Advocacy Updates

State Budget Update – Pending Ohio Senate

The legislature is continuing its consideration of House Bill 96, the state’s biennial budget bill. The House was the first of the two chambers to hold hearings and make changes to the governor’s proposal. Now that the House has passed its version of HB 96, the bill is being considered by the Ohio Senate. The Senate’s budget amendment deadline was May 16^th. The Senate will take a little over a week to review the amendments and craft its version of the budget. We expect to see a substitute bill by June 4. The Senate will make another round of changes before their scheduled vote on June 11. The House will almost certainly not concur with the Senate's changes, sending the budget to a conference committee for final negotiations.

With Governor DeWine in his final two years of service, this budget presents an opportunity for him to advocate for and cement his top priorities, leaving behind a legacy. These priorities include children’s initiatives, such as his student wellness and success funds, as well as a fair school funding formula. 

The House passed its version of the budget on April 9, 2025, by a mostly party-line vote. (A few Republicans joined the Democrats in voting no). There is much discussion on the future of the Medicaid program. On top of mind is how the state will react to any changes at the federal level, specifically regarding the federal match for the Group VIII population.  This is known as the Medicaid expansion population. Currently, the federal government provides a 90% match for this population. If they dip below that rate, Ohio could opt out of covering the population. Ohio also submitted a federal waiver to institute a work requirement for the expansion population. If that is approved, the implementation of that will create a new dynamic in Medicaid coverage.

Ohio ACEP has recently joined the Ohio Medicaid Matters coalition to advocate for the program to be administered responsibly and in the best interest of Ohioans. The Coalition is focused on the “trigger” language that would opt Ohio out of covering the expansion population if the federal share decreases. They are also reviewing any changes and their corresponding impacts on the hospital franchise fee.

Medical Debt Legislation Introduced

New legislation has been introduced in the House this week regarding medical debt.  House Bill 257  would:

• Cap interest on medical debt at 3%.
• Prohibit medical debt from being reported on a credit report. If the debt is reported, the consumer can file a claim and get the debt forgiven.
• Prohibits wage garnishment for repayment of medical debt.

Sponsors Representative Jean Schmidt and Michele Grim held a press conference on May 6^th to roll out the bill’s introduction. You can watch that here. The bill has already been referred to the House Health Committee.

Naloxone Legislation Introduced

Senator and physician Terry Johnson has introduced Senate Bill 137, which requires hospitals to provide overdose reversal drugs, like naloxone. This initiative is championed by The Naloxone Project and supported by Ohio ACEP. The bill also allows the hospital to seek reimbursement for the drug. The Senate Health Committee will consider this legislation.

Insurance Reform Package Updates

Numerous bills related to health insurance were introduced on April 1, 2025. All of these bills aim to alleviate the burdens that insurers impose on healthcare providers and patients. Ohio ACEP will be working with other healthcare organizations to support this effort. While not all of the bills may directly affect emergency medicine, we support the broader effort to reduce provider and patient burdens.

Senate Bill 162 – Senator Bill Blessing – Limits the time insurers have to recoup payments to the amount of time providers are given to submit claims. It also prohibits insurers from charging a fee to appeal recoupments. Status: Referred to the Senate Financial Institutions, Insurance and Technology Committee.

Senate Bill 164 – Senator Al Cutrona – Prohibits insurers from using AI as the sole basis for making claims decisions.  Requires insurers to submit a report to the Ohio Department of Insurance outlining their use of AI. Status: Referred to the Senate Financial Institutions, Insurance and Technology Committee.

Senate Bill 165 – Senator Susan Manchester – Prohibits insurers from denying claims based solely on “diagnosis code or impression, current ICD code, duration of an appointment as deemed clinically necessary by the enrollee's provider or select procedure code relating to the enrollee's condition.” Clarifies that the prudent layperson standard includes mental health conditions.  Specifies that health plans shall not require patients to self-diagnose.  Specifies that insurers “shall not reduce or deny a claim for reimbursement based on the absence of an emergency medical condition if a prudent layperson with an average knowledge of health and medicine would have reasonably expected the presence of an emergency medical condition.” SB 165 is a revamped version of HB 99 from the previous General Assembly. Status: Referred to the Senate Financial Institutions, Insurance and Technology Committee.

Senate Bill 166 – Senator Nathan Manning – Specifies that insurers are not permitted to charge a provider for receiving reimbursement electronically. Status: Referred to the Senate Medicaid Committee.

House Bill 214 – Representative Kevin Miller – creates a prior authorization gold card. Requires insurers to report data on prior authorization. Status: Sponsor hearing held before the House Insurance Committee on May 20, 2025.

House Bill 219 – Representative Kellie Deeter – Establishes network adequacy standards. This includes ensuring enrollees have access to emergency services at all times.  The Department of Insurance would be charged with establishing the ratios for demonstrating adequacy. Status: Sponsor hearing held before the House Insurance Committee on May 6, 2025.

