OSMA TESTIFIES IN SUPPORT OF NETWORK ADEQUACY LEGISLATION

The following information was released by the Ohio State Medical Association (OSMA):

OSMA VP of Advocacy, Monica Hueckel, recently testified in support of HB 219 in a hearing before the Ohio House Insurance Committee. HB 219 is sponsored by Rep. Kellie Deeter (R-Norwalk). This legislation would establish standards for both the creation and maintenance of insurance networks and assure the adequacy, accessibility, transparency, and quality of health care services being offered under a network plan.

Ohio is actually one of only a handful of states in the country that does not have network adequacy requirements for commercial health insurance plans. Ohio Medicaid plans have network adequacy standards for Medicaid plans, and ACA plans are subject to federal network adequacy requirements, but our other commercial insurance plans are not held to any specific standards.

When patients struggle to access care because of narrow networks, they may feel forced to go out-of-network to seek care, where they are likely to experience significant and potentially unmanageable out-of-pocket costs. Additionally, some patients may decide to forgo necessary care entirely.

OSMA believes that creating network adequacy standards for commercial insurers is imperative in order to properly address access issues Ohio is currently facing. We have heard from our physician members about the burden they feel from Ohios lack of network adequacy standards. Insufficient networks not only significantly decrease a medical practices negotiating power, but contribute to longer wait time for appointments, physician burnout, and even increased potential liability associated with care delays.