Regulatory Affairs


Actively Monitoring the Activities
of State & Federal Regulatory Agencies

OSMA takes a very active role in advocating for physicians not just in the Ohio Legislature, but also in the regulatory arena—specifically at state agencies and state boards. We constantly monitor administrative rules at the Ohio Departments of Health, Medicaid, Insurance, Mental Health, along with state Boards such as Medical, Pharmacy, and Nursing to name a few. When one of these agencies propose changing these regulations, we work directly with our member committees to analyze how these regulations will affect our members, and when appropriate, we advocate to improve and protect the regulatory climate of our member practices. With evolving regulations such as telehealth and cross-state licensing, it is now more important than ever to participate in advocating for the medical profession.

How to get involved in advocating on these regulations
for your profession:

OSMA maintains advocacy subcommittees to review and discuss legislative and regulatory issues facing medicine. We highly value the participation of our members in these subcommittees and we encourage anyone interested in participating to do so.


Get Involved >
Or call OSMA at 614-527-6762.

Latest News:

Find updates below on the activities of relevant state boards and OSMA's active engagements.


Ohio Legislature Returns for the Fall: What’s on OSMA’s Agenda?

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.


2024 OSMA Annual Meeting – Key Dates & Deadlines

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...


CMS Seeking Comments on Quality Payment Program in 2024 Physician Fee Schedule Changes

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...


Save these Dates to Connect with OSMA's Leadership Team

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.


OSMA Collaborates to Reform Medicare’s Payment System

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.


OSMA Advocacy Priorities for Physician & Patient Mental Health Passed in Ohio Budget

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.


OSMA Advocacy Delivers: Medicaid Physician Fee Schedule Increase Coming in 2024

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.


Monthly Advocacy Update from Monica Hueckel

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.


State Budget Bill Passed, Signed by Governor

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.


OSMA Provides Key Supportive Testimony for Ohio Prior Authorization “Gold Card” Bill

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.


OSMA Supports AMA “Fix Medicare Now” Initiative

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.


Cigna Update to Modifier 25 Policy

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.


Take Action: Contact Congress to Fix Prior Authorization

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.


Introducing OSMA’s New President: A Q&A with Eric Drobny, MD

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.


OSMA Spring Legislative Update

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.


Public Health Emergency Ends

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.


Medicare Annual Visits: How to make them work in your office

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.


Tort Reform in Ohio: 20-Year Anniversary Reflections

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.


Are Employee Health Insurance Costs Giving You a Headache?

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.


United Healthcare to Reduce Prior Authorizations

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.


OSMA Advocates for Medicare Physician Payment Changes

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.


Advocacy Update on Non-Compete Proposed Rule 

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.


OSMA/National Response to Cigna's Re-release of Modifier 25 Policy

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.


We Need Your Help to Make the Prior Authorization Gold Card a Reality in Ohio!

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.


Prior Authorization Gold Card Legislation Introduced in Ohio House

March 30, 2023 – Proposed HB 130 would ease regulatory burdens of prior authorization, improve healthcare system and outcomes for patients. 


OSMA Comments on Federal Prior Authorization Rules

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.


OSMA Needs Your Help—New Prior Authorization Legislation to Be Introduced

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.


Public Health Emergency Expiration—Reminders

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.


OSMA Physicians & Staff Advocate for Medicare Funding & Prior Authorization Reform in D.C.

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).


Ohio’s New Telehealth Rules Effective Feb. 28—What to Know

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.


OSMA Joins National Effort to Reform Prior Authorization in Medicare Advantage Plans

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...


OSMA's Top Advocacy Priorities for 2023

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...


FTC Releases Draft Rule Regarding Non-Compete Agreements

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.


OSMA Joins Public Health Advocates Urging the Governor to Veto H.B. 513

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.


Lame Duck Legislative Update

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.


OSMA Continues Advocacy Push to Avert 4.5% Cut to the Medicare Physician Fee Schedule

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.


Recent Legal Actions to Note

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.


OSMA’s 2022 Midterm General Election Recap

November 10, 2022 – After a whirlwind midterm election day, millions of Ohio voters have made their voices heard. Overall, the candidates endorsed by the Ohio State Medical Association Political Action Committee (OSMAPAC) prevailed in the majority of races for various statewide offices. Ohio also set a record as far as early and absentee voting in a midterm election - a total of 1,392,767 votes were cast through either in-person early voting or returned absentee ballots as of the end of early voting on Monday.


OSMA Joins AMA, Other Organizations in Opposition to Federal Allied Practitioner Scope of Practice Legislation

November 10, 2022 – OSMA was among dozens of national and state medical societies and associations that signed an opposition letter, expressing concerns that this bill would negatively impact the quality of care received by Medicare and Medicaid patients.


Sean McCullough Joins OSMA Advocacy Team, Monica Hueckel Promoted

October 26, 2022 – Sean joins our team as our new Director of Policy and Legal Counsel. OSMA has also promoted Monica Hueckel, who has been with OSMA for more than eight years, to the role of Vice President of Advocacy.


Ohio Medicaid Changes Coming: Important Updates & Training Reminders

October 20, 2022 – The Ohio Department of Medicaid (ODM) is in the process of major administrative and program updates and changes. Many of these will directly impact physician practices. Earlier this week, ODM provided the following information and training opportunities to ensure you are up-to-date on what you need to do and know.


Advocacy Update: Election Day is Approaching—and Know What’s in Store for the Rest of 2022

October 20, 2022 – Early voting began last week for the upcoming general election on Tuesday, November 8. Many important races will feature on your Ohio ballot this year, including decisions for U.S. Senate, Congress, state House and Senate and Ohio Supreme Court. Additionally, Ohioans will elect candidates for the offices of governor, attorney general, and secretary of state.


October's Medical Board Meeting Recap

October 19, 2022 – At its regularly scheduled Board meeting on October 12, the Board adopted three additional offenses to its list of disqualifying offenses for application for licensure.


Key Federal Legislation Update: Take Action

Sept 27, 2022 – OSMA wants to ensure Ohio physicians are aware of the following pending issues in Congress, which are highly impactful to the practice of medicine. Physicians are encouraged to reach out to their elected officials in D.C. to urge support for these federal legislative proposals using these provided links.


Introducing OSMA’s New President: A Q&A with Brian Santin, MD

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.


Introducing OSMA’s New President: A Q&A with Lisa Egbert, MD

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.


Health Equity Q&A with OSMA President Anthony Armstrong, MD

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.


Ohio Physicians Give Feedback on Medicaid Managed Care Program

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.


Wrap Up: Ohio Delegation to the American Medical Association

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.


Ohio Budget Process Complete

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.


Dollars & Sense: The State Budget

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...


OSMA Goes to Washington

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.


What is the OSMA Doing for You?

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.


Ohio’s Lame Duck Legislative Session 2018 – What Happened & What You Should Know

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.