Physicians have come out in force to speak out against House Bill 561 and the danger it poses to our community. As Bill Cotton, MD, co-chair of the CMA Public Policy Committee, shared in this letter to our members, the legislation would: 

• Remove a requirement that the Hepatitis B vaccine be administered to children attending childcare or preschools, putting our children at risk for lifelong liver disease, liver cancer, and chronic infections.  
• Bar public schools from keeping out unvaccinated students if outbreaks of any disease occur, putting all students at risk of contracting vaccine-preventable diseases, including those who are medically vulnerable and at a higher risk of serious complications.  
• Prohibit schools from requiring additional documentation for students to be considered exempt from vaccine requirements, causing inaccurate records and complicating the ability for schools and health department officials to respond quickly when there is a disease outbreak to protect others.   

The bill was introduced in the fall and currently sits in the House Health Committee, which held its third hearing on March 25. The Columbus Medical Association joined a coalition of state health care provider organizations to share our grave concern about the legislation: 

"Public health advocates, including physicians and nurses, are deeply concerned that this legislation weakens long-standing, evidence-based protections that prevent disease in childcare and school settings. The existing policies are not punitive. They exist to safeguard classrooms, protect medically vulnerable children and minimize disruption for families and schools. HB 561 is not about choice, but rather convenience and puts not just children but communities at risk for outbreaks."

Read the full coalition letter here. A number of physicians provided testimony during the hearing, including CMA member Zach Rossfeld, MD, who reminded committee members that Ohio already allows vaccine exemptions for reasons of conscience: 

"Parental choice in Ohio is already protected. What is not protected — what this bill actively undermines — is the health of children who have no voice and no choice in whether the community around them is vaccinated. HB 561 offers a name that sounds like empowerment. What it delivers is increased risk of preventable disease."

House Bill 561 remains in the House Health Committee. You can continue to voice your opposition by contacting members of the committee by phone or email. 

Physician voices are needed to speak out against concerning legislation aimed at weakening long-standing public health protections that help prevent disease outbreaks in our community. 

Ohio is one of 14 states that allows vaccine exemptions due to religious or conscientious reasons, along with medical exemptions that exist nationwide. House Bill 561, which was introduced in the fall and is now being considered by the House Health Committee, takes additional and extremely concerning steps. 

The legislation would: 

• Remove a requirement that the Hepatitis B vaccine be administered to children attending childcare or preschools, putting our children at risk for lifelong liver disease, liver cancer, and chronic infections. 
• Bar public schools from keeping out unvaccinated students if outbreaks of any disease occur, putting all students at risk of contracting vaccine-preventable diseases, including those who are medically vulnerable and at a higher risk of serious complications. 
• Prohibit schools from requiring additional documentation for students to be considered exempt from vaccine requirements, causing inaccurate records and complicating the ability for schools and health department officials to respond quickly when there is a disease outbreak to protect others.  

These proposed changes would increase preventable disease risk across our state, where we are already are experiencing worrying outbreaks in majority unvaccinated or under-vaccinated individuals. It would be easier than ever for parents to decide against vaccinating their children based on myths and misinformation and without consulting with their trusted physician.  

That’s why we joined a coalition of other public health advocates urging members of the House Health Committee to vote against this harmful measure, stating that we all “respect parental choice and support transparency. However, opting out of vaccination should be a deliberate, informed decision and not the path of least resistance.” 

House Bill 561 had its first hearing in the House Health Committee on February 4 and a second this week, on Wednesday, March 18.  

Call to Action 

You can help speak out against this harmful legislation by contacting members of the House Health Committee. Please call and email members right away and share your expertise to urge them to vote against House Bill 561. 

Thank you, 

Bill Cotton, MD, FAAP 

Co-Chair, CMA Public Policy Committee 

A number of state measures that impact the practice of medicine and public health had movement in the past month.

• House Bill 8, requiring insurance coverage of biomarker testing, passed the House and is now headed to the Ohio Senate.
• House Bill 52, signed into law by Governor DeWine on March 3, eliminates the requirements that a Certified Registered Nurse Anesthetist (CRNA) practice with supervision.
• House Bill 220, a bill supported by the Ohio State Medical Association (OSMA), aims to reform insurance prior authorization processes to reduce burdens on physicians and patients. This measure reported out of House Health Committee on March 17 and will now move to the full House for a vote.
• House Bill 449 and House Bill 508 are similar bills that would allow Advanced Practice Registered Nurses (APRNs) to practice without a standard care agreement (SCA) and collaborating practitioner and permit an APRN’s collaborator to be another APRN. HB 508 had a 4th hearing on March 17; HB 449 had a first hearing on March 11.
• House Bill 589, which would require health insurance companies to provide material amendments to the contract to providers at least 90 days prior to the effective date, had a second hearing on March 11.
• Senate Bill 137 requires hospitals to provide overdose reversal drugs to patients who present to the emergency department for adverse events related to opioid use. This was signed into law by the Governor on March 5.
• House Bill 561 would permit parents to object to immunization requirements and not vaccinate their children in daycare, preschools, and schools. The bill had a first hearing in the House Health Committee on February 4 and a second hearing on March 18.

