The amendment proposed by state Rep. Jim Butler, R-Oakwood, requires that an out-of-network provider providing emergency care be paid the in-network rate or the out-of-network rate, whichever is higher, the report states.
Mr. Butler told the Daily News that the bill also includes an arbitration provision to settle price disputes between physicians and insurers.
The arbitration provision is based on a New York law that includes a binding arbitration process inspired by Major League Baseball.
Mr. Butler said that under the Ohio proposal, the provider would be allowed to go to mediation with the insurer if the provider believes the reimbursement was incorrect, and the two sides then could go to binding arbitration if mediation is unsuccessful.
Mr. Butler said his proposal will protect patients and is a fair solution. But the Ohio chapter of the American College of Emergency Physicians opposes Mr. Butler’s proposal, saying it does not include definitions for the in-network or out-of-network rates and would put physicians at risk of being shortchanged, according to the report.
The Ohio State Medical Association said the issue should go through the full legislative process and not be added as a budget amendment.
More articles on healthcare finance:
Billing revamp expected to cost Zuckerberg hospital up to $2.2M in lost revenue
Healthcare reacts to federal push for surprise-billing protections
Earthquake regulations may rock S&P ratings for California hospitals
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
