Below is the relevant legislation related to parity that has been introduced during the current or recently adjourned legislative session. State parity legislation passed in any state since 2008 is usually designed to increase compliance with the federal law and to strengthen state laws.
Regular Session: 1/7/2019 Will adjourn: 12/31/2019 Governor’s Deadline: 1/10/2020
SB 243 Introduced: 12/2017 Sponsor: Sen. Dolan Status: Passed Senate; Died in House committee Summary: This bill amends the state medicaid law by prohibiting copayments for any medicaid service for patients who have a developmental disability or serious mental illness and their sole source of income is either social security disability insurance or supplemental security income.
SB 154 Introduced: 5/2017 Sponsor: Sens. Schiavoni and Yuko Status: Died in committee Summary: Among many other things, this bill amends state insurance laws to:
Require medicaid, individual and group health insurers, and public employee health plans that cover prescription drugs to cover abuse-deterrent opioid analgesics. Reimbursement may not be denied because a generic equivalent is available at a lower cost. Plans may not implement a requirement that a non abuse-deterrent is tried before coverage, and plans may not impose cost-sharing requirements higher than that of the lowest cost sharing requirements imposed on non abuse deterrent opioid analgesics.
Require medicaid, individual and group health insurers, and public employee health plans to cover, without prior authorization and for as long as they are necessary, medication-assisted treatment, including medical, psychological treatment, prescribed drugs, and referral services for alcohol and drug abuse or addiction. The superintendent of insurance will establish and administer a program by January 1, 2019 to reimburse individual and group health insurers and public employee health plans for costs incurred by these requirements.
HB 350 Introduced: 10/2015 Sponsor: Rep. Grossman Status: Dead 10/2015 Summary: This bill requires health insurers to cover benefits associated with the screening, diagnosis, and treatment of autism spectrum disorders for individuals under the age of twenty-one. The minimum benefits an insurer must cover are listed below:
20 visits per year of speech/language therapy or occupational therapy by a licensed therapist
20 hours per week of clinical therapeutic intervention by or under the supervision of a licensed professional
30 visits per year of mental or behavioral health outpatient services by a licensed psychologists, psychiatrist, or other physician
HB 248 Introduced: 6/2015 Sponsor: Rep. Sprague Status: Dead 6/2015 Summary: Among other things, this bill requires all individual and group health plans and Medicaid plans that offer a prescription drug benefit to provide coverage for abuse-deterrent opioids. The bill also requires that any prior authorization requirements for abuse-deterrent opioids can not require a fail-first protocol. It also prohibits insurers from increasing cost-sharing requirements to cover any costs associated with this bill.
HB 251 Introduced: 6/2015 Sponsor: Reps. Sprague and Driehaus Status: Dead 6/2015 Summary: Among other things, this bill tries to change state law so that Medicaid care management system will cover “community-based behavioral health” services. Managed care organizations that administer these benefits must comply with the following requirements:
Cannot deny a “qualified and willing provider” from becoming in-network providers
SB 381/HB 598 Introduced: 10/2012 Sponsor: Sen. Seitz and Reps. Grossman and Terhar Status: Dead 10/2012 Summary: This bill tried to change the sections of the state law about parity so that plans would have to cover pervasive developmental disorder (autism). It required plans covered by those sections to also cover a $50,000 annual maximum for autism coverage. Pervasive developmental disorders were defined as:
Pervasive developmental disorder not otherwise specified
Plans can only review child’s treatment plan once every 6 months
Autism spectrum disorder is defined as autistic disorder, Asperger’s disorder, pervasive developmental disorder, Rett’s disorder, and childhood disintegrative disorder
SB 15 Introduced: 2/2009 Sponsor: Sen. Dale Miller Status: Dead 2/2009 Summary: This bill tried to change the sections of the state insurance law about parity. This would have changed the sections about “biologically-based” mental illness so that they would now apply to all mental health conditions and substance use disorders in the DSM or ICD. It also would have repealed the sections of the insurance law that applied to non “biologically-based” mental health conditions and coverage for “alcoholism.” (These sections of the law are summarized at the bottom of this page under “Ohio Parity Law.”
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