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OH HB220

Bill

Status

Introduced

4/1/2025

Primary Sponsor

Heidi Workman

Click for details

Origin

House of Representatives

136th General Assembly

AI Summary

  • Amends Ohio Revised Code sections 1751.72, 3923.041, and 5160.34 to modify prior authorization requirements for health insuring corporations, sickness and accident insurers, public employee benefit plans, and Medicaid programs

  • Requires insurers to honor prior authorization approvals for dosage changes of already-approved drugs for chronic conditions without requiring new authorization

  • Prohibits insurers from retroactively denying prior authorizations for mental health or substance use disorder treatment when the patient was eligible and the service was covered at the time of approval

  • Requires insurers to identify the name, specialty, and relevant qualifications of the clinical peer who evaluates prior authorization appeals

  • Prohibits insurers and Medicaid from charging fees for appealing adverse prior authorization determinations

Legislative Description

Regards health insurance, Medicaid prior authorization

Health and Human Services : Health Care

Last Action

Referred to committee: Insurance

4/9/2025

Committee Referrals

Insurance4/9/2025

Full Bill Text

No bill text available