The Columbus Medical Association joined a coalition of health agencies and associations to urge members of the Ohio House of Representatives Health Committee against House Bill 561, expressing grave concern about our community’s ability to prevent infectious disease outbreaks. Read more in this letter from Public Policy Committee Co-Chair Dr. Bill Cotton here. 

We are excited to welcome a number of new members to the team working to elevate the physician voice and shape policies that protect and promote public health at the local and state level.

Public Policy Consultants
Stanley Gates with Shumaker Advisors has joined our team of public policy consultants.  Stanley is the Director of Government Affairs at Shumaker. The former Director of Community Engagement at Columbus City Council, he brings a clear track record of shaping transformative initiatives in the community. He was also honored with the Change Maker Award by the Iota Phi Theta Fraternity at the Shades of Melanin Awards Gala.

Stanley joins Daphne Kackloudis, a partner and health care attorney at Shumaker, Loop & Kendrick, who we have been working with for the past year. Daphne and Stanley will continue to consult with our Board and work with our public policy co-chairs, Drs. Chris Brown and Bill Cotton, to keep us updated on local and state legislation and advocate for physicians and the most vulnerable populations in our community. Daphne is offering CMA Members-only discount on legal counsel. Find more information here.

Public Policy Committee Members
We’d like to extend our gratitude to the following members of our Public Policy Committee, who are working to ensure we are a united voice in protecting evidence-based medicine, strengthening physician leadership, and working toward a healthier community.

• Chris Brown, MD, Co-Chair 
• Bill Cotton, MD, Co-Chair 
• Luis Alcalde 
• Roma Amin, MD 
• Nita Bhatt, MD 
• Joshua da Silva, DO 
• Andrew Detty, MD 
• Patrick Ecklar, MD 
• Douglas Finnie, MD 
• Kathy Harter 
• Rose Pellerite 
• Catherine Romanos, MD 
• John Stechshulte, MD 
• Rongkai Yan, MD 
  

Thank you to these physicians and advocates for their leadership, dedication, and commitment to advocating for sound public policy and the patients and communities we serve.

We are pleased to offer physician members preferred access to legal counsel through Daphne Kackloudis of Shumaker, Loop & Kendrick, LLP, who is extending a 10% discount off her hourly rate for physician-related legal services.

Daphne brings focused experience in healthcare and also serves as the Columbus Medical Association’s Public Policy Consultant on healthcare-related issues. CMA Members may access counsel on scope of practice and licensure matters; payor issues; employment matters (including employment and independent contractor agreement review and non-compete analysis), corporate matters (including practice and partnership issues), regulatory concerns, litigation, and select personal legal planning needs.

This benefit is designed to provide trusted legal guidance when important professional decisions arise.

You can contact Daphne via email at dkackloudis@shumaker.com or 614-940-4543.

President Trump has signed the Fiscal Year 2026 Appropriations Bill for the Department of Labor, Health and Human Services, and Education that includes critical funding for health and emergency preparedness initiatives in Ohio and nationwide. The bill, signed on February 3, 2026, provides funds for Health Care Readiness and Recovery (HCRR), formerly known as the Hospital Preparedness Program (HPP).

This is welcome news after the Administration attempted to eliminate or consolidate many public health programs on its federal budget proposal, which included completely eliminating HPP. In Ohio, our affiliate COTS relies on that funding to coordinate emergency preparedness and response for 36 of Ohio’s 88 counties.

Many of our members and partners joined health care organizations nationwide to advocate that this funding stay in the budget. Thank you to everyone who contacted their representatives.

This was one of many appropriations bills signed into law this week, which will fund the government through September 30, 2026.

State Policy Updates

The Ohio General Assembly was busy at the end of 2025! Both houses introduced legislation affecting physicians, health care organizations, and patients, and also moved legislation that had been previously introduced. The most noteworthy updates include the following: 

HB 508 (Enact the Better Access to Health Care Act): This legislation received two hearings in the House Medicaid Committee in November, including proponent and opponent testimony. The Ohio State Medical Association (OSMA) testified in opposition to the bill, which grants an advanced practice registered nurse (APRN) who is a certified nurse practitioner, clinical nurse specialist, or certified nurse-midwife the option to practice without a Standard Care Arrangement and collaborating practitioner if the APRN has practiced in a clinical setting for 5,000 hours; and also permits an APRN’s collaborating practitioner to be not only a physician, but also an APRN who is not practicing with another collaborator.  

HB 567: This was introduced in the House and referred to the House Health Committee. This bill is aimed at restructuring the governance and operational standards of the nursing profession in Ohio. Among other things, the bill seeks to expand clinical autonomy for advanced practice registered nurses, introduces a tiered regulatory framework for midwifery, and clarifies the Board of Nursing’s authority to discipline licensees for disqualifying offenses. 

HB 589: This bill was introduced in the House and referred to the House Insurance Committee. It requires health insurance companies to give to providers material amendments to their contract at least 90 days prior to the effective date of such amendment(s). 

HB 629 (Enact the Pharmacist Prescribing Authority Act): This was introduced in the House. In accordance with a protocol that meets requirements described in the bill, the legislation would permit a pharmacist to provide treatment and related services to individuals age 13 or older for any of the following health conditions by ordering or performing laboratory or diagnostic tests or screenings; evaluating or interpreting the results of the tests or screenings; prescribing drugs and drug therapy related devices, excluding any controlled substance: (1) Influenza; (2) Pharyngitis caused by the bacteria known as "group A Streptococcus"; (3) COVID; (4) Bronchitis; (5) Sinusitis; (6) Lice; (7) Skin conditions, including ringworm and athlete's foot; (8) Urinary tract infections; (9) HIV prevention, including pre-exposure and postexposure prophylaxis; (10) Any other minor or generally self-limiting condition specified in the protocol. 

