To enact section 3902.55 of the Revised Code to prohibit health plan issuers from requiring or inducing providers to collect copayments and other cost sharing amounts.
HB390 would add a new section to the Ohio Revised Code governing how health plan issuers handle patient cost sharing. Beginning January 1, 2027, the bill would prohibit health plan issuers from requiring or otherwise inducing providers to collect copayments, deductibles, and other cost-sharing amounts from covered persons. It would also require health plan issuers to make reimbursement for covered services directly to the health care provider rather than routing payment through the patient or relying on the provider to collect the patient share.
The bill applies to a broad range of providers, including hospitals, nursing homes, physicians, dentists, pharmacists, chiropractors, and other reimbursable health care providers. It defines key terms such as benefits contract, provider, and reimburse, and it preserves providers’ ability to collect for uncovered services or accept cash payments in lieu of insurance reimbursement. Existing contracts or plans entered into before January 1, 2027, would generally be exempt unless amended or renewed after that date, at which point they must comply with the new requirements.
HB390 would change the relationship between health plan issuers, providers, and covered persons by shifting responsibility for collecting cost sharing away from providers and toward insurers. It would require direct payment to providers for covered services and would prohibit contract terms in new or renewed health benefit plans that require providers to collect cost-sharing amounts from patients. The bill would affect insurance contracts, provider billing practices, and reimbursement procedures across Ohio’s health care system, while leaving room for providers to bill for uncovered services and to accept direct cash payments outside the insurance arrangement.
Based on the available context, the bill appears to be introduced and has not yet generated recorded committee testimony or votes, so there is no documented public debate in the provided materials. The bill’s structure suggests a consumer- and provider-protective approach, aiming to reduce administrative burden on providers and avoid placing collection responsibility on patients at the point of care. Because there are no transcripts or vote records, the overall sentiment cannot be measured beyond the bill’s apparent policy intent.
The main potential point of contention is the shift in collection responsibility from providers to insurers, which could affect insurer billing systems, contract administration, and enforcement of patient cost-sharing obligations. Insurers may view the mandate as interfering with plan design or payment processes, while providers may support it as a way to reduce front-desk collection disputes and administrative complexity. Another possible issue is the bill’s treatment of existing contracts, since it delays application until renewal or amendment for pre-2027 agreements, which may raise questions about transition timing and compliance.