(November 14, 2017) State Rep. Steve Huffman, MD, has introduced legislation to allow Ohioans to obtain detailed cost estimates for medical procedures that are scheduled at least seven days in advance or are subject to prior authorization. Emergency services would be exempted.
HB 416 requires health care providers to offer a good-faith estimate, which may be stated within a price range. The estimate may be written, oral or electronic and must include whether the provider is out of network with the patient’s plan. It does not require estimates for any future services that might be deemed necessary as a result of the scheduled visit.
The Ohio Hospital Association and physician groups (including the OOA), filed a lawsuit last December, preventing implementation of a previous mandate approved by the legislature. This bill has been proposed as a more workable compromise, that is based on prior authorization and receipt of necessary information from health plans within 48 hours.
For more information about the pending lawsuit see http://www.ooanet.org/aws/OOSA/pt/sd/news_article/132281/_PARENT/layout_details/false