Legislative Update: Liability Reform Protection Among Top Issues
This week, the Ohio Legislature returned for several socially-distanced hearings and sessions, with many legislators donning face masks as they convened in a spaced-out manner on the floor and in the hearing rooms.
On Tuesday and Wednesday, several committees met to proceed with hearings on several key bills, among them a Senate proposal concerning liability in light of the ongoing pandemic, and a House bill regarding surprise medical billing.
In addition, Governor DeWine announced plans to implement a series of budget cuts in the next two months to address anticipated budget shortfall as a result of COVID-19.
OSMA continues to be the voice of Ohio physicians, advocating for your interests as these policy issues are considered by state leaders. Here are the major details about this week’s legislative activity you need to know. If you have any questions or would like more details about OSMA’s advocacy activities, email our Government Relations Team.
Liability Reform Protections
On Tuesday, Senator Matt Huffman (R-Lima) introduced Senate Bill 308, regarding liability of service providers (including medical professionals) during an emergency. This has been a major OSMA priority throughout the COVID-19 pandemic, and has been on the radar of the entire medical community.
SB 308, which was referred to the Senate Judiciary Committee and discussed in its first hearing on Wednesday, expands the tort action immunity granted to certain health care providers and emergency medical technicians who provide health care or emergency services during a declared disaster.
The expanded civil immunity covers:
- Actions taken during a declared emergency,
- Actions by additional health care providers, such as licensed practical nurses; respiratory care professionals; medical assistants and technicians; dental assistants; nurse aides; orderlies; home health agencies; hospice programs; and facilities, including their agents, employees, officers, board members, and volunteers,
- Decisions to withhold or withdraw health care services, and,
- Compliance with an executive order or director’s order.
Additionally, the bill extends the immunity to professional discipline and other civil actions. The immunity does not apply to actions, omissions, decisions, or compliance that constitute willful or wanton misconduct.
SB 308 also makes changes to immunity law as follows:
- Excludes from immunity actions that are outside the skills, education, and training of the provider, instead of actions that are outside the scope of authority of the provider;
- Eliminates an exception for wrongful death actions against a health care provider who provides emergency medical services, first-aid treatment, or other emergency professional care as a result of a disaster.
This issue will continue to be a major priority for the OSMA, and we will monitor this legislation in the coming weeks as well as keep you updated about its progress.
On Tuesday, the House Finance Committee convened for a hearing in which OSMA’s Senior Director of Government Relations, Monica Hueckel, testified on OSMA’s behalf regarding HB 388, the House proposal on surprise billing.
Surprise billing has been a priority issue for the OSMA for several years. While members are supportive of eliminating the surprise billing burden on patients, we have been emphasizing to lawmakers that any measure put in place must not disrupt the contracting process between insurers and physicians, and must not tip the scales too far in favor of insurers. Physicians must be able to maintain the little leverage they have in contract negotiations with insurers, and it is OSMA’s belief that the system set up in HB 388 would have a troubling ripple effect on the health insurance contracting process for all Ohio physicians, including those specialties which may not typically deal with surprise billing.
Several months ago, OSMA asked members to sign on to a letter expressing these concerns, and as a result, OSMA was able to submit this letter to the House Finance Committee with dozens of logos from county medical societies, medical specialty organizations, and individual physician practices from all over the state. This was compelling testimony to present to the committee, showing that their physician constituents, while wanting to work to remove patients from the middle of billing disputes, share the OSMA’s concerns.
In addition, during this week’s testimony, we reminded the legislators that Ohioans cannot be subject to a surprise medical bill for COVID-19-related care or testing, per a bulletin issued by the Ohio Department of Insurance effective March 20.
We will continue to work with lawmakers to find a solution to surprise billing that will not upset the delicate balance of insurance contracting and will protect Ohioans from the financial burden of out-of-network surprise bills.
Other Issues in the House:
Also in the House this week, legislators added an amendment to Senate Bill 1, an unrelated bill, which would specify that health department orders issued by the Director of Health would cease to be effective 14 days after the original effective date unless the Joint Committee on Agency Rule Review (JCARR) approves extensions of those orders by a majority vote.
The proposal passed out of the House on Wednesday, and OSMA is now monitoring the situation closely in the Senate. It is uncertain whether the Senate will choose to act on the amended SB 1, and Governor DeWine has already announced his intentions to veto the bill if it were to come across his desk for signature.
“Creating more uncertainty regarding public health and employee safety is the last thing we need as we work to restore consumer confidence in Ohio’s economy,” Governor DeWine said in a statement about this amendment.
The OSMA is prepared to act should the Senate choose to take up the measure, and supports the governor’s intention to veto SB 1 if approved by the Senate.
State Budget Cuts
In response to the economic impact of COVID-19, Governor DeWine announced earlier this week the state would pursue $775 million in reductions to Ohio's General Revenue Fund for the remainder of Fiscal Year 2020, which ends on June 30.
Ohio is required to balance its state budget each fiscal year. Before COVID-19 arrived in Ohio, state revenues for the fiscal year had been ahead of estimates by more than $200 million, but by the end of April, those revenues were below budgeted estimates by about $776.9 million.
The announced budget reductions include the following cuts:
- Medicaid: $210 million
- K12 Foundation Payment Reduction: $300 million
- Other Education Budget Line Items: $55 million
- Higher Education: $110 million
- All Other Agencies: $100 million
We know many physicians are wondering about the impact of Medicaid cuts on billing and patient access to healthcare. The OSMA is working to get more information and hopes to obtain details regarding these Medicaid cuts, and we will share details as we receive them.
Governor DeWine stated that while these decisions are very difficult, he believes that making these cuts now is the best way to provide the most stability possible moving forward.
As a reminder, the governor also issued a directive on March 23 which froze all hiring, new contracts, pay increases, and promotions at state agencies, boards and commissions.
It’s important to note these cuts will not apply to critical services or COVID-19 pandemic services. The governor added that for now, he does not intend to withdraw from the Ohio Budget Stabilization Fund (also known as the “Rainy Day Fund”).
The state administration emphasized its intentions to work with the Ohio Office of Budget and Management and the Ohio General Assembly to continue supporting Ohio’s economy during the ongoing pandemic and the recovery process in the months ahead.