Ohio House Bill HB699

Ohio 2025-2026 Regular Session

• Introduced: 2/17/26

Caption

To enact section 3902.65 of the Revised Code to require prescription drug coverage by health plan issuers.

Summary

HB699 would require Ohio health benefit plans that cover prescription drugs to cover any FDA-approved drug prescribed for a covered person’s disease, disorder, or condition, so long as the condition is not expressly excluded under the plan and the drug is recognized in an approved prescription drug compendium or in substantially accepted peer-reviewed medical literature. The mandate would apply to plans delivered, issued, modified, or renewed on or after January 1, 2027. The bill also requires coverage for medically necessary services associated with administering the prescription drug. It limits insurers’ ability to deny coverage based on a “medical necessity” standard when the denial is unrelated to the legal status of the drug’s use. At the same time, the bill preserves exceptions for experimental drugs not FDA-approved for the condition and for drugs the FDA has determined are contraindicated for that condition.

Impact

If enacted, HB699 would add a new section to the Ohio Revised Code, section 3902.65, and would expand prescription drug coverage requirements for health plan issuers in the state. It would affect health benefit plans delivered, issued for delivery, modified, or renewed on or after January 1, 2027, and would likely increase the scope of covered medications and related administration services for insured patients. The bill would also constrain insurer utilization-management practices by limiting denials based on medical necessity where the denial is not tied to the legal status of the drug use.

Sentiment

Based on the bill text and the absence of recorded committee testimony or votes, the available context suggests the measure is still early in the legislative process and has not yet generated documented public debate in the provided materials. The bill’s sponsors and cosponsors indicate support from its introducers, and its purpose is framed as a coverage-expansion measure. No opposing arguments or amendments are reflected in the supplied record.

Contention

The main likely point of contention is the breadth of the coverage mandate, especially the requirement that insurers cover any FDA-approved drug supported by compendia or peer-reviewed literature, which could be viewed as limiting plan design and increasing costs. Insurers may also object to the restriction on denying coverage under medical necessity standards. Supporters would likely emphasize patient access to clinically appropriate treatments, while critics may focus on premium impacts, administrative burden, and reduced insurer discretion. The bill’s exceptions for experimental and contraindicated drugs suggest an attempt to balance access with safety, but those boundaries could still be disputed.