Federal Policy Updates 

On January 20, the U.S. House of Representatives released the text of the Consolidated Appropriations Act, 2026, which includes the FY26 Labor, Health and Human Services, and Related Agencies appropriations bill. This bill represents a bipartisan negotiation between Congress and provides funding for the remainder of FY26. The bill is part of a larger "minibus" package designed to prevent a government shutdown. It provides $116.6 billion to the U. S. Department of Health and Human Services, notably rejecting many of the deeper cuts and department restructurings initially proposed by the Administration. 

• National Institutes of Health (NIH): Received approximately $48.7 billion. Key allocations include $7.4 billion for cancer research, $3.9 billion for Alzheimer’s, and $2.3 billion for diabetes. The bill specifically protects the NIH from a proposed 15% cap on indirect cost rates. 
• CDC: Funded at roughly $9.2 billion (near-level funding). It includes modest $10 million increases for both Public Health Infrastructure ($360 million total) and Data Modernization ($185 million total). 
• Mental Health & Substance Abuse: 
  • $5.5 billion total for mental health services. 
  • $1.6 billion for State Opioid Response Grants. 
  • $535 million for the 988 Suicide & Crisis Lifeline (a $15 million increase). 
• Preparedness: $3.7 billion for the Administration for Strategic Preparedness and Response (ASPR), the line item that funds the Hospital Preparedness Program. This appropriation includes $240 million, or level funding, for formula grants. 
• Community Health Centers: $1.86 billion in discretionary funding, plus extensions of mandatory funding. 
• Rural Health: $418 million, specifically targeting rural hospitals at risk of closure and increasing rural residency spots. 
• Maternal Health: $1.2 billion for the Maternal and Child Health Bureau, including a new $15 million "Food is Medicine" pilot for maternal produce prescriptions. 
• Ryan White HIV/AIDS: Maintained at $2.6 billion, including level funding for the "Ending the HIV Epidemic" initiative. 

Policy changes encompassed in the bill include: 

• Language that requires hospitals to ensure each off-campus outpatient department (OPD) has a unique National Provider Identifier distinct from the main hospital. Noncompliance will render the OPD ineligible for Medicare payment starting in 2028. 
• Extension of pandemic-era Medicare telehealth waivers through 2027. 

The bill does not include an extension of the enhanced subsidies for buying Affordable Care Act (ACA) marketplace insurance. The status quo means ACA enrollees will continue to face premium payments that have been projected to more than double the 2025 out-of-pocket premium, on average. 

Physicians in the Ohio General Assembly play a vital role not only in caring for patients but also in shaping the future of healthcare policy in Ohio. With new legislative sessions ahead and the 2026 election cycle on the horizon, it’s more important than ever that physicians have a seat at the table helping lawmakers understand how policy decisions impact real people and practices.

In Ohio, there are three physicians in the legislature state Senators Steve Huffman and Beth Liston, and state Representative Anita Somani. Having physicians representing our communities ensures that the voice of medicine is represented on issues ranging from patient safety and access to care to workforce challenges and public health. These leaders bring firsthand experience and bipartisan collaboration to the conversations that shape Ohio’s healthcare landscape.

We encourage you to learn more about these physicians and the issues they’re advocating for:

• Sen. Steven Huffman, MD (R) - District 5
  • Ohio Senate webpage
  • Campaign website
• Sen. Beth Liston, MD, PhD (D) - District 16
  • Ohio Senate webpage
  • Campaign website
• Rep. Anita Somani, MD (D) - District 8 
  • Ohio House of Representatives webpage
  • Campaign website

The CMA’s Public Policy Committee will meet in November to refine its 2026 policy agenda and advocacy priorities guided by the belief that evidence-based medicine and the patient-physician relationship must remain at the center of healthcare decision-making. Watch for updates in the CMA News email newsletter next month.

In addition, find additional advocacy-related resources on the CMA website:

• Advocacy Resource Page
• Advocacy Updates on the CMA blog
• Advocacy Training from past CMA President Sen. Beth Liston, MD
• Share your public policy concerns, priorities, and feedback
  

The CMA’s Public Policy Committee is taking important steps to amplify the voices of central Ohio physicians during this time of attacks on evidence-based medicine and severe funding cuts. 

Physician voices are incredibly important to help shape public policy in Ohio. Having physicians like Sen. Beth Liston, MD, (D) District 12 and Rep. Anita Somani, MD (D) District 8 in the Ohio legislature is invaluable to ensuring policy matters are analyzed from a healthcare lens. Additionally, it is more critical now than ever that legislators hear directly from us. 

The Public Policy Committee convened on August 27, 2025, to discuss its policy and advocacy goals and how to help physicians share their expertise. With so much occurring at the state and federal levels, they are tasked with identifying the priority areas where physicians can make a difference for the practice of medicine, physicians, and community health.

