Gov. Signs Historic Physician-Insurance Contracting Reform Bill

Gov. Ted Strickland signed HB 125 into law, March 25. The measure has been described as one of the most sweeping physician-insurance industry contract reform bills in the nation.

The new law, which takes effect in 90 days, promotes fairness and transparency in the contracting process and establishes a standard physician credentialing process. Specifically, it will ensure physicians get a copy of the full fee schedule from insurers; ban the selling or renting of a physician's contract to another company unless the rental is disclosed and all of the original contract terms are honored; require all insurers to use the same physician credentialing form, and to credential physicians in 90 days; and ban use of clauses in contracts that force physicians to provide services at a lower rate than originally called for in their contract.

The OOA actively worked for the bill's passage, along with the Ohio State Medical Association and handful of provider associations. In contrast, more than 30 managed care groups worked in opposition to the bill.

Insurers raised concerns about the initiative, saying that some portions will limit health plans and physicians' ability to communicate by telephone. "While our industry group believes there are some elements of this legislation that will meet our goal of providing affordable, high quality healthcare, there is concern about the additional administrative burdens that all parties will incur . running counter to the intent of simplification," the Ohio Association of Health Plans and the American Association of Preferred Provider Organizations said in a joint statement.

In February 2008, the Ohio Senate Judiciary Committee approved HB 125 and the following month, the entire Senate voted unanimously to approve the measure.

During the floor vote, Sen. Bill Seitz (R-Cincinnati) noted the bill was produced through negotiations involving parties that don't share "a great deal of love."

State Rep. Matt Huffman (R-Lima) was the primary sponsor of the bill. He said he introduced HB 125 because physicians are spending increasingly more time on administrative issues and paperwork.

Read HB 125 at http://www.legislature.state.oh.us/bills.cfm?ID=127_HB_125


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