The Prior Authorization Reform Act
New rules for a more transparent, efficient & fair process!
Ohio now has one of the country’s most comprehensive patient advocacy laws, after the governor signed the Prior Authorization Reform Act (SB 129) into law in June 2016. The Ohio State Medical Association (OSMA)-backed measure ushers in new reform-minded changes aimed at assuring that patients receive the quality care they need and that their insurance carriers will provide the necessary coverage.
SB 129 strengthens the communication between patients, providers, pharmacies and insurers, ultimately making it easier for patients to be granted coverage for the care they need. Some provisions of the new law began in January 2017, and others are effective in January 2018.
More than 80 health care organizations – including The Cleveland Clinic, Ohio Children’s Hospital Association, Ohio Pharmacy Association, the American Cancer Society and the Ohio Osteopathic Association – joined the OSMA in backing SB 129.
- OSMA press release regarding the signing of SB 129 into law.
- Prior Authorization Reform Act reference sheet, which summarizes the provisions of the law and provides the effective dates of these provisions.
- If you are experiencing an issue with a payer not complying with the enacted provisions of the law, you can file a complaint online or by mail with the Ohio Department of Insurance.
- Complete our on-demand education about the Prior Authorization Reform Act here.