment

1. The OSMA recognizes Substance Use Disorder as a medical condition, and recognizes that those suffering from this disease should be treated like any other patient with a serious illness and should thus have appropriate access to treatment.
2. The OSMA supports affordable and accessible evidence-based prevention and treatment of Substance Use Disorder.

---

Policy 24-2021 – Acknowledging Death in Custody in the State of Ohio as a Public Health Crisis

1. The OSMA supports actions that enable accurate reporting and data acquisition to target efforts to address the issue of arrest- and custody-related deaths.

---

Policy 09-2021 – Pandemic Preparedness

1. The OSMA recommends that The State of Ohio establish a standing board to continuously review pandemic preparedness including, but not limited to, stockpiles of personal protective equipment, plans for isolation protocols, mobilization of testing, and immunization procedures, and ensure that physicians (MD/DO) are central to the administration of vaccinations to the citizens of Ohio. This board should include the Ohio State Medical Association, Ohio State Board of Pharmacy, the Ohio Hospital Association, and the Ohio Department of Health, and other interested parties.

---

Policy 09-2019 – Impact of Climate Change on Human Health

1. That the Ohio State Medical Association supports efforts at the state level for expansion of renewable sources of energy.

---

Policy 03-2018 – Pursuit of a Strategic Partnership with the Ohio Public Health Association

1. The OSMA create a formal partnership, establishing an open line of communication, with the Ohio Public Health Association for medical students and physicians.
2. The OSMA support policies and initiatives that may, based on reasonable evidence, produce population health improvements, as well as incentivize healthcare providers, hospitals, clinics, and other healthcare facilities to engage in health promotion.

---

---

Policy 21-2016 – Addressing Food and Housing Insecurity for Patients

1. The OSMA shall recognize food and housing insecurity as a predictor of health outcomes.
2. The OSMA shall encourage the use of housing and food insecurity screening tools by physicians and healthcare staff, similar to the depression screening tools, and assist physicians in identifying appropriate resources and avenues of referral. 

---

Policy 15-2015 – Recommendations for Expanded Allergen and Gluten Labeling in Ohio’s Restaurants and Schools

1. The OSMA recommends that Ohio restaurants and schools include allergen and gluten information on menus for each menu item.

---

Policy 41-2013 – Identifying Chemicals Used by the Oil and Gas Industry as Part of Hydraulic Fracturing

1. The OSMA advocates for provisions in Ohio state law that would allow doctors, first responders, emergency agencies, and the Local Emergency Planning Commission in each county to obtain the needed information on all chemicals located at an oil or gas exploration well pad, including hydraulic fracturing.

---

Policy 12-2013 – Advocating for Public Education for the Use of Appropriate Health Care Resources

1. The OSMA supports public education initiatives addressing the effective and efficient use of health care resources. 

---

Policy 31-2012 – Third Party Carriers Should Include Incentives for Patient Accountability

1. The OSMA supports efforts to encourage third party insurance carriers to include incentives for patient accountability to reduce obesity, tobacco use, physical inactivity and other behaviors contributing to excessive morbidity, mortality and health care costs. 

---

Policy 16-2011 – Sexually Transmitted Infections (STI) Education and Prevention Initiative

1. The OSMA requests that the AMA and other appropriate organizations promote a campaign or campaigns to educate the public about the adverse effects of high risk sexual behavior.

---

Policy 24-2010 was reaffirmed at the 2019 OSMA House of Delegates.

---

Policy 24-2010 – Updating of the Safe Drinking Water Act

1. The OSMA shall petition the appropriate state agencies to identify those local water utilities at risk and to take appropriate steps to assure safe drinking water.

---

Emergency Policy 1-2008 – Ohio Tobacco Use Prevention

1. The OSMA supports ongoing efforts to reduce tobacco use among Ohioans.

---

Policy 41-2008 – Childhood Obesity and Nutrition in the Schools

1. The OSMA recommends that our members advocate that their local schools remove soft drinks and candy from vending machines.
2. The OSMA recommends that our members be involved in advocating for healthy nutrition in their local schools.

---

Policy 17-2007 – Physician and Medical Student Involvement in Public Health Preparedness and Disaster Response

1. The OSMA supports physician and medical student training, participation, and education in public health preparedness and disaster response.

