SB 136: Health Insurance Modernization Act

In 2008, the OSMA was successful in passing House Bill 125, The Healthcare Simplification Act. Since then, the Healthcare Simplification Act has gone a long way toward reducing some of the complexity that health care professionals encounter when interacting with health insurance companies.

While that legislative effort has been helpful, there are additional things that need to be done to assist physicians and other health care professionals in how they interrelate with HMOs and health insurers.

The ultimate goal is to have greater transparency, fairness and uniformity in the rules that insurers impose upon Ohio’s health care providers. To this avail, the OSMA is working with Sen. Scott Oelslager (R-North Canton) and Sen. Capri Cafaro (D-Warren) to pass Senate Bill 136, the Health Insurance Modernization Act.

The legislation has three major components: New rules for how insurers conduct prior authorization (PA); shorter timeframes to process and pay claims and shorter timeframes to “take back” payments; and new rules for how contracts can be amended. Click below for more information.