AMCNO Scores A Victory with the Passage of HB 122 in the Ohio House Health Committee

On Wednesday October 14th, HB 122 passed out of the Health Committee in the Ohio House of Representatives with a unanimous vote. The bill was introduced to the Ohio House of Representatives and by AMCNO on April 2nd under the sponsorship of State Representative Barbara Boyd from Cleveland Heights who also serves as chairwoman of the committee. HB 122 was introduced with the strong support of the AMCNO in order to establish standards for physician designations by health care insurers. With the help of Rep. Boyd, the bill was able to navigate through the rigorous committee process and after four hearings it cleared the committee. Rep. Boyd believes the bill is much needed and the legislation protects consumers, promotes fairness, and ensures due process.

A clerical amendment was added to the bill before the bill was brought up for a vote and Rep. Boyd asked the committee to favorably report the legislation. The amendment made changes to the bill that gave the Ohio Department of Insurance rulemaking authority and the authority to establish a process to approve the appointment of independent ratings examiners, expanded the scope of the bill to third party administrators, and lengthened the process for timelines and appeals.

On behalf of AMCNO, Dr. John Bastulli appeared before the Health Committee to urge its passage and no parties appeared before the committee in opposition to the bill. AMCNO met with many groups during this process including: Attorney General Richard Cordray, the Ohio State Medical Board, the Ohio Department of Insurance, the Speaker of the Ohio House of Representatives Armond Budish, and numerous members of the Ohio General Assembly. Interested parties in the legislation were the Ohio Association of Health Plans (OAHP) and the Ohio Department of Insurance.

Specifically, under House Bill 122, insurers will be required to:

• Ensure that physician rankings for doctors are not based solely on cost and clearly identify the degree to which any rankings are based on cost;

• Use established national standards to measure quality and cost efficiency, including measures endorsed by the National Quality Forum and other generally accepted national standards;

• Utilize measures to assure more accurate physician comparisons, including risk adjustment and valid sampling;

• Provide consumers with information on how the program is designed and how doctors are ranked, and provide a process for consumers to register complaints about the system;

• Disclose to physicians how rankings are designed and a process to appeal incorrect rankings;

• Attain and pay for an independent ratings examiner, with expertise in efficiency measurement, to oversee compliance.

The next step in the process will be for the bill to be brought to the floor of the Ohio House of Representatives for a vote by the entire chamber and then reported to the Ohio Senate where it will be referred to a committee and go through the same process as in the House. After a bill goes through both chambers of the Ohio General Assembly it is then sent to the Governor’s desk where he can do one of three things: sign the bill and make it into law, not sign the bill and after a period of ten days it becomes law, or veto the bill. With the sponsorship of Rep. Boyd the bill is certain to pass the Ohio House. Members of the Health Committee from Northern Ohio that voted in favor of the bill were Rep. Kenny Yuko of Richmond Heights, Rep. Robert Hagan of Youngstown, Rep. Tom Letson of Warren, Rep. Steve Slesnick of Canton, and Rep. Scott Oelslager of Canton. The AMCNO will keep you apprised of further developments on HB 122.