---

Policy 2-2005 – Federal Medical Liability and Patient Safety Reform

1. The OSMA supports federal medical liability reform, as well as AMA federal patient safety initiatives.

---

Policy 7-2001 – Support of Four Principles of Hand Awareness

1. The OSMA endorses the Four Principles of Hand Awareness: (1) Wash your hands when they are dirty and before eating, (2) Do not cough into your hands, (3) Do not sneeze into your hands, and (4) Above all, do not put your fingers into your eyes, nose or mouth.

---

Policy 29-2000 – Education to Prevent Teenage Pregnancy and Sexually Transmissible Diseases

1. The OSMA adopts as policy, AMA policy H-170.968 Sexuality Education, Sexual Violence Prevention, Abstinence and Distribution of Condoms in Schools, which states that the AMA supports responsible sex education which includes: information on reproductive biology, accurate and understandable information on sexual abstinence, sexual responsibility, availability and reliability of contraceptives including condoms, alternatives in birth control, and other information aimed at prevention of pregnancy and sexual transmission of diseases.

---

Policy 54-1997 – Youth Leadership Programs

1. The OSMA encourages physicians to be involved with youth related leadership programs and activities in their communities.

---

Policy 24-1995 – Motorcycle Helmets

1. The OSMA supports mandatory safety helmet use by all motorcycle or motorized bicycle drivers and passengers.
2. The OSMA supports legislation to require that all persons under the age of 18 years be required to wear a protective helmet while operating a bicycle anywhere in Ohio.

---

Policy 62-1991 – Mandatory Use of Protective Helmets

1. The OSMA, recognizing the loss of useful life and expense of care resulting from head trauma occurring in motorcycle or other unprotected vehicle crashes, supports mandatory use of protective helmets at all times when operating motorcycles, bicycles, ATVs, mopeds and snowmobiles.

---

Policy 61-1991 – Infectious Disease Precautions for Cadaver Transport

1. The OSMA supports requiring hospitals and morgues to put an infectious disease warning tag on all bodies determined to have died of a reportable infectious disease, such as TB, syphilis, serum hepatitis, or HIV.

---

Policy 53-1991 – Prevention of Sexually Transmitted Human Papilloma Virus (HPV) Infections

1. The OSMA supports human papilloma virus infection awareness and prevention.

---

Policy 54-1990 – Raise Revenue for Health-Care Needs

1. The OSMA supports an increase in federal excise taxes for tobacco and alcohol which would be allocated to health-care needs.

---

Policy 66-1989 – Warning Label on Personal Listening Devices

1. The OSMA supports requiring all manufacturers of personal listening devices with earphone speakers to label their products with "MAY BE DANGEROUS TO YOUR HEARING" in an easily recognizable location.

---

Policy 62-1988 – Donation of Professional Time to Poor

1. The OSMA commends its members for continuing to donate professional time to serving the poor.

---

Policy 55-1987 – Early Detection of Disease

1. The OSMA supports funding for programs for early detection of life threatening diseases under physician direction, if consistent with current screening criteria guidelines and with adequate follow-up, as procedures important in saving lives and health care dollars.

---

Policy 45-1986 – Eye Safety

1. The OSMA encourages its members to educate their patients to wear safety lenses or goggles while operating equipment in home workshops, for lawn care, hunting or any other activity that may prove hazardous to their eyesight. 

---

Policy 43-1984 – Financial Support - Homeless and Chronically Mentally Ill

1. The OSMA supports adequate and appropriate support for the care of chronically mentally ill.

---

Policy 41-1983 – Boxing as a Health Hazard

1. The OSMA supports the elimination of boxing from amateur, scholastic, intercollegiate and governmental athletic programs as detrimental to the health of participants.

---

Policy 39-1983 – Corporal Punishment in Schools

1. The OSMA supports the abolition of corporal and abusive punishment in schools throughout the State of Ohio with these exceptions: 1) disarming a student; 2) breaking up fighting among students; 3) self-protection of teachers, protection of students, or another teacher.

