Ohio Governor Signs Physician Insurance Contract Reform Bills

In a ceremony attended by Ohio’s physician leaders, Governor Ted Strickland today signed House Bill 125, some refer to as the most sweeping physician-insurance industry contract reform bills in the country, into law.

The new law, which will take effect in ninety days, is composed of reforms to the contracting process and a standardized and time-efficient physician credentialing process, proponents say.

“This new law is a terrific step toward eliminating some of the most bureaucratic, unfair and anti-competitive practices that have been imposed on physicians by Ohio’s HMOs and other health insurers,” said OSMA President Craig W. Anderson, MD, a Columbus neonatologist. “When this bill takes effect, there will be more balance and fairness in the contracting process between physicians and health insurers.”

Anderson was present at the bill-signing ceremony along with OSMA physician leadership including President-elect Warren Muth, M.D. and Immediate Past President James M. Sudimack, M.D.

Features of the new healthcare simplification law include:

– A provision to ensure that physicians will know in advance what they will be paid for their services by having each insurer provide contracting physicians with a copy of their reimbursement rates.

– A ban on the selling or renting of a physician’s contract to another company unless the rental is disclosed to the physician and all of the original contract terms between the physician and the insurer are honored.

– A requirement that all insurers use the same physician credentialing form and that they complete the credentialing process in 90 days.

– A prohibition against insurers using predatory clauses in their contracts with physicians which have the effect of forcing physicians to provide services at a lower rate than originally called for in their contract with the insurer.

A proponent of the legislation, OSMA is a statewide association representing 20,000 Ohio physicians, residents and medical students and is affiliated with the American Medical Association on the national level and county medical societies on the local level.

Source: Ohio State Medical Association