Advocacy Update—July, 2026
- 10 hours ago
- 3 min read
The Ohio Legislature’s 136th General Assembly is nearly complete, with the legislators now out of town campaigning for the upcoming fall elections while on summer recess. The two-year legislative cycle will officially conclude after the elections in November, at which point state Senators and Representatives will return to the Statehouse for a whirlwind session known as “lame duck.”
In the meantime, there was plenty of legislative activity this spring, and thanks to continuous advocacy efforts, the physician community has already made huge, notable strides and achieved several big victories on the insurance reform front.
Read on for the exciting progress of these OGS-supported initiatives:
Insurance Takebacks Reform Legislation Set to Become Ohio Law
In a momentous victory for physicians, Senate Bill 162 (sponsored by Sen. Bill Blessing, R-Colerain Twp.) passed out of the Ohio House unanimously on 6/10/2026 and was concurred upon by the Senate and sent to Governor DeWine to be signed into law. This is one of the most significant legislative successes for Ohio physicians in recent memory.
It means:
o Increased predictability and financial stability, as rather than 24 months, health plans will have one year in which they can audit claims and recoup payments.
o A fairer appeals process, which extends the provider response period to 60 days from 30 days, allowing ample time to submit documentation.
o Streamlined communication and reduced administrative burden, as insurers will be required to give electronic notification of takebacks when an electronic system is available.
Non-Medical Switching Legislation Passes in Ohio Senate
Additionally, on the same day as SB 162’s passage, Senate Bill 160 passed out of the Ohio Senate and is now poised to move through the House. This means that this legislation has cleared the halfway mark in its legislative journey, and has a better chance at being able to pass through the House in time for the end of the two-year legislative cycle.
As a reminder, this bill, which is sponsored by Sen. Terry Johnson (R-McDermott) and Sen. Beth Liston (D-Dublin) addresses non-medical switching by prohibiting insurers from issuing mid-year drug formulary changes. This occurs when insurers require patients to switch medication treatments for a non-medical reason.
Prior Authorization Legislation Starts Hearings Process in Senate
House Bill 220, which passed out of the Ohio House earlier this spring, started the second half of its path through the Legislature. This legislation, which is sponsored by Rep. Heidi Workman (R-Rootstown) has since started the committee hearings process in the Senate Financial Institutions, Insurance and Technology Committee, with its first hearing on 6/9/2026.
HB 220 would make several notable improvements to the prior authorization process by:
Prohibiting retroactive denials except for in the case of non-covered benefits or lack of coverage at the time of service.
Requiring peer review of prior authorization appeals to occur between the provider and a clinical peer, who must identify themselves.
Prohibiting insurers from charging providers to appeal rejected claims.
Requiring insurers to account for dosage adjustments in drug prior authorizations to treat chronic conditions.
HB 220 having started this committee process in the Senate means it is well on its way, and is in an advantageous position when it comes to the goal of making it through the Senate to become law by the end of the year.
During lame duck, any and all legislation introduced since January 2025 must cross the finish line before the adjournment at the end of this year. Anything that does not pass through both chambers to be signed into law by the governor before then would need to be reintroduced and go through the legislative process all over again in 2027 with the new 137th General Assembly.
OGS is honored to be a part of the continued effort to shed light on and help address the massive burdens that insurance companies are putting on our healthcare system, and specifically the way those burdens impact physicians and their patients. These wins are worthy of celebration, and we hope that they can be a solid foundation for more success in the lame duck legislative session, and beyond.
Find out more information about the full list of insurance reform legislation, and read or watch videos of the testimonies from the legislative committee hearings by visiting OSMA’s Insurance Reform page >