News & Advocacy
State Advocacy Update: Moving Forward on Our Priorities
posted: January 4, 2022
By Monica Hueckel, OSMA Senior Director of Government Relations
The 2021 year is coming to a close, and the Ohio Association of Rheumatology has made the best of another somewhat challenging year during the ongoing COVID-19 pandemic with respect to our advocacy agenda. In the coming year, we will work to expand upon the groundwork from 2021 and move forward on our priority legislative goals.
Here's a summary of the work we have accomplished on our major legislative issues from this year, and a look ahead to 2022:
Virtual Advocacy Day
On Friday, May 7th, 2021, the OAR conducted its second virtual Advocacy Day. During the prior general assembly, in September 2020, OAR did a similar Advocacy Day event in a virtual setting for the first time. Speaking with elected officials and connecting on key issues via Zoom is the next best thing to meeting in-person at the Statehouse, and a small group of OAR members took this opportunity as a valuable chance to advocate for our biggest legislative priorities to our legislators, including:
Non-Medical Switching
Non-medical switching occurs when patients are forced to switch to a different medication in the middle of a plan year for no medical reason due to formulary changes from the health insurer. House Bill 153, reintroduced legislation from the previous general assembly, would prohibit insurers from engaging in the practice of non-medical switching.
This bill, sponsored by Rep. Beth Liston (D-Dublin) and Rep. Sara Carruthers (R-Hamilton), would avoid the disruption of a physician’s ability to exercise their medical expertise and help their patients caused by abrupt and unwarranted treatment changes. Additionally, HB 153 would prohibit private health plans from increasing patient cost-sharing or from moving drugs to a more restrictive tier during a plan year.
Dr. Stephanie Ott provided supportive testimony for HB 153 in May 2021, telling the House Insurance Committee about the impact of non-medical switching on her patients. “Physicians may spend multiple years of trial and error finding a treatment regimen that properly manages their condition. The resulting course of treatment must carefully balance each patient’s unique medical history, co-morbid conditions, and side-effect balancing drug interactions. This equilibrium is carefully chosen and tenuous. Even slight derivations in treatment and variations between drugs, even those in the same therapeutic class, can cause serious adverse events.”
This continues to be a priority issue for OAR, and we will continue to pursue progress for this bill in 2022.
Co-pay Accumulator
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.
House Bill 135 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. This legislation is sponsored by Rep. Susan Manchester (R-Waynesfield) and Rep. Thomas West (D-Canton). There have been several hearings on the bill this year, and OAR provided proponent testimony in March, urging the House Health Committee to “protect patients’ pocketbooks” and continuity of care by supporting House Bill 135.
OAR will continue to push for advancement of this legislation in 2022.
Scope of Practice – APRN Independent Practice
OAR advocates for team-based care with the physician at the head of the care team. For years, the legislature has been asked to act in response to a variety of independent practice proposals for APRNs. OAR is in continued opposition to the APRN independent practice legislation, House Bill 221.
The bill would allow advanced practice registered nurses to practice independently with no physician oversight and is sponsored by Rep. Tom Brinkman (R-Mt. Lookout) and Rep. Jennifer Gross (R-West Chester), who is a nurse practitioner. The bill has yet to have any committee hearings, but we will continue to keep an eye on the issue in the coming year.
Telehealth
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 passed out of the House earlier this year, and out of the Senate this month. Governor DeWine is expected to sign HB 122 into law soon.
The State Medical Board of Ohio recently voted to extend the moratorium on enforcement of in-person patient care requirements until March 31, 2022. The physician community has been advocating for extension (or permanent change) to the rules related to telehealth, which were adjusted near the start of the COVID-19 pandemic. HB 122 contains provisions that would make many of the telehealth rule changes which were enacted due to the pandemic permanent.