Top Legislative Issues
OSMA's Government Relations team serves as the voice of Ohio’s physicians—advising state departments and influencing state policy on health issues. Through leadership and education, we support and advance the physician profession in the state of Ohio.
We continue to monitor the major issues affecting the practice of medicine at the state and federal level. The top priority issues impacting the practice of medicine in Ohio are detailed below.
Current advocacy priorities include the following:
Criminalization of Medicine/Legislative Interference and Overreach in Medicine and the Physician-Patient Relationship
Legislative & Regulatory News
November 28, 2023 – In addition to our direct advocacy efforts, we’re asking members to contact Congress to help fix Medicare now. We need everyone’s help to avert the cut.
November 28, 2023 – OSMA’s top legislative priority for 2023 was to increase Medicaid reimbursement for physicians. Working with the administration, a provision to increase the Medicaid fee schedule was included in the initial budget proposal and remained in the version passed by both the House and Senate—and ultimately signed by the governor at the end of June.
November 27, 2023 – Ohio Department of Medicaid (ODM) and its Ohio Medicaid Enterprise System vendors are diligently focused on providing transparency and visibility regarding care and services.
November 9, 2023 – As Congress enacted the No Surprises Act in 2020 to address the issue of “surprise medical bills” for patients and provider payment issues, the Biden administration has proposed a recent rule specifically addressing the Independent Dispute Resolution (IDR) process. And as a reminder, this summer the Board eliminated the previous One Bite Program addressing physician substance use impairment in favor of a vastly more appropriate program structure.
November 9, 2023 – After weeks of early in-person and absentee mail-in voting, the 2023 general election culminated in this week’s Election Day, with many Ohioans heading out to the polls to cast their votes on Tuesday. Numerous local races all over the state were decided by Ohio voters, and in the evening after the polls closed, all eyes were on the incoming results, particularly concerning statewide ballot issues 1 and 2.
November 8, 2023 – The State Medical Board of Ohio (SMBO) developed a Confidential Monitoring Program in partnership with the Ohio Professionals Health Program (OhioPHP) for all licensees and applicants. This program is a confidential path for individuals to seek help for burnout, mental health, substance use disorders, and a therapeutic alternative to regulatory awareness.
October 26, 2023 – The OSMA Delegation to the American Medical Association (AMA) had the privilege of representing our association at the 2023 Annual Meeting of the AMA House of Delegates (HOD), from June 9 to 14 in Chicago, Illinois. The business of this Annual Meeting is robust and diverse in both range and topic. There were several hundred items of business (reports and resolutions) considered at the meeting. The Delegation worked throughout the summer to summarize our activities at the meeting for review by the OSMA Council and membership.
October 19, 2023 –Over the past few weeks, the Ohio Statehouse has been bustling with hearings, interested party meetings, and other activity, and your OSMA advocacy team, along with several OSMA physician members, have been busy in downtown Columbus to make physician voices heard.
October 19, 2023 –The new program provides individual treatment plans and confidential (non-disciplinary) programming, along with the inclusion of physical and mental health related impairment in addition to substance abuse.
October 18, 2023 – Earlier this month the GOP Doctors Caucus released a discussion draft of legislation seeking to reform the Medicare Physician Fee Schedule (MPFS). In the press release, the Caucus outlined three main areas it hoped to address.
October 4, 2023 – Earlier this year, OSMA was successful in advocating for a Medicaid rate increase in the state budget. A top priority for OSMA, in its entirety, for the 18-month period starting in January, estimates are that the increase should result in more than $200 million in new funding for physician professional services.
September 29, 2023 – Press release: Columbus, Ohio – Ohio State Medical Association (OSMA), the state’s largest and oldest physician-led organization, issues the following statement on Ohio’s November ballot initiatives.
September 26, 2023 – The Ohio Department of Medicaid (ODM) recently provided the following update on claims submissions for all Ohio physician practices.
September 20, 2023 – Along with monitoring dozens of pieces of legislation so far this year, there are several items we will be focusing our advocacy efforts on heading into late September, October, and beyond.
August 24, 2023 – OSMA's Annual Meeting will take place April 5-7, 2024 at the Renaissance Polaris Hotel in Columbus. We look forward to seeing everyone—and in the meantime, here is what to plan for...
August 23, 2023 – Provide your feedback on the proposed changes to the Quality Payment Program by September 11. CMS recently sent out the following request to all physicians...
August 17, 2023 – Join our live updates on the following dates for a brief audio interaction on how your OSMA team is working to advance important state legislative and regulatory issues that protect you and your patients.
August 17, 2023 – OSMA has joined with the AMA and other state and national medical association to reform Medicare’s broken physician payment system. The AMA sent the below alert to physicians across the country to contact members of congress when their home for the August recess. We encourage all OSMA members to contact congress and stress the importance of fixing Medicare now.
August 4, 2023 – During the spring state budget process, OSMA advocated for funding to secure the 988 Suicide & Crisis Lifeline in Ohio, and changes to how to better protect physicians' personal data on the medical board's website.