---

Policy 52-1981 – Comprehensive Health Education in Ohio Schools

1. The OSMA supports comprehensive K-12 health education programs.

Policy 20-2007 – Stem Cell Research

1. The OSMA adopts the AMA policy regarding stem cell research.

Policy 63-1989 – Mandatory Random Drug Testing in Competitive Sports

1. The OSMA supports local requirements for mandatory random drug testing as a requirement for participation in scholastic sports in Ohio.

---

Policy 1962 – That a Doctor of Medicine Be Present at All Ohio High School Athletic Body-Contact Contests

1. The OSMA:
   
   a. Encourages schools to make arrangements to obtain the services of a                  physician to counsel coaches and trainers on a continuous basis with regard        to the medical aspects of the athletic program and to be available when                emergencies arise in any sport.
   
   b. Encourages team physicians to avail themselves of the postgraduate medical      courses on athletic injuries.

Policy 21-2009 – Medical Expense Tax Deduction

1. The OSMA supports changes in the federal tax code to reduce the threshold of tax deductibility of patient out-of-pocket medical expenses to 2% of adjusted gross income.

---

Policy 52-2000 – Tax Relief for Health Insurance

1. The OSMA and AMA support 100% tax relief for health insurance.

---

Policy 73-1994 – Changes in Taxation of Health-Care Premiums So That All Citizens Are Treated Equally

1. The OSMA supports equal tax law treatment of health-care expenses of all workers in the same manner.

Policy 13D-2020 – Combating the Vaping Epidemic and Vaping-Associated Lung Injuries

1. The OSMA supports educating the public regarding the health impacts of non-commercial cartridges and non-nicotine containing e-cigarettes.

---

Policy 13C-2020 – Combating the Vaping Epidemic and Vaping-Associated Lung Injuries

1. The OSMA supports restriction of sale of E-cigarette flavors that appeal particularly to minors.

---

Policy 13B-2020 – Combating the Vaping Epidemic and Vaping-Associated Lung Injuries

1. The OSMA supports stricter regulation of substances linked to vaping-associated lung injury.

---

Policy 13A-2020 – Combating the Vaping Epidemic and Vaping-Associated Lung Injuries

1. The OSMA supports AMA policies H-495.972 and H-495.986.

---

Policy 02-2015 – Standardizing Physicians’ Stance toward Electronic Cigarettes

1. The OSMA supports both a ban on sales of e-cigarettes to minors and a prohibition on the consumption of e-cigarettes by minors.
2. The OSMA supports AMA Policy H-495.973.
3. The OSMA encourages more research into the potential health risks associated with e-cigarettes.

---

Emergency Policy 1-2008 – Ohio Tobacco Use Prevention

1. The OSMA supports ongoing efforts to reduce tobacco use among Ohioans.

---

Policy 67-1990 – Substance Abuse as a Public Health Hazard

1. The OSMA supports prohibition of advertising of tobacco and tobacco products.

Policy 28-2022 – Substance Use Disorder in Pregnant People

1. The OSMA opposes any efforts to assert that a diagnosis of substance use disorder in a pregnant person alone constitutes child abuse or inherent parental unfitness.
2. The OSMA supports prioritizing funding for the expansion of integrative mental health and substance use treatment programs explicitly for pregnant persons.
3. The OSMA opposes the removal of a child based solely on a prenatal drug screen or positive newborn toxicology screening without a full safety evaluation of newborn care upon disposition.

---

Resolution 15-2022 – Opposing the Criminalization of Self-Managed Medication Abortion

1. The OSMA amends Policy 07-2020, Legislative or Regulatory Interference in the Practice of Medicine in the State of Ohio, by addition as follows:

Legislative or Regulatory Interference in the Practice of Medicine in the State of Ohio, OSMA Policy 07 – 2020

1. The OSMA actively works to ensure that the sanctity of the physician-patient relationship is protected in all legislative and regulatory matters.
2. Current OSMA Policy 18 - 2012 (Criminalization of Medical Care) is amended to read as follows:

The OSMA opposes any portion of proposed legislation or rule that criminalizes clinical practice that is the standard of care.