While this committee moves forward with this important work, we will soon reignite our Advocacy Community, a space where all CMA physicians and affiliates can come together to learn, discuss timely policy issues, and connect directly with colleagues who understand the importance of and share a passion for advocacy.

There are a number of actions you can take right now:

• Advocate for HPP Funding: HPP is the primary source of funding for health care preparedness and response nationwide, which is managed by COTS in 36 of Ohio’s 88 counties. Through the federal reconciliation process of breaking federal appropriations into smaller bills by subject matter, the U.S. Senate approved the bill that includes HPP funding. It is now being considered by the House Appropriations Committee before moving to the full house.
  • Contact Ohio’s two representatives on the House Appropriations Committee and ask them to maintain HPP funding:
    • Rep. Marcy Kaptur (D), OH-9, (202) 225-4146, marcy.kaptur@mail.house.gov
      
    • Rep. David Joyce (D), OH-14, (202) 225-5731, david.joyce@mail.house.gov
    • Find key messages about the risk of funding cuts here.
• Join our Advocacy Community: Details on upcoming meetings will be posted on this page soon.
• Take our Advocacy Training: These trainings were developed with former CMA President and current Ohio Senator Dr. Beth Liston, and detail how to effectively engage in the public policy process.
• Find your Legislators and Community Leaders: Make sure you are up to date on who represents you and you know how to contact them when you are ready to advocate for an issue. 
• Read our Advocacy Alerts and Take Action: All alerts are found on this page and are also sent via email. If you are not receiving CMA emails, please check your junk or spam folders, or contact Lynn Manoogian at lmanoogian@columbusmedicalassociation.org. 
• Ensure you are Registered to Vote: The deadline to register to vote for the November General Election is October 6. Also review the voter identification requirements as they have changed in the past few years.

During this divisive time, we know we are better together. By uniting our voices, we can better protect evidence-based medicine, strengthen physician leadership, and ensure healthier communities across Ohio.

From the federal funds that fuel health care preparedness and response in Ohio and across the country to Ohio Administrative Code rules and state-level insurance reform, there are a number of important policy updates that impact our physicians and community. 

Update on HPP Funding & Federal Appropriations 

Unlike the federal reconciliation process, federal appropriations bills are broken into smaller bills by subject matter. The appropriations bills determine funding for discretionary programs, which is everything other than mandatory programs (such as Medicaid, Medicare, Social Security, etc.) and taxes.

Appropriations bills move through the House and Senate at the same time. Last week, the Senate Appropriations Committee passed the Labor, HHS, and Education Appropriations Bill, which was advanced by a vote of 26-3 and provides $197 billion in discretionary funding. 

The most important thing for members of the Columbus Medical Association and its affiliates to know is that the bill largely rejected the Administration's federal fiscal year 2026 budget proposal to restructure, eliminate, or consolidate many public health programs, including the Hospital Preparedness Program (HPP). HPP funds are the primary source of funding for health care preparedness and response nationwide. CMA affiliate COTS coordinates emergency preparedness and response for 36 of Ohio's 88 counties for the Ohio Department of Health, which administers the HPP in Ohio. 

Though the proposed funding levels included in the appropriations bill are subject to change as both chambers of Congress are expected to engage in negotiations before the expiration of the current federal fiscal year on September 30, the Senate bill includes the following:

• $309 million for Health Care Readiness and Recovery (formerly the Hospital Preparedness Program), an increase of $4 million.
• Language requiring the Secretary of the U.S. Department of Health and Human Services to submit a detailed plan and justification to the Committees on Appropriations prior to initiating a reorganization or transfer of functions carried out by the Centers for Disease Control.
• Full funding for the 988-suicide hotline.

How can you help? It’s important to continue to reach out to your representatives in Congress to advocate for emergency preparedness funding.

• Find your U.S. House Representative here.
• Contact Sen. Bernie Moreno and Sen. Jon Husted here.

Miscellaneous Topics

• Click here to read all about the Ohio State Medical Association’s insurance reform legislative effort, a wrap-up of the state budget, and more in their July 2025 Advocacy Report. 
• On July 10, 2025, the U.S. Department of Health and Human Services (HHS) rescinded a 1998 interpretation of “federal public benefit” as used in Title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA). As a result, HHS has expanded the health care and social service programs for which it deems undocumented people ineligible. Read more about the change here.
• The Ohio Board of Pharmacy recently issued a slew of new, amended and rescinded rules. See summaries of the changes at this link.
• In late June, the US. Supreme Court upheld the authority of the U.S. Preventive Services Task Force to make determinations about preventive coverage mandated by the Affordable Care Act. Read about the impact of the Kennedy v. Braidwood Mgmt., Inc. decision here.
  

There has been considerable activity coming from both the state and federal governments within the past few weeks. Each level has passed a budget and is considering legislation that could directly impact providers and patients. Below is a reference to key changes and ways in which you can get involved. 

Find key updates below and click here to skip ahead to the federal budget update, including the status of funding for the Hospital Preparedness Program (HPP), which is crucial for emergency preparedness in Ohio.

State Budget

Ohio Gov. Mike DeWine signed the state’s biennial operating budget into law on June 30, 2025. Click here to read about key provisions, as well as the Governor’s vetoes. The House is expected to return on July 21 to override some of the Governor’s vetoes. 