August 2, 2023 – During the spring state budget process, OSMA advocated for an increase in the Medicaid physician fee schedule. The final passed and signed version included language for a 5% increase.
July 20, 2023 – Hear firsthand from OSMA's advocacy leadership on current issues we're working on in the legislative space, including state budget wins for physicians and the practice of medicine, insurance and prior auth issues, public health topics, and some recent scope of practice activity.
OSMA Champions New Medicaid Physician Payment Increase Included in Budget Legislation
July 5, 2023 – This spring, the Ohio Legislature embarked on the biennial state budget process, tasked with passing legislation creating the budget for fiscal years 2024-2025. The Ohio State Medical Association (OSMA)’s Government Relations team engaged with legislators on many health care budget items from the start, when the governor’s initial proposal for the budget was released.
June 15, 2023 – HB 130 was introduced in the Ohio House in March by Rep. Kevin Miller (R-Newark), and is one of OSMA’s major legislative advocacy priorities this year. The bill, if enacted, would create an exemption system that rewards Ohio healthcare providers who consistently receive a prior authorization approval rate of 80% or more for a specific service, device, or drug in the prior 12-month period.
June 14, 2023 – In addition to reforming prior authorization at the state and federal level, OSMA joins the AMA and organized medicine across the country to fix major flaws in the Medicare physician fee schedule.
May 31, 2022 – Cigna has updated its modifier 25 policy to announce a delay in implementing the required submission of documentation to support the use of modifier 25 when billed with E/M CPT codes 99212 – 99215 and a minor procedure.
May 25, 2023 – In addition to our efforts at the state level with HB 130, OSMA is also involved with our national and state partners to reform prior authorization practices in Medicare Advantage plans.
May 23, 2023 – We are thrilled to welcome Dr. Drobny as our new President, and we thank Dr. Brian Santin who tactfully completed his term. Read on to learn more about Dr. Drobny, his medical career, and his vision for leading OSMA.
May 17, 2023 - The OSMA government relations team continues activity related to the state budget bill, which recently passed out of the Ohio House and is now in hearings in the Ohio Senate Finance Committee. As summer approaches, OSMA has been involved in advocacy efforts regarding several pieces of legislation in the last few weeks.
May 16, 2023 - On Thursday, May 11, 2023, the federally declared Public Health Emergency (PHE) ended. As many flexibilities for physicians and practices were provided by federal regulatory agencies during the PHE, it is important to know which, if any, of those flexibilities will be going away.
May 4, 2023 - Medicare annual wellness visits provide an important opportunity to promote health and to provide disease screening and advance care planning with patients who have Medicare. However, billing for the wrong visit or at the wrong time can result in denied claims.
May 4, 2023 – OSMA Exclusive Partner, The Doctors Company (TDC) CEO and Chairman, Dr. Richard Anderson reflects on the history of tort reform in Ohio.
May 3, 2023 – OSMA can help. According to a recent survey of 1,000 employers by Forbes Advisor, employer-sponsored health coverage is the most important benefit to employees in 2023. Yet one of the biggest costs facing employers today continues to be health insurance coverage for employees.
May 3, 2023 - OSMA's continued focus at the state and federal level is starting to result in individual plans announcing revisions to prior authorization practices. We’re also supporting HB 130 in Ohio that creates a prior authorization gold card and we anticipate additional legislation in Ohio related to prior authorization and billing later this year.
April 27, 2023 – OSMA has joined with more than 120 other state and national medical societies communicating our support to the sponsors of H.R. 2474—the Strengthening Medicare for Patients and Providers Act.
April 25, 2023 – In January of this year, the Federal Trade Commission issued notice of a proposed rule which would prohibit non-compete agreements between nearly every employee/employer under the FTC’s jurisdiction, including physician employment agreements.
April 24, 2023 – Cigna is re-releasing its policy to require the submission of medical records with all Evaluation and Management (E/M) claims with CPT 99212-99215 and modifier 25 when a minor procedure is billed. Last week, OSMA joined the AMA and almost 100 other state and national medical/specialty societies in a collective letter urging Cigna to reconsider this policy.
March 30, 2023 – This is an important time for healthcare in the Ohio legislature, as House Bill 130 was introduced—which, if passed, will create a Prior Authorization Gold Card Program for Ohio providers. Get involved and help us drive meaningful change in the insurance industry.
March 30, 2023 – Proposed HB 130 would ease regulatory burdens of prior authorization, improve healthcare system and outcomes for patients.
March 23, 2023 – Prior Authorization reform is OSMA’s top advocacy issue in 2023 and 2024. In addition to advocating for major legislative reforms at the state level that will impact commercial and Medicaid plans, we have also been involved in initiatives at the federal level that will impact Medicare advantage plans.
March 2, 2023 – The goal of this legislation, which will be sponsored by Rep. Kevin Miller (R-Newark), is to create a “gold card” system for prior authorization, giving physicians a way to “earn” their way out of prior authorization requirements by demonstrating a high prior authorization success rate. Similar legislation was recently passed and enacted in the state of Texas.
