Ohio Senate approves amended hospital price transparency bill eliminating earlier requirements

Jun. 17—The Ohio Senate recently approved a stripped down version of Ohio's hospital price transparency bill, eliminating the majority of the requirements included in the House version of the bill.

The amended bill passed with 27 votes in favor of it and six against it during a recent Ohio Senate session.

The Ohio Senate Small Business and Economic Opportunity Committee replaced many of the requirements with a general requirement that hospitals follow the federal price transparency rule.

"This rule has been a solid foundation that has provided a fair framework to keep hospitals accountable, but also to allow businesses to flourish, given that they conduct business ethically," said state Sen. George Lang, R-West Chester. "House Bill 49 is a bill that takes very important steps to ensure that hospitals abide by the federal rule without making it overly onerous to do business within our state."

The bill requires hospitals follow hospital price transparency rules adopted by the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS).

In the case of shoppable services, which are services a patient can schedule in advance, a hospital must make public the standard charges for as many of the 70 CMS-specified and other shoppable services for a total of at least 300 shoppable services it provides.

CMS requires the standard charge information for shoppable services to be updated annually.

The proposed bill prohibits a hospital or multi-hospital system from collecting facility fees at outpatient physician facilities it acquires, in connection with any health care services or items provided at that outpatient facility, beginning July 1, 2027.

The Ohio Senate's version of the bill is "a step in the right direction," the Ohio Hospital Association and the Ohio Children's Hospital Association said in testimony they submitted together. The associations were still critical of the bill itself, as well as the facility fees and penalties to hospitals not in compliance.

"Significant monetary penalties, in addition to threats to the hospital's license, is excessively punitive," the associations' testimony said. The bill includes a requirement for the director of health to consider whether a hospital has violated the price transparency rule when the hospital renews its license under Ohio law.

The amendment to H.B. 49 removed a number of provisions related to patients, including actions to hold hospitals accountable and to receive medical debt paid to the hospital back.

One provision senators removed would have allowed a patients to submit complaints to the Ohio director of health if they believed there had been a violation of the hospital price transparency requirements. The director of health will still be charged with maintaining a running list of non-compliant hospitals.

The committee's amendment removed certain consequences related to medical debt, debt collections and credit reports if hospitals did violate the hospital price transparency requirements. Those included stipulations for returning medical debt to the patient and/or having claims, lawsuits or credit reports dismissed.

The bill does prohibit medical creditors or medical debt collectors from sharing or reporting any patient medical debt to a consumer reporting agency for a period of one year after the patient's first bill.

"Medical debt is a poor indicator of credit risk," Gary Dougherty, director of state government affairs for the American Diabetes Association, said in submitted testimony for the bill.

Credit scores impact many aspects of people's lives and should not be an additional burden because they needed medical care, Dougherty said.

"Medical debt reported to the credit bureaus lowers an individual's credit score, further impacting their ability to afford medical care," Dougherty said.

A hospital can only be fined if it both fails to comply with the bill and fails to comply with the bill's requirements relating to corrective actions.

The amendment also replaced the minimum penalties prescribed by the House version with the following maximum penalties: $300 for a hospital with 30 beds or fewer, $10 per bed for a hospital with 31 to 550 beds and $5,500 for a hospital with more than 550 beds.

Since the bill was amended in the Senate, the House will have to vote to concur with the bill or it will return to committee.