State Miscellaneous

House Bill 281 was introduced into the Ohio House on May 20, 2025. This bill would allow the enforcement of federal immigration laws in Ohio hospitals. Click here to learn more about the potential impacts from this legislation.

There are a number of other bills pending in the state legislature that will impact physicians and patients. See the our June 13 State Policy Advocacy Alert to learn more about those bills. There are no current updates to those bills, but we will monitor the legislation to provide the latest updates when applicable.

TAKE ACTION: After passing the state budget, the Ohio legislature (mostly) adjourned for the summer. Now is a great time to meet with your legislator in your district to discuss current or potential bills or issues of importance to you. Click here to identify your legislator and legislators representing locations where your patients are served. 

Federal Budget

The U.S. Congress passed the federal reconciliation budget on July 3, 2025. The reconciliation bill addresses mandatory spending for programs such as Medicaid. Click here to learn more about how the federal budget bill impacts physicians and patients, particularly those on Medicaid.

The federal appropriations budget, which controls discretionary spending for programs such as the Hospital Preparedness Program (HPP), is currently working its way through the House and Senate Appropriations Committees. The Trump Administration proposed eliminating funding to the HPP. 

There is positive news—with support from the Association of State and Territorial Health Officials (ASTHO), the current versions of the appropriations budgets include funding for Health Care Readiness and Recovery, which includes the HPP. Action from our members and partners is still needed to join a number of organizations, including our affiliate COTS, to continue to push to keep and increase funding for the HPP. 

For more details on the importance of HPP funding for our safety in Ohio: 

• Read our HPP Advocacy Alert here.
• Read the Columbus Dispatch article on the proposed cuts here.
• Watch the 10TV story on the proposed cuts here.

TAKE ACTION: To advocate for stable funding for the HPP, you can contact Rep. David Joyce (District 14) and Rep. Marcy Kaptur (District 09) who are both representatives from Ohio and on the House Appropriations Committee. 

If you have questions about COTS, contact Sherri Kovach, COTS President, at skovach@cotshealth.org.

Federal Budget

President’s Budget Slashes the Hospital Preparedness Program

What is it?

• President Trump’s budget proposes a drastic reduction in federal funding to the Hospital Preparedness Program, the program that coordinates healthcare preparedness and response. In Central Ohio, the HPP is coordinated by COTS.  

What does it mean?

• The proposed cuts make it impossible to collectively prepare for and respond to healthcare emergencies and jeopardizes healthcare readiness for crises that include natural and man-made disasters, pandemics, and cyber incidents with extended downtime. For more information, click here.
  

What can I do?

• Be on alert for a call to action! COTS is working with other regional preparedness and readiness programs in Ohio to advocate to House and Senate appropriators to maintain stable funding for the HPP. We will call on you to help!
  

House-Passed Reconciliation Bill Cuts Medicaid Coverage to Millions

What is it?

• The reconciliation bill passed by the House reduces federal funding for the Medicaid program by hundreds of billions of dollars over the next 10 years.

What does it mean?

• The Medicaid program is the largest single source of health care coverage in the United States, covering nearly half of all children, many low-income elderly and disabled individuals, and working adults in low-wage jobs. The $822 billion in Medicaid cuts included in the House Budget Reconciliation bill is projected by the non-partisan Congressional Budget Office to result in the loss of coverage for at least 7.6 million Americans. The cuts will lead to even more crowding of emergency departments, closures of rural hospitals and community physician practices, and widespread health and economic instability.  For more information, read the Coalition of State Medical Associations’ letter to Congress, available on the OSMA’s website. 
  

What can I do?

• Contact Senators Husted and Moreno and share your concerns regarding the impact of the cuts on your patients, your business, and the health care system at large.

Federal Miscellaneous

Trump Administration Enforces Immigration in Formerly “Protected Areas” 

What is it?

• One of President Trump’s first actions upon taking office was eliminating the existing (at the time) prohibition against enforcing immigration in “protected areas”, which protected certain areas, including healthcare facilities, from immigration enforcement. 
  

What does it mean?

• Immigrants seeking health care in a health care facility can be detained or arrested by Immigration and Custom Enforcement (ICE) and Border Patrol (BP) agents. Health care facilities are expending time and resources preparing for ICE and BP raids. Additionally, the fear of such raids is dissuading immigrants from seeking health care and other services. 
  

What can I do?

•  Ask the CMA for information about how to educate yourself about this issue. For more information, visit this link.

CMS Rescinds EMTALA Guidance on Emergency Abortions

What is it?

• The Centers for Medicare & Medicaid Services rescinded on June 3, 2025, guidance from 2022 that clarified that if a hospital emergency department physician believes that an abortion is the stabilizing treatment necessary to resolve a patient’s emergency medical condition, the physician must provide that treatment, regardless of state law. 
  

What does it mean?

• Emergency department physicians must be knowledgeable about the Emergency Medical Treatment and Labor Act (EMTALA) and state abortion laws, including the Ohio Reproductive Freedom Amendment, and render clinical decisions based on their understanding of such laws.
  

What can I do?

• Stay informed. For more information, see this link. 

Miscellaneous Updates

Physicians May Be Eligible to Participate in a Huge Blue Cross Blue Shield Settlement Opportunity

What is it?

