AMCNO meets with Ohio Attorney General regarding physician ranking legislation

AMCNO representatives met recently with the Ohio Attorney General Richard Cordray to discuss the AMCNO legislative initiative regarding physician ranking. AMCNO provided background on the issue to the Ohio AG and his legislative staff on the history of the bill noting that this legislation was introduced in the last General Assembly and there is now similar legislation under review in the current General Assembly.

The Ohio AG was interested to learn that the legislation was introduced in Ohio following a review of the actions taken by New York Attorney General Cuomo on the issue of physician ranking. The purpose of this legislation is to provide patients with accurate information when selecting a physician. This legislation would prevent health insurance companies from ranking physicians based solely on specific criteria to persuade a consumer to choose one physician over another. Under this legislation, the designations would be made based on cost efficiency, quality of care or clinical experience and it would establish standards for the physician designations. If passed, Ohio will be on the forefront of implementing important new policy that promotes accurate, safe and effective health care transparency for everyone.

The Ohio AG was aware that recently the New York Attorney General’s office reached a settlement agreement with CIGNA and the other major New York health insurers that provide guidelines to which the physician profiling programs must adhere. The AMCNO also provided information to the Ohio AG regarding the physician profiling law that passed in Colorado in 2008 that required health plans to disclose all data and the methodology used upon which the provider’s designation is based.

The AMCNO approached the Ohio AG to determine what role, if any the AG may want to have relative to this initiative. Currently the legislation as drafted utilizes the trade secrets law as the enforcement mechanism with oversight of the law by the Ohio Department of Insurance. The AMCNO assured the Ohio AG that the legislation does not set up the ODI as the ranking service in the state and there is no appropriation to do that in the legislation. Rather, the intent is that the ODI would act as an overseer of the process. The AMCNO informed the Ohio AG that our representatives have met with the Director of the ODI and they are reviewing the legislation at this time and plan to take the bill to the Governor’s staff for additional review.

As a result of the meeting, Attorney General Cordray has agreed to review the legislation with his staff to determine what level of involvement or support they may have in this process, noting that if the criteria addressed by the New York AG is included in the legislation it may get a favorable reaction. The representatives from the AMCNO were appreciative of his input and noted that we would be amenable to changes in the enforcement process or the providers that would be covered under the legislation based upon review by his office.