House Bill 220 – Representative Heidi Workman – Prohibits plans from denying coverage of a change in medication dosage on a medication that had been prior authorized. Prohibits insurers from retroactively denying coverage of mental and substance use disorder treatment.  Prohibits insurers from charging a fee for appealing prior authorization denials. Status: Referred to the House Insurance Committee.

EMS Bill Introduced

Representatives David Thomas and Thomas Hall have introduced House Bill 274 regarding EMS Services. The bill would generally require municipalities and townships to provide EMS and fire services.  This can be provided directly by the jurisdiction, under a contract for the services, or as part of a joint district.  The bill also creates a grant program under the State Fire Marshal’s office for townships and municipalities to access assistance in complying with the legislation.

Non-Compete Legislation Pending

Senate Bill 11 has been introduced by Senators Louis Blessing (R-Colerain Township) and William DeMora (D-Columbus).  This legislation would broadly prohibit noncompete agreements between employers and workers. Under the bill, no employer would be permitted to enter into or attempt to enter into a non-compete agreement with an employee, including presenting a non-compete agreement as a condition of employment. Employers would also be barred from actions such as restricting workers from working for other employers for a specific period, in a particular geographical area, or a similar capacity.

SB 11 would extend these protections to employees, independent contractors, externs, interns, volunteers, apprentices, sole proprietors providing services to clients, and individuals offering services through businesses, nonprofit organizations, or associations.

The Senate Judiciary Committee will consider the legislation.  Ohio ACEP will be supporting this legislation. We also expect legislation focused more specifically on physician non-compete agreements to be reintroduced.

Off-Label Drug Bill Reintroduced

Legislation introduced by Representatives Jennifer Gross and DJ Swearingen would require the dispensing and administration of off-label use of drugs. House Bill 12 is similar to House Bill 73, which failed to pass in the last General Assembly due to disagreements between the House and Senate. A portion of HB 12 regarding “medical free speech” was sent to the Governor in December as part of a larger package of proposals, but the Governor exercised his veto authority.  The proposal initially responded to COVID patients’ desire to use drugs not approved for the treatment of the virus. The bill would require pharmacists to dispense the drugs or make accommodations for off-label drugs to be dispensed and administered. If the attending provider does not recommend the care, the patient has the right to receive treatment from another provider.

This legislation is pending in the House Health Committee, and four hearings have been held so far. It is opposed by hospitals, physician organizations, pharmacists, and business organizations.

EMS Bill Would Create Penalties for Harassment

Representatives Thomas Hall and Phil Plummer have introduced House Bill 20, which aims to criminalize the harassment of EMS providers. The bill classifies harassment as a misdemeanor in the fir^st degree if the offender disregards warnings to keep their distance or fails to maintain a safe distance (within 14 feet). Additionally, the bill includes probation officers within the definition of an emergency service responder. This bill is being considered by the House Public Safety Committee.

CRNA Legislation Introduced

Legislation regarding the scope practice of certified registered nurse anesthetists (CRNA) has been introduced by freshman legislator Representative Kellie Deeter, herself a CRNA. House Bill 52 removes supervision requirements for CRNAs to administer anesthesia, order drugs, and perform other clinical tasks. Instead, under the bill, they would do these things in consultation with a physician, dentist, or podiatrist. This bill has been referred to the House Health Committee, but there have not been any hearings held.

“Conscientious Right to Refuse Act” Introduced

Representatives Jennifer Gross and Beth Lear have introduced House Bill 112, which provides protections for employees, students, and others who refuse medical interventions, including vaccines. It would generally prohibit discrimination based on someone’s vaccination status. This includes hospitals, nursing homes, and businesses. Under the bill, unvaccinated individuals, or individuals who refuse any medical interventions covered by it, cannot be treated any differently than those who have been vaccinated or received specific medical interventions. Entities that do not comply with the bill's provisions may face civil penalties.  In addition to vaccines, the bill prohibits requiring employees and patrons to wear masks. Furthermore, the bill forbids denying services to individuals based on their vaccine status, willingness to wear a facial covering or other provisions.

My Child-My Chart Act Re-Introduced

Representative Gary Click has reintroduced the “My Child-My Chart Act.” House Bill 162 would require a healthcare provider to ensure, to the fullest extent permitted under HIPAA and Ohio law, that the minor's parent or guardian has access to the electronic health record system containing their minor child’s health records.

HB 162 requires providers to inform parents annually of the circumstances under which minors can receive care without their consent and remind them that any care obtained without their consent cannot be disclosed unless the minor authorizes it. This includes emergency services for victims of sexual offenses (2907.29) and diagnosing and treating venereal disease (3709.241).  It requires providers to give the minor the opportunity, at their annual well visit, to sign off on ‘general, ongoing written consent’ for their parent to access records of care they underwent without their consent (this also applies to future care they may receive without their consent). However, providers do not have to do this every year if the minor has already signed off on it at a past visit.

This legislation has had a sponsoring hearing before the House Health Committee.

Want to Learn More?

If you’re interested in viewing the status of all of the bills Ohio ACEP is tracking, you can find that here.