• The class action lawsuit, In re: Blue Cross Blue Shield Antitrust Litigation, addresses Provider Plaintiffs’ claims that Blue Cross Blue Shield (BCBS) violated antitrust laws by illegally dividing the United States into "Service Areas" and agreeing not to compete in those areas. Provider Plaintiffs also claim that BCBS fixed prices for services. The case is pending in the United States District Court for the Northern District of Alabama, and both parties have agreed to a Settlement. If approved by the court, the Settlement will establish a $2.8 billion Settlement Fund.

What does it mean?

• Class Members who are providers who submit a valid approved claim will receive a payment from the Net Settlement Fund if the Settlement is approved. 
  

What can I do?

• Submit a claim by going to this link. For additional information, including eligibility criteria, see this article.

State Budget

The following provisions are included in the Senate-passed version of the state operating budget for state fiscal years 2026-2027 (beginning July 1, 2025). The budget bill will next head to a House-Senate Conference Committee where the content of the bill will change again, meaning some or all of the provisions described below may be changed or eliminated and not become codified in law. You can educate yourself about the provisions of the bill by accessing the bill here and contacting your state legislators, including members of the Conference Committee.

R.C. 9.05 Sex Recognition

What is it?

• Establishes a state policy recognizing only two sexes, male and female, which “are not changeable and are grounded in fundamental and incontrovertible reality”.
  

What does it mean?

• The ability of people who do not identify as male or female or whose sex has changed or will change to access affirming health care will be challenged, as will the ability of health care professionals to provide appropriate healthcare.

R.C. 3701.511 Genetic Services Funds for Abortion Referral or Counsel

What is it?

• Eliminates the availability of Ohio Department of Health Genetic Services funds to counsel or refer for abortion in the case of a medical emergency.
  

What does it mean?

• Medical professionals will be prohibited from using Genetic Services funds to counsel or refer a patient for an abortion. 

R.C. 3701.79, 2919.171 Abortion Reporting Changes

What is it?

• Requires the abortion report to be completed by an attending physician when an abortion is performed surgically or through abortion-inducing drugs. Also requires that the pregnant woman’s state of residence and her zip code be reported. 
  

What does it mean?

• This requirement could result in additional administrative work for attending physicians, but the abortion report is already required, so there may no be real effect for physicians.

R.C. 3705.16, 4731.22 Medical Certificate of Death

What is it?

• Clarifies that the coroner or medical examiner certifies a death when a decedent dies of criminal or other violent means, while an attending physician certifies the cause of death in all other circumstances. Authorizes the physician who last examined or treated a decedent to certify the decedent’s cause of death and complete and sign the medical certificate of death, but only in the cases where the decedent did not have an attending physician in charge of a patient’s care for the illness or condition that resulted in the patient’s death. Extends the timeline by which a medical certificate of death must be completed and signed, from 48 hours after death to 48 hours after notice of death. Revises existing law provisions that apply when a decedent’s cause of death remains pending. 
  

What does it mean?

• Clarifies responsibilities related to medical certificates of death.

R.C. 3748.13 Inspection Fees

What is it?

• Increases inspection fees for radiation-generating equipment used in facilities operated by medical practitioners or medical practitioner groups
  

What does it mean?

• Inspection fees for dental x-ray tube, medical x-ray tube, ionizing radiation-generating equipment, and nonionizing radiation-generating equipment will increase.

R.C. 4730.25, 4731.22, 4759.07, 4760.13, 4761.09, 4762.13, 4772.20, 4774.13, and 4778.14 Summary Suspensions

What is it?

• Revises the law authorizing  the State Medical Board of Ohio to issue summary suspensions against its license holders by:
  • Eliminating provisions specifying that an order is not subject to suspension by a court before the State Medical Board of Ohio issues its final adjudicative order and, instead, specifies the following: (a) that a summary suspension is not a final appealable order and is not an adjudication that may be appealed under the Administrative Procedure Act and (b) that once a final adjudicative order has been issued, any party adversely affected by it may file an appeal in accordance with the requirements of the Administrative Procedure Act.
  • Eliminating provisions specifying that the period during which a summary suspension is in effect applies unless reversed on appeal.

R.C. 333.13 Social Gender Transition

What is it?

• Prohibits Medicaid reimbursement for mental health services that promote or affirm social gender transition.

What does it mean?

• Individuals will lose access to mental health services, and providers will be tasked with complying with a law that is vague.
  

R.C. 5163.11 Medicaid Group VIII Eligibility Redeterminations

What is it?

• Requires the Ohio Department of Medicaid to conduct eligibility requirements for Group VIII enrollees (i.e., the Medicaid expansion population) every six months.

What does it mean?

• Every six months, Group VIII enrollees’ coverage will be threatened if they are unable to meet Medicaid eligibility requirements, meaning more people will become uninsured. Providers’ population of Medicaid patients is likely to decline, while their population of uninsured patients is likely to increase. 
  

State Miscellaneous 

OSMA Insurance Reform Effort

The Ohio State Medical Association (OSMA) is launching an Insurance Reform Campaign that seeks to reduce burdens placed on physicians by insurers. According to the OSMA, these bills (House Bills 214, 219, 220 and Senate Bills 160, 162, 164, 165, 166) “will bring much-needed transparency to the insurmountable power insurers have at dictating medical care—power that too often disrupts the ability of physicians to effectively provide patient care, and can lead to patients facing delays and denials of medically-necessary and even life-saving treatments”.  Right now, the call to action is to educate yourself about these bills and be prepared to advocate for them when the time is right.

