05/15/2024

May Legislative Advocacy Update

There are very few legislative session days scheduled at the Ohio Statehouse between now and the fall election, and we expect the elected officials to mostly wrap up their work until the fall by the end of June. This means that our OSMA Advocacy team is currently facing the additional challenge of limited chances for movement on our priority issues, but thankfully we can report that due to our efforts, progress continues for the OSMA advocacy agenda.

Read on for a summary of what we have been working on for Ohio physicians:

Prior Authorization “Gold Card” – House Bill 130:

The OSMA Advocacy team has continued its advocacy in support of HB 130, which would create a prior authorization “gold card” program in order to lessen the burden that prior authorization puts on physicians and their practices. We are hoping to secure an opposition hearing for the bill in the House Insurance Committee by the end of May, in order to keep HB 130 moving through the legislative process. This will mean that the insurance industry will be given the opportunity to come to the Statehouse and testify, and OSMA will be on-hand to hear their talking points and prepare ourselves for the next steps in the process.

Non-Medical Switching – House Bill 291:

OSMA is also pushing for another hearing for HB 291, legislation which would limit the ability of insurers to engage in the practice of non-medical switching. As a reminder, we are advocating for HB 291’s passage to avoid the disruption of a physician’s ability to exercise their medical expertise and help their patients caused by abrupt and unwarranted treatment changes. It also is currently assigned to the House Insurance Committee.

Takebacks & Automatic Downcoding:

OSMA is currently collecting information from practices to assist our advocacy efforts to ensure that current laws are enforced, while also working toward some updates in the law. Current Ohio law is very specific on what the third party payer is required to do before taking back a payment that has already been made. See the full language in our previous communication. If you have experienced takebacks when the requirements haven’t been followed, we need to hear from you. In particular, we want to know what provisions aren’t being followed, and the frequency of this happening—both in terms of numbers of claims and total dollar values. Please email your examples to info@osma.org and put "takeback information" in the subject line. OSMA appreciates your help!

Medicare/Medicaid Reimbursement:

• Ohio Medicaid Fee-for-Service (FFS) Claim Challenges: After working with OSMA regarding administrative challenges related to FFS claims, the Ohio Department of Medicaid (ODM) issued an update about upgrades which we hope will address some of the problems practices have been facing.
• Medicare Reimbursement: OSMA continues to work with our national colleagues at the American Medical Association on a rate fix solution for Medicare reimbursement. We hope to advance a proposal which will tie reimbursement rate increases to inflation and will keep members updated as work on the issue continues.

Scope of Practice:

• Certified Mental Health Assistants – House Bill 97/Senate Bill 60: We continue to work in partnership with the Ohio Psychiatric Physicians Association to express our concerns with legislation which would create an entirely new type of allied practitioner in Ohio which does not exist in any other state, the certified mental health assistant. The certified mental health assistant would operate under a two-year license and under the direct supervision of a physician. We continue to work closely with the sponsors of these bills and other interested parties to deliberate on specific issues we have regarding the scope of practice, training and education of CMHAs.

• Advanced Practice Respiratory Therapists – House Bill 102: OSMA is also continuing work in opposition to legislation which would license advanced practice therapists in Ohio. We have specific concerns about vague language in the bill and the scope of practice of APRTs. 

• Certified Registered Nurse Anesthetists – House Bill 362: House Bill 362 would revise the scope of practice of certified registered nurse anesthetists in Ohio by removing the requirement that CRNAs be supervised by a physician, and instead replace this with language requiring them to “consult with” a physician. Further, it would allow for CRNAs to direct other individuals to perform certain clinical and patient care-related tasks, even if the CRNA is not present on-site where the tasks are to be performed. This legislation would erase the compromise language OSMA worked for years on regarding the scope of CRNAs, which went into effect in 2020. It reverts back to an expanded scope of practice similar to what was originally proposed before said compromise, including granting CRNAs hospital-based prescriptive authority. OSMA is in active opposition to this bill and continues to express our concerns to legislators.

Increase Penalty for Sale of Tobacco Products to Minors – House Bill 258:

OSMA is supporting HB 258 which would increase penalties against businesses for sale of tobacco products to minors. This legislation has also recently seen movement in the legislature, having passed out of the House earlier this year and then having been referred to the Senate Judiciary Committee, where it recently had its first hearing.

