Healthcare (Insurance)

passed · Ohio · Senate Jun 16, 2026

SB 160: Regards prescription drugs and medication switching

SB 160 prohibits health insurance plans from making certain changes to drug coverage during a plan year, such as increasing patient costs, moving drugs to more restrictive tiers, or removing drugs from formularies (except for specific safety or manufacturer discontinuation reasons). It directly affects health insurance issuers and plan members by limiting how insurers can adjust coverage for prescription drugs. Key provisions include allowing generic substitution when available, preventing prior authorization for covered drugs, and exempting plans from restrictions if a drug’s cost rises more than 5% plus inflation. The bill aims to stabilize drug access for patients while permitting standard practices like formulary additions and generic substitutions.

Topics ✓ HealthcareSupports HealthcareSB 160 protects patient access to prescription drugs and prevents increased costs by limiting insurers' ability to change drug coverage during a plan year.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Ohio · House Apr 9, 2025

HB 219: Establish network adequacy standards for health insurers

HB 219 requires Ohio health insurers to maintain networks ensuring all plan members - especially low-income individuals, children, people with disabilities, and those with chronic conditions - can access needed care without unreasonable travel or delays. Insurers must provide sufficient providers by specialty (including those serving underserved communities), guarantee 24/7 emergency services, and meet specific geographic accessibility standards. The state insurance superintendent will set evaluation criteria (like provider-to-patient ratios and appointment wait times) and monitor compliance through surveys, with insurers required to file network plans for approval. This law directly affects health insurers operating in Ohio, mandating concrete network standards to improve access to care.

Topics ✓ HealthcareSupports HealthcareHB 219 mandates network adequacy for health insurers, directly improving patient access to care, emergency services, and specialized providers, especially for vulnerable populations.95% confidence

Sub-Topics Insurance

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signed · Ohio · Senate Jul 8, 2026

SB 162: Regards timing of health insurer recoupment from providers

SB 162 amends Ohio's Revised Code section 3901.388 to change the timeframe health insurers must use when recouping overpayments from healthcare providers. This directly affects health insurers and the providers who bill them for services. The bill specifies a new deadline for insurers to request repayment after identifying overpayments, replacing the previous timeframe outlined in the existing law. The change focuses solely on the timing mechanism for recoupment, without altering the conditions under which recoupment occurs.

Topics ✓ HealthcareSupports HealthcareSB 162 amends regulations for health insurer recoupment from providers, a procedural change likely aimed at refining financial operations within the healthcare system.65% confidence

Sub-Topics Insurance

in committee · Ohio · Senate Jun 11, 2025

SB 220: Establish paramedicine programs; require insurance coverage

To enact sections 3902.65, 4765.362, and 5164.11 of the Revised Code to establish community paramedicine programs and to require insurance coverage for services provided under those programs.

Topics ✓ HealthcareSupports HealthcareEstablishes community paramedicine programs and requires insurance coverage for services provided, expanding health services and coverage.95% confidence

Sub-Topics Insurance

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in committee · Ohio · House Sep 15, 2025

HB 390: Prohibit health plans from requiring providers to collect copays

To enact section 3902.55 of the Revised Code to prohibit health plan issuers from requiring or inducing providers to collect copayments and other cost sharing amounts.

Topics ✓ HealthcareSupports HealthcareThe bill removes the requirement for providers to collect copays, potentially improving patient access to health services by reducing immediate out-of-pocket costs.90% confidence

Sub-Topics Insurance

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in committee · Ohio · House Feb 18, 2026

HB 8: Require health plan and Medicaid coverage of biomarker testing

HB 8 requires health insurance plans and Ohio Medicaid to cover biomarker testing for diagnosis, treatment, and ongoing disease monitoring when ordered by a provider as medically necessary. The bill mandates coverage only for tests supported by specific evidence, such as FDA-approved uses, clinical guidelines, or peer-reviewed studies showing improved health outcomes, and explicitly excludes screening purposes. It also requires plans to minimize disruptions in care (like multiple biopsies) and ensures an accessible appeal process for coverage denials. This affects patients with conditions requiring these tests and healthcare providers ordering them, but does not change existing coverage for screening.

Topics ✓ Budget & TaxesSupports Budget & TaxesBill mandates Ohio Medicaid coverage for biomarker testing, directly increasing government spending and appropriations for healthcare services.85% confidence ✓ HealthcareSupports HealthcareHB 8 mandates health insurance and Medicaid coverage for medically necessary biomarker testing, expanding patient access to diagnostic and monitoring services.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentHB 8 mandates health insurance plans to cover biomarker testing, thereby expanding the scope of health benefits available to workers.75% confidence

Sub-Topics Insurance Medicaid

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passed · Ohio · House Apr 15, 2026

HB 220: Regards health insurance, Medicaid prior authorization

To amend sections 1751.72, 3923.041, and 5160.34 of the Revised Code regarding health insurance and Medicaid program prior authorization requirements.

Topics ✓ HealthcareSupports HealthcareBill amends health insurance and Medicaid prior authorization requirements, a common legislative effort to improve patient access and streamline healthcare processes.75% confidence

Sub-Topics Insurance Medicaid

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in committee · Ohio · House Feb 5, 2025

HB 33: Require insurance coverage for certain prostate cancer screening

To enact section 3902.66 of the Revised Code to require health insurers to cover preventive screenings for certain men at high-risk for developing prostate cancer.

Topics ✓ HealthcareSupports HealthcareHB 33 requires health insurers to cover preventive screenings for prostate cancer, directly expanding health coverage and access to healthcare services.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentThe bill requires health insurers to cover specific preventive screenings, which expands health benefits often provided as part of employment.75% confidence

Sub-Topics Insurance

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in committee · Ohio · House Sep 15, 2025

HB 388: Regards state employee reimbursement for GLP-1 drug costs

HB 388 requires state health plans to reimburse state employees and elected officials for costs associated with GLP-1 medications (used for conditions like diabetes or obesity). It adds these specific drugs to the list of covered expenses under existing reimbursement policies. The bill establishes a clear process for employees to seek reimbursement for these medications through their state health plan. This directly affects state workers who use GLP-1 drugs and ensures their costs are covered under state health benefits.

Topics ✓ Budget & TaxesSupports Budget & TaxesHB 388 requires state health plans to reimburse GLP-1 drug costs for state employees, directly increasing state government spending and affecting the state budget.95% confidence ✓ HealthcareSupports HealthcareHB 388 mandates state health plans to cover GLP-1 drug costs, expanding health coverage and access to medication for state employees and officials.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentThe bill expands health benefits for state employees by requiring reimbursement for GLP-1 drug costs, directly supporting worker welfare and employment standards.95% confidence

Sub-Topics Insurance Prescription Drugs Public Employees

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in committee · Ohio · Senate Apr 2, 2025

SB 166: Prohibit health insurance, Medicaid electronic claim fees

To amend sections 3901.382 and 5164.46 of the Revised Code to prohibit fees for electronic claims submission by health insurer and the Medicaid program.

Topics ✗ Budget & TaxesOpposes Budget & TaxesThe bill prohibits the Medicaid program from collecting electronic claim fees, which would reduce a potential revenue stream for the state budget.75% confidence ✓ HealthcareSupports HealthcareProhibits electronic claims fees, reducing administrative burden/costs for health insurers & Medicaid, strengthening the healthcare system.85% confidence ✓ TechnologySupports TechnologyThe bill prohibits fees for electronic claims submission, which encourages the adoption and use of digital processes and technology in healthcare administration.75% confidence

Sub-Topics Insurance Medicaid

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