Advocacy Updates

APN Independent Practice Legislation

There are 3 different bills pending in the Ohio legislature that would give advance practice nurses (APNs) a path to independent practice. 

• Senate Bill 258– Senators George Lang and Mark Romanchuk - Eliminates the requirement to for APNs to have a collaboration agreement after they complete 2000 hours of clinical work. It also allows APNs to be a “collaborating provider” to other APNs if they have completed their 2000 clinical hours and are practicing independently. Status: Referred to Senate Health
• House Bill 449 - Representatives Tim Barhorst and Roirdan McClain - Eliminates the requirement to for APNs to have a collaboration agreement after they complete 2000 hours of clinical work. It also allows APNs to be a “collaborating provider” to other APNs if they have completed their 2000 clinical hours and are practicing independently. Status: Referred to House Health Committee
• House Bill 508 – Representatives Jennifer Gross and Rachel Baker - Eliminates the requirement to for APNs to have a collaboration agreement after they complete 5000 hours of clinical work. It also allows APNs to be a “collaborating provider” to other APNs if they have completed their 5000 clinical hours and are practicing independently. Status: Sponsor hearing in House Medicaid Committee on October 21, 2025.

Ohio ACEP has already shared a call to action with the membership and will plan to testify in opposition to these bills when the time comes. Data supports the importance of physician led healthcare, especially in the emergency department and we will fight to keep that the expectation in Ohio.

Hearing Held on Insurance Related Bills

• 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: Pending in the Senate Financial Institutions, Insurance, and Technology Committee. Proponent hearing on October 21, 2025. Proponents include the OSMA and other healthcare provider organizations.
• Senate Bill 165 – Senator Susan Manchester – This is priority legislation for Ohio ACEP. It 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.” Status: Pending in the Senate Financial Institutions, Insurance, and Technology Committee. Sponsor hearing held on October 14, 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: Pending in the House Insurance Committee. Amended on October 7, 2025, to add a provision requiring health plan issuers to complete provider enrollment and credentialing within 90 days of receiving a complete application.
• House Bill 390- Representative Jean Schmidt – Puts the responsibility of collecting patient co-pays, deductibles, and other cost-sharing amounts on the insurers. Currently, insurers generally require the provider to collect these cost-sharing amounts and co-pays, even though they are set by the insurer. Under the legislation, this would take effect in January 2027. It also requires all reimbursement for covered services to be made directly to the healthcare provider. Status: Pending in the House Insurance Committee. Sponsor hearing held on October 21, 2025.

Ohio ACEP Supported of Naloxone Legislation Moves Forward

Senator and physician Terry Johnson introduced Senate Bill 137 to require 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. On June 4, 2025, Ohio ACEP Past President Michael McCrea testified in support of the legislation. Dr. James Neuenschwander, presenting the Ohio Naloxone Project, also provided in-person testimony in support. There are no opponents to the legislation and it was unanimously passed by the Ohio Senate. The bill is now pending in the House Health Committee.  

My Child My Chart Passes Ohio House

Representative Gary Click introduced the “My Child-My Chart Act”, House Bill 162, to generally 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. Ohio ACEP was able to work with the bill sponsor on an amendment the bill to clarify that emergency physicians are not required to send annual notifications to patients they have seen.

This legislation passed the Ohio House by a vote of 87-6 on October 15, 2025.

PA Name Change Legislation

Legislation is pending in the House Health Committee to change the title of physician assistants to physician associates. House Bill 353 was introduced by Representatives Brian Lampton and Gayle Manning. Ohio ACEP will oppose this legislation, along with other medical societies, including the OSMA. Changing the name of the profession will cause patient confusion. National ACEP has issued a position on this, as PAs are pursuing this change nationwide. At the proponent hearing on October 22, 2025, several physician assistants testified. 

Healthcare Provider Non-Compete Legislation Reintroduced

Senator Terry Johnson has reintroduced legislation regarding healthcare provider non-compete clauses. Senate Bill 301 applies to physicians, physician assistants and APNs. Under the bill, non-profit hospitals would be prohibited from requiring that a physician, PA or APRN, as a condition of employment with the hospital, agree to refrain from obtaining employment in a specified geographic area at the conclusion of the employment with the hospital, for a specified period of time, with a particular employer, or in a particular industry or practice specialty.

However, a non-profit hospital may require a healthcare professional, as a condition of employment with the hospital, to agree that, at the conclusion of the employment with the hospital, the employee will refrain, for a period not to exceed six months, from obtaining employment within a radius of fifteen miles of the physical location where the employee was employed with the hospital.

A broader piece of  legislation, Senate Bill 11, that would generally ban all non-compete agreement, has been introduced as well.

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.