News & Advocacy

OAR Spring 2021 Legislative Summary

posted: May 19, 2021

With a new general assembly well underway, the Ohio Association of Rheumatology (OAR) has picked up several familiar issues from last year and is working to push for meaningful change for Ohio into 2021. Here's a summary of the work on our major legislative issues so far:

Non-Medical Switching (HB 153)

OAR is urging legislators to pass House Bill 153, legislation that would prohibit insurers from engaging in the practice of non-medical switching. This occurs when patients are forced to switch to a different drug treatment in the middle of a plan year for no medical reason. Non-medical switching disrupts a physician’s ability to exercise their medical expertise and help their patients. HB 153 is sponsored by Rep. Beth Liston (D-Dublin) and Rep. Sara Carruthers (R-Hamilton). It has only had one hearing in the House Insurance Committee so far this year. In the coming weeks, OAR hopes to provide proponent testimony in a subsequent hearing before the Committee.

Co-pay Accumulator (HB 135)

Health plans and pharmacy benefit managers (PBMs) may apply co-pay accumulator adjustment policies when patients attempt to use copay assistance programs. These prohibit a patient’s copay assistance amount from count toward their deductible and maximum out-of-pocket cap. OAR is advocating for House Bill 135, which is sponsored by Rep. Susan Manchester (R-Waynesfield) and Rep. Thomas West (D-Canton). The bill would require insurers and PBMs to count all payments made by patients directly or on their behalf toward their deductibles and out-of-pocket costs, increasing predictability as vulnerable patients face high out-of-pocket costs for their prescriptions. It has had several hearings in the House Health Committee this year, and OAR has provided testimony in support. Take Action.

Telehealth (HB 122)

During the pandemic, utilization of telehealth has soared, and it has proven to be a valuable tool in increasing access to high quality care, particularly for underserved populations. The general assembly has taken up legislation concerning telehealth over the past year. HB 122, sponsored by Rep. Mark Fraizer (R-Newark) and Rep. Adam Holmes (R-Nashport), would modify requirements related to the provision of telehealth services in Ohio. The bill has passed out of the House and is now pending in the Senate Health Committee.