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Ohio Legislature Passes Legislation To Prevent Costly Surprise Medical Bills

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In December 2020, the Ohio Senate passed a bill that would prevent residents of Ohio from receiving surprise medical bills from out of network providers.  House Bill (HB) 388, legislation to end unexpected, expensive bills sent to patients after they unknowingly receive health care from an out-of-network provider, or for services such as lab work or ambulance transport, had previously passed the House on May 20, 2020.

Under the legislation, an out-of-network provider would send its bill to the patient’s insurance company. The insurer could then propose a different payment: the highest of its in-network rate, its out-of-network rate, or the federal Medicare rate. The provider can then accept the payment or negotiate another rate. If that fails, the parties go to arbitration, with the loser paying 70% of arbitration costs and the winner paying the rest. The added expense is intended to encourage an agreement during the negotiation period.

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