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Sub-SB 162, regarding insurance payment takebacks, unanimously passed out of the Senate in April, and it has now started its journey through the Ohio House. OSMA has supported this legislation since last spring alongside a slate of other key insurance reform initiatives.

As a reminder, this legislation, which is sponsored by Rep. Bill Blessing (R-Colerain Twp.) would:

• Decrease Ohio’s current 24-month insurer takeback timeframe, decreasing it to one year. This will give physician practices more predictability and financial stability, which is critical as many operate with limited administrative resources.
  
  
• Extend the provider appeal period from 30 to 60 days. This acknowledges how complex and time consuming it can be for providers to respond to takeback determinations, and ensures physicians have a fair chance to submit the necessary documentation. 
  
  
• Require electronic notification of takebacks when an electronic system exists. This will help streamline communication and reduce unnecessary administrative work for practices, allowing more time to be spent on patient care.

Dr. Marc Antonchak, OSMA physician member and current president of the Ohio Association of Rheumatology, joined Monica Hueckel in joint supportive testimony, telling members of the House Health Committee about the real-world impact of takebacks on medical practices and the patients they serve.

Dr. Antonchak was able to illustrate how disruptive and challenging the takebacks process can be by giving powerful examples of takebacks which occurred from over a year to several years after the payment date. These examples were based on actual experiences of the small, independent practice where he sees patients, and described in plain terms the undue financial and administrative strain that physicians and practice staff face with payment recoupments that occur many months after the care is provided. 

"This coupled with the time and effort required to try to appeal takeback determinations interferes with our ability to focus on providing the best possible care to the people in our community who need it," Dr. Antonchak said in testimony. "SB 162 is important to me as a physician in our state as I believe it will truly help alleviate significant administrative burden for us, and allow for more time and resources to go toward patient care."

There are several weeks of legislative session left at the Statehouse before the legislators depart for their summer recess in advance of the November 2026 elections. Sub. SB 162 will continue through the committee hearing process, and must be voted out of committee before it can be voted on by the full House. OSMA is optimistic about the progress of this legislation and continues to push for Sub. SB 162 to advance forward. 

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Watch the June 3 hearing of the Ohio House Health Committee here.

Or, read a written copy of the testimony here.

Stay tuned for more advocacy updates from the OSMA Government Relations team!