As Introduced

136th General Assembly

Regular Session H. B. No. 390

2025-2026

Representative Schmidt

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.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That section 3902.55 of the Revised Code be enacted to read as follows:

Sec. 3902.55. (A) As used in this section:

(1) "Benefits contract" means an agreement by a health plan issuer to reimburse a provider for covered health care services rendered to a covered person up to the limits and exclusions contained in the benefits contract or the covered persons' health benefit plan.

(2) "Health care service" has the same meaning as in section 4743.10 of the Revised Code;

(3) "Provider" means a hospital, nursing home, physician, podiatrist, dentist, pharmacist, chiropractor, or other health care provider entitled to reimbursement by a health plan issuer for services rendered to a covered person under a benefits contract.

(4) "Reimburse" means indemnify, make payment, or otherwise accept responsibility for payment for health care services rendered to a covered person, or arrange for the provision of health care services to a covered person.

(B) On and after January 1, 2027, no health plan issuer shall require or otherwise induce a provider to collect cost sharing amounts for health care services, including copayments and deductibles, from covered persons.

(C) On and after January 1, 2027, a health plan issuer shall make all reimbursement for covered services directly to the health care provider.

(D) Divisions (B) and (C) of this section do not apply to the extent those divisions conflict with a benefits contract or health benefit plan entered into before January 1, 2027, unless the contract or plan is amended or renewed after that date, in which case the health plan issuer shall ensure that the contract or plan meets the requirements of this section.

(E) A health benefit plan or benefits contract entered into, amended, or renewed on or after January 1, 2027, shall not require either of the following:

(1) Health care providers to collect cost sharing amounts from covered persons;

(2) Covered persons to pay cost sharing amounts to a health care provider.

(F) This section shall not be construed to prohibit a health care provider from doing either of the following:

(1) Collecting amounts owed for uncovered services;

(2) Accepting a cash payment from a covered person in lieu of accepting reimbursement under a health benefit plan.