HB 214 Require Medicaid, Health Insurers Report on Prior Authorization

What is it?

• Requires health insurers to make prior authorization data available on their websites in a readily accessible format and submit such data in a report to the Ohio Department of Insurance which, in turn, must provide the data to the General Assembly. 
• Requires health insurers and the Ohio Department of Medicaid (ODM) to exempt a healthcare provider from prior authorization when at least 90% of the provider’s requests for a service, device, or drug within the prior 12 months have been approved.  
• Permits providers to request evidence from a health insurer or ODM that supports the insurer’s or ODM’s decision to deny an exception, and to appeal that exception. Providers would not be required to initiate a request as a condition of receiving an exemption. Exemptions are to be reviewed after a year. Establishes guidelines for the exception of the review process and permits a provider to appeal an exemption revocation.

HB 219 Establish Network Adequacy Standards for Health Insurers

What is it?

• Requires health plan issuers to establish and maintain adequate provider networks to ensure all covered benefits are accessible to covered persons. 
• Requires a health plan issuer to establish and maintain a process to ensure covered persons are able to obtain covered benefits at an in-network level from an out-of-network provider whenever there are not a sufficient number of in-network providers.
• Requires a health plan issuer to establish and maintain adequate arrangements to ensure all covered persons have reasonable access to in-network providers near the covered person’s home or place of employment. 
• Requires a health plan issuer to monitor the ability, clinical capacity, and legal authority of in-network providers to furnish covered benefits under the network plan. 
• Prohibits a health plan issuer from delivering, issuing for delivery, or using a network plan before a copy of the plan, premium rates, and an access arrangement are filed with the Ohio Department of Insurance (ODI). 
• Requires a health plan issuer to notify the Superintendent of any material change to a network plan or access arrangement within 15 business days of the change or implementation of the change. 
• Requires a health plan issuer to provide covered persons a directory that identifies which providers and facilities belong to each network and which networks are applicable to each specific plan offered in Ohio. 

HB 220 Regards Health Insurance, Medicaid Prior Authorization 

What is it?

• Requires health insurers and the Department of Medicaid (ODM) to honor a prior authorization approval if a provider prescribes a change in dosage of an approved drug. 
• Requires that the name, specialty, and relevant qualifications of the clinical peer, who is required by continuing law to review prior authorization appeals, to be identified. 
• Prohibits health insurers from charging a fee for appealing an adverse prior authorization determination. 
• Prohibits health insurers and ODM from retroactively denying a prior authorization for mental health or substance use disorder treatment. 
  
   

SB 160 Regards Prescription Drugs and Medication Switching

What is it?

• Prohibits insurers from making mid-year drug formulary changes to avoid abrupt and unwarranted treatment changes that disrupt a physician’s ability to exercise their medical expertise to help their patients.

SB 162 Regards Timing of Health Insurer Recoupment from Providers

What is it?

•  Shortens the time period in which a payment made by a third-party payer to a provider shall be considered final. 
  

SB 164 Regulate the Use of Artificial Intelligence by Health Insurers

What is it?

•  Requires health plan issuers to annually file a report with the Superintendent of insurance covering a variety of information including: each provider in the health plan issuer’s network, the number of covered persons enrolled in health benefit plans issued by the health plan issuer, whether the health plan issuer is using, or will use artificial intelligence-based algorithms in utilization review processes for those health benefit plans, and much more information as listed in the bill. 
  
• Prohibits health plan issuers from making a decision regarding the care of a covered person, including the decision to deny, delay, or modify health care services based on medical necessity, based solely on results derived from the use or application of artificial intelligence.
  

SB 165 Prohibit Denial of Health Insurance Claim for Certain Factors, SB 166 Prohibit Health Insurance, Medicaid Electronic Claim Fees

What is it?

• Prohibits insurers from imposing any charge, fee, or other payment requirement (including through withholding from payment), on any provider for electronic fund transfers or remittance advice transactions. 
  

HB 172 Prohibit Mental Health Service to Minors Without Parental Consent

• Prohibits the provision of mental health services by mental health professionals (including psychiatrists) to minors without parental consent

• More limited access to mental health services for minors and a greater administrative burden for providers. 
  

• The bill was introduced in the House in March and referred to the House Health Committee in March. Interested parties can read more about the bill here and contact the bill sponsor to weigh in.

HB 277 Health Care Workers’ Employment Status

• Specifies conditions under which a health care worker providing services to patients is not an employee of a healthcare worker platform or a healthcare facility for purposes of state overtime and minimum wage requirements, the Bimonthly Pay Law, the Workers’ Compensation Law, the Unemployment Compensation Law, and the Income Tax Law.
  

• Strengthens a health care worker’s ability to be treated as an independent contractor when the health care worker seeks work through a healthcare worker platform. 

• The bill was introduced in the House in May and referred to the House Commerce and Labor Committee in May. Interested parties can read more about the bill here and contact the bill sponsor to weigh in.
  
