OH HB219

Health insurers must maintain provider networks sufficient in number and specialty to allow covered persons access to benefits without unreasonable travel or delay, including 24/7 emergency services availability

Superintendent of Insurance must establish criteria for evaluating network adequacy based on provider-to-patient ratios, geographic accessibility, appointment wait times, and ability to serve vulnerable populations including low-income individuals, children, and those with disabilities

Insurers must allow covered persons to receive out-of-network care at in-network cost-sharing rates when no appropriate in-network provider is available without unreasonable travel or delay

Network plans and access arrangements must be filed with the Department of Insurance before use, with material changes reported within 15 business days

If a provider is incorrectly listed as in-network in a directory, the insurer must compensate that out-of-network provider at their billed rate with no additional cost to the patient beyond normal in-network cost sharing