AEDs in Schools – House Bill 47:

HB 47, an OSMA supported bill, would require placement of automated external defibrillators in each public and chartered nonpublic school and each public recreational facility and to require the Ohio Department of Health to develop a model emergency action plan for the use of AEDs. The Ohio Chapter of the American College of Cardiology was recently in downtown Columbus for their advocacy day and they made the rounds meeting with legislators about this bill. HB 47 passed out of the House last June and is now assigned to the Senate Health Committee. We hope to see it cross the finish line this year, and will continue to advocate in its favor.

Prohibit Use of Indoor Tanning for Minors – House Bill 169/Senate Bill 59:

OSMA, in partnership with the Ohio Dermatological Association, continues to support legislation which would prohibit use of indoor tanning by minors in Ohio. ODA has an upcoming advocacy day at the Statehouse in order to make the rounds with elected officials in hopes of helping the bill(s) move forward, and OSMA will continue its work on advocating for HB 169 and SB 59. HB 169 has had several hearings in the House Health Provider Services Committee and SB 59 has had several in the Senate Health Committee.

Anti-Vaccine Bill – House Bill 319:

OSMA is opposing House Bill 319, a gravely concerning piece of legislation which would threaten our critical public health framework and hinder efforts to fight the spread of communicable diseases. This bill would apply to COVID, flu, and childhood immunizations, and would make opting out of vaccine requirements for any reason significantly easier. OSMA has serious concerns with HB 319 and is watching it carefully for movement in the legislature and for the opportunity to testify and share our opposition with elected officials. It is currently assigned to the House Health Provider Services Committee.

Hospital Violence Prevention – House Bill 452:

A recently introduced bill, House Bill 452, aims to addressprevention of hospital violence and contains various provisions regarding training, security plans, and incident reporting.OSMA is supporting this bill, and it had its first hearing this week in the House Public Health Policy Committee.

FTC Final Rule on Non-Competes:

In January of 2023, the Federal Trade Commission (FTC) issued notice of a proposed rule prohibiting non-compete agreements between nearly every employee/employer under the FTC’s jurisdiction, including physician employment agreements. While OSMA could not support the proposed rule, we did provide comments explaining our position and taking into account all of our members—specifically to create a workable solution tailored to restrictive covenants in medicine. Although the final rule will become effective 120 days following its official publishing, the US Chamber of Commerce and other business groups have already filed an action in a Texas federal court to halt the rule from going into effect. The Chamber has requested the court vacate the rule and enjoin it from becoming effective. This litigation will likely take months or years to be completely resolved, so the rule is unlikely to be effective within 120 days. Thus, the rule language that eventually becomes effective (if at all) may be significantly different from this final rule. OSMA will continue to monitor the next steps in this rulemaking to determine what advocacy action may be required.

Gender-Affirming Care for Minors – House Bill 68:

OSMA continues to monitor the situation regarding House Bill 68, the legislation which would prohibit the administration of gender-affirming care to minors. HB 68 has been temporarily blocked from going into effect by a judge in order to await the result of a lawsuit filed against the measure on behalf of a transgender child and her family. In the meantime, gender-affirming care for minors can continue in Ohio. As a reminder, HB 68 originally passed in the Ohio Legislature in mid-December 2023, and Governor DeWine vetoed the bill on December 29, citing conversations he had with families of transgender youth, along with serious concerns and requests to veto expressed by the medical community. OSMA and a large coalition of several dozen medical organizations and hospitals were among those asking the governor to veto the bill, and had also testified and advocated in opposition to the bill during its journey in the legislature. We will continue to monitor this issue in the coming weeks.

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OSMA will continue to provide updates on these and other issues ahead of the summer recess and as activities pick back up for the fall lame duck sessions, which we anticipate will be hectic and extremely active. Please stay tuned!

OSMA is always there for you to help make your voice heard on the issues that matter most – and the Ohio State Medical Association Political Action Committee (OSMAPAC) is crucial to our continued success. Contributions to the OSMAPAC from physicians like you empower our advocacy agenda, fuel day-to-day OSMA advocacy efforts on your behalf, and help us elect legislators who are committed to improving healthcare in Ohio.

To make a contribution in any amount, please visit osma.org/pac or text OSMAPAC to 41444.