That current OSMA Policy 10 – 1990 (Policy on Abortion) be amended as follows:

1. It is the position of the OSMA that the issue of support of or opposition to abortion is a matter for members of the OSMA to decide individually, based on personal values or beliefs.
2. The OSMA shall take no action which may be construed as an attempt to alter or influence the personal views of individual physicians regarding abortion procedures.
3. Items 1 and 2 notwithstanding, the OSMA shall take a position of opposition to any proposed Ohio legislation or rule that would:

• Require or compel Ohio physicians to perform treatment actions, investigative tests, or questioning of a patient which are not consistent with the medical standard of care; or,
• Require or compel Ohio physicians to discuss treatment options that are not within the standard of care and/or omit discussion of treatment options that are within the standard of care.

---

Policy 10-2022 – Enhancing Education and eliminating Inequitable Time Constraints for Contraceptive Sterilization Procedures 

1. The OSMA supports the sufficient education of physicians involved in prenatal care, obstetrics, and family planning on current Medicaid policy.
2. The OSMA encourages physicians to spend sufficient time educating and counseling patients on the Consent to Sterilization form, necessary steps for its completion, and the implications of contraceptive sterilization procedures.
3. The OSMA supports the elimination of inequitable time constraints for consent for contraceptive sterilization procedures.

---

Policy 09-2022 – Access to Standard Care for Nonviable Pregnancy

1. The Ohio State Medical Association (OSMA) supports patients’ timely access to standard treatment of nonviable pregnancy, including but not limited to miscarriage, molar pregnancy, and ectopic pregnancy, in both emergent and non-emergent circumstances.
2. The OSMA opposes any hospital directive, policy, or legislation that may hinder patients’ timely access to the accepted standard of care in both emergent and non-emergent cases of nonviable pregnancy.

---

Policy 30-2021 – Condemning Forced Sterilization

1. The OSMA condemns and opposes the practice of forced sterilization as defined by the World Health Organization; or comparable practices such as the forced use of birth control.
2. The OSMA supports the education of physicians on the history and current practice of forced sterilization, particularly against marginalized communities, and the implications these practices have had on the persistent distrust of reproductive health services among marginalized patient populations.

---

Policy 07-2019 – Female Genital Mutilation Ban

1. The OSMA condemns the practice of female genital mutilation as defined by the World Health Organization and considers female genital mutilation a form of child abuse
2. The OSMA encourages physicians to engage in culturally competent counseling to individuals at risk of female genital mutilation.

---

Policy 13-2013 – Adolescent Pregnancies

1. The OSMA supports initiatives to reduce the incidence of adolescent pregnancies.

---

Policy 12-2002 – Emergency Contraception

1. The OSMA encourages hospitals to assure that sexual assault victims are informed about the availability and effectiveness of emergency contraception.

---

Policy 11-1998 – Prescription Equity for Contraceptives

1. The OSMA supports efforts to ensure that, notwithstanding any provision of law to the contrary, each employer group health policy, contract, plan or agreement issued or renewed in the state of Ohio that provides prescription drug coverage, shall provide coverage for any FDA-approved prescriptive contraceptive drug or device, nor shall they impose any unusual co-payment, charge or waiting requirement for such drug or device.

---

Policy 28-1996 – Breast Reconstruction Availability

1. The OSMA supports access to breast reconstruction surgery for all women, if they desire it, and that access should be available regardless of timing in relationship to the onset of the deformity or absence of their breast, and that insurance carriers’ coverage should not discriminate against the female breast for reconstructive coverage including symmetry operations on the opposite breast.

---

Policy 26-1995 – HIV Testing of Pregnant Women

1. The OSMA recommends routine HIV counseling and testing of pregnant women as a part of pre-natal care.

---

Policy 49-1984 – Preference for Hospital Delivery Over Home Births

1. The OSMA encourages its members to educate their patients about the increased risks of home delivery compared to hospital delivery.

---

Policy 36-1978 – Contraceptive and Prenatal Services for Minors/Contraceptive Services for Minors

1. The OSMA supports permitting Ohio physicians, according to their own conscience, to counsel and prescribe methods for contraception to minors, to provide objective pregnancy options counseling to minors, and to provide medical management of pregnancy of minors at the request of the minor (including abortion in compliance with Ohio state law).