February 20, 2023 – It has been announced that the PHE will be extended through May 11, at which point it will permanently expire, marking the end of PHE extensions. Because the PHE has been in place for nearly three years, it can be difficult to remember which rules existed before then, and which have been temporary. Here are a few highlights of what is expected to change.
February 16, 2023 – Several OSMA physicians joined your OSMA Government Relations team in D.C. to participate in the American Medical Association’s National Advocacy Conference (NAC).
February 16, 2023 – Physicians across Ohio have continued to embrace remote healthcare services. After a lengthy rule promulgation process, including our member feedback and input from OSMA, the Board has finalized new telehealth rules, which will become effective this month.
February 15, 2023 – While we focus on prior authorization reform in Ohio that will impact commercial and Medicaid plans, Medicare Advantage plans are regulated federally and therefore reforms must occur through congressional legislative action or rulemaking by CMS. In the letter, we urged CMS to focus on the following...
January 26, 2023 – We anticipate several familiar issues to remain major OSMA advocacy priorities this year, and are always monitoring the legislative and regulatory spaces for new and emerging topics that arise throughout the year. Here’s our current advocacy forecast...
January 25, 2023 – The rule applies to all existing and future non-compete agreements between employers and employees. It also includes non-competes with independent contractors. It would nullify nearly every non-compete agreement for our physician owned practices and prohibit those going forward.
HHS Proposes to Standardize Electronic Health Care Attachments Transactions & Electronic Signature Process
January 2, 2023 – The U.S. Department of Health and Human Services released the following information on Dec. 19 along with a fact sheet and full press release.
December 21, 2022 – H.B. 513 passed in the Ohio legislature last week, which would remove all local control over tobacco policies including implementing local tobacco retail licensure programs, conducting local compliance to ensure retailers are not selling to kids, and furthering policies to end the sale of flavored tobacco products.
December 15, 2022 – OSMA is proud to represent you and advocate on your behalf. Your OSMA Advocacy team has experienced a whirlwind of activity at the Statehouse after the election, and has been carefully monitoring what has happened during the lame duck legislative session.
December 15, 2022 – Last week, OSMA joined the AMA—and every other state medical society in the country—signing a letter to Congress urging them to take action before the end of the year to avert the projected 4.5% cut to the 2023 Medicare Physician Fee Schedule.
December 13, 2022 – OSMA joined the Ohio Hospital Association in filing an amicus brief in the Ohio Supreme Court to support the decision of Ohio’s 10th District Court of Appeals that when a medical malpractice claim is barred by Ohio’s statute of repose, that any loss of consortium claim arising out of that malpractice claim is also barred.
April 26, 2022 – We are thrilled to welcome Dr. Santin as our new President, and we thank Dr. Lisa B. Egbert who tactfully completed her term. Read on to learn more about Dr. Santin, his medical career, and his vision for leading OSMA.
April 23, 2021 – We are thrilled to welcome Dr. Egbert as our new President, and we thank Dr. Anthony Armstrong who skillfully completed his term. Read on to learn more about Dr. Egbert, her medical career, and her vision for leading OSMA.
February 11, 2021 - The COVID-19 pandemic and elevated conversations about racial justice have brought the issue of healthcare equity to the forefront for healthcare professionals everywhere. As we support members in 2021, we’re pleased to share thoughts from OSMA President Anthony Armstrong, MD on health equity and what this means for Ohio physicians.
Many of our members provide daily patient care to Ohio’s Medicaid population and thus are uniquely qualified to provide meaningful information to assist the Ohio Department of Medicaid in its upcoming competitive Medicaid managed care procurement process. The comments we received from our members generally centered on areas where improvement is most desired, including plan accountability, grievances and appeals, provider support, benefits and delivery, and care coordination and management.
Your OSMA Delegation to the AMA worked diligently on behalf of Ohio physicians during the recent 2019 Annual Meeting in Chicago. Ohio resolutions were carried forward and either adopted as new policy or committed the AMA to continue existing policy for another ten years.
The OSMA Government Relations team has been engaging with legislators on health care-related budget items since the governor’s initial proposal was released, and has been following and participating in the ongoing debates about a number of health policy decisions.
Earlier this week, the state budget became a bill on Capitol Hill—or at least on Capitol Square in Columbus, Ohio. The OSMA has completed an initial review of the bill language...
Earlier this month, several OSMA members along with the OSMA Government Relations staff traveled to Washington DC to meet with members of Congress to discuss how existing laws are affecting patients and practices.
With a new governor in office and Ohio legislators back at the Statehouse, the OSMA is putting our advocacy agenda—based on the priorities of our members—in motion.
The final months of 2018 were a whirlwind beyond the usual frenzied legislative activity of “lame duck” – with Ohio’s legislators staying in session until just days before the Christmas holiday, and returning for more action just days after. This scenario is extremely rare and hasn’t happened in Ohio’s legislature to this extent in decades.