Advocacy Updates

State Budget Update – Passes Ohio House

The start of each General Assembly begins with the governor’s introduction of the state’s biennial budget bill. This General Assembly the budget bill is House Bill 96. 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, which is also expected to make additional changes. The budget process will conclude with a conference committee in June, where the two chambers will come together with the governor to craft a final bill for enactment.

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 their 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 possibly 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 recently joined an Ohio Medicaid Matters coalition to advocate for the program be administered responsibly and to the best benefit of Ohioans.

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.

Higher Education Overhaul Signed into Law

Senator Jerry Cirino introduced legislation to overhaul Higher Education, Senate Bill 1. Cirino had championed SB 83 in the previous General Assembly, which ultimately stalled in the House. The bill walks back some of the changes made to SB 83 in an attempt to reach a consensus. Notable changes included in SB 1 is a provision that was removed in the last General Assembly, banning all union employees employed by a public institution from striking. Additionally, SB 1 includes a ban on any DEI initiatives, except where compliance with state and federal law is required. The House added an amendment that specifies institutions can seek a waiver to comply with state or federal professional licensure requirements or to obtain or retain accreditations.

SB 1 has passed both the House and the Senate by mostly party line votes. With the Governor signing the bill into law, some groups are now contemplating legal challenges.

Insurance Reform Package Introduced

Numerous bills related to health insurance were introduced on April 1, 2025. All of these bills seek to resolve burdens that insurers place 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.

Senate Bill 164 – Senator Al Cutrona – Prohibits insurers from using AI as the sole bases from making claims decisions. Requires insurers to submit a report to the Ohio Department of Insurance outlining their use of AI.

Senate Bill 165 – Senator Susan Manchester – Prohibits insurers from denying claims bases 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 to include mental health condition. Specifies that health plans shall not require to 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.

Senate Bill 166 – Senator Nathan Manning – Specifies that insurers are not permitted to charge a provider for receiving reimbursement electronically.

House Bill 214 – Representative Kevin Miller – creates a prior authorization gold card. Requires insurers to report prior authorization data.

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.

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 assessing a fee to appeal prior authorization denials.

Non-Compete Legislation Reintroduced

Senate Bill 11 has been reintroduced 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 noncompete agreement with an employee, including presenting a noncompete agreement as a condition of hire. 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 in a similar capacity
● Mandating workers to pay back lost profits, lost goodwill, or liquidated damages resulting from the termination of the work relationship
● Imposing a fee for replacement hires, retraining, reimbursement of immigration or visa-related costs, bonding, or covering the costs of training, evaluation, or orientation.
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 legislation will be considered by the Senate Judiciary Committee. Ohio ACEP will be supporting this legislation. We also expect legislation focused more specifically on physician non-competes to also be re-introduced.

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 originally 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 that care is not recommended by the attending provider, the patient would have the right to receive the treatment from another provider anyway.

Ohio ACEP opposed the legislation in the last General Assembly.

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 first 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.

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. As with other efforts to expand the scope of practice for CRNAs, action on this bill will be led by the Ohio Society of Anesthesiologists and the OSMA.

“Conscientious Right to Refuse Act” Introduced

Representatives Jennifer Gross and Beth Lear have introduced House Bill 112, regarding 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 that refuse any medical interventions covered by it, cannot be treated any differently than those who have been vaccinated or received certain 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 bill would require a healthcare provider to ensure to the fullest extent permitted under the HIPAA and Ohio law that the minor's parent or guardian has access to the electronic health record system with their minor child’s health records.

HB 162 requires providers to inform parents every year of the circumstances under which minors can get 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 an opportunity every year 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.

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.