   
  
  

Dear COTS Valued Partners,

CMA’s affiliate, COTS, needs your help! President Trump’s proposed federal budget eliminates funding for the Hospital Preparedness Program (HPP), the primary source of funding for health care preparedness and response. COTS coordinates emergency preparedness and response for 36 of Ohio's 88 counties for the Ohio Department of Health, which administers the HPP in Ohio. The complete elimination of this program is an existential threat to the safety of all Ohioans. In addition, the proposed federal budget significantly decreases funding for public health coordination and emergency management. See COTS' impact here.

COTS is taking action by creating awareness with our Board of Trustees, stakeholders, and committee members, and developing an advocacy plan.

You can help! Please email or call one or more of these Representatives who represent districts in COTS’ service area. If you have a personal relationship with any of these Members of Congress or others, we welcome your direct advocacy to them, as well.

• Bob Latta – House District 5; Covered by Region 4 | Phone: (202) 225-6405
• Troy Balderson – House District 12; COTS Regions 4, 7, and 8 | Phone: (202) 225-5355 | Email: Rep.Balderson@mail.house.gov
• Michael Rulli – House District 6; COTS Region 8 | Phone: (202) 225-5705  | Email: michael.rulli@mail.house.gov
• David Taylor – House District 2; COTS Regions 4, 7 | Phone: (202) 225-3164
• Joyce Beatty –House  District 3; COTS  Region 4 | Phone: (202) 225-4324 | Email: joyce.beatty@mail.house.gov
• Jim Jordan – House District 4; COTS Region 4 | Phone: (202) 225-2676
• *Mike Carey – House District 15; COTS Region 4 | Phone: (202) 225-2015

 *Congressman Carey is also a member of the House Budget Committee, so your advocacy with him will be particularly effective.

The message is simple:

“Congressman/woman, the President’s budget proposes elimination of the Hospital Preparedness Program. The House Energy & Commerce Committee’s marked up reconciliation bill does NOT implement those cuts. Please keep funding for the HPP at current levels. Defunding emergency preparedness programs will not only result in lost lives but significant economic costs, including higher response and recovery expenses, overwhelmed hospitals, and lost productivity. These decisions will place a severe financial burden on our healthcare system, with costs extending well beyond those associated with an immediate disaster. The compounded impact of these cuts will lead to avoidable fatalities, long-term recovery costs, and inefficiencies in addressing regional crises.” 

About the Hospital Preparedness Program

The Hospital Preparedness Program (HPP) Hospital Preparedness Program prepares the health care delivery system to save lives through the development of health care coalitions (HCCs) that incentivize diverse and often competitive health care organizations with differing priorities and objectives to work together. HPP is the only source of federal funding for health care delivery system readiness, intended to improve patient outcomes, minimize the need for federal and supplemental state resources during emergencies, and enable rapid recovery. 

The purpose of the Regional Healthcare Coalition is to provide training and exercises, the coordination of plans, and operational support during emergency response, and to develop policies and procedures that identify responsibilities required for the successful interoperability of coalition partners: hospitals, public health, Emergency Medical Services (EMS), emergency management, and community partners during a major disaster. 

The Ohio HPP activities include:

• Guidance and development of health care coalitions
• Management of the Ebola Assessment Hospital (EAH) and Ebola Coalition contracts
• Participation in the Great Lakes Healthcare Partnership with Ohio, Indiana, Wisconsin, Minnesota, Illinois, Michigan, and Chicago
• Facilitation of Burn Surge planning committee
• Management of the bed tracking (EMResource), and patient tracking (EMTrack) systems
• Facilitation and participation in healthcare planning, training and exercises

We appreciate your collective partnership.  Please let me know if you have any questions.

Respectfully,

Sherri

Sherri Kovach, MS, BSN, RN, EMT
President
HIPAA Privacy/Security Officer

With research and nonprofit funding concerns, a measles outbreak, and attacks on evidence-based medicine, health care policy and advocacy is more important now than ever. I’m excited to share that we are working with a new public policy consultant to guide us through these turbulent times, help us understand our role, and give us concrete action steps to advocate for public health and our patients.

Daphne Kackloudis is the head of the health care practice at Columbus-based law firm, Brennan Manna Diamond (BMD), a longtime supporter and sponsor of the CMAA. Daphne has broad experience in health care operations, regulatory compliance, board governance, Medicaid, public policy, and government affairs. She works with a number of health care trade and membership-based associations, as well as with physicians group and solo practices.

Consulting with our Board and public policy co-chairs, Drs. Chris Brown and Bill Cotton, we selected Daphne because of her deep understanding of local and state policy, her track record of working with physician-led organizations, and her commitment to advocating for the most vulnerable populations. Her insight into the practical challenges facing both clinicians and patients makes her an ideal partner in helping us elevate the physician voice and shape policies that protect and promote public health.

The physician’s voice is crucial for us to navigate these turbulent times. Policymakers at all levels need to hear from you as experts when policies are concerning or off base. We encourage our membership to keep a close eye out for our advocacy alerts and calls for in-person or written testimony. Additionally, the Ohio State Medical Association (OSMA) is a partner with a strong state-wide voice. Their 2025 top legislative issues can be found here.

It’s also important we hear from our membership. Please let us know your concerns, public policy priorities, and any skills you can offer by submitting the information through this form.

The primary concern for our organization and physicians is the Ohio budget and the potential catastrophic impact on Ohioans, especially those in need. The two-year budget passed by the Ohio House of Representatives last week includes a provision that would enable the state to back out of the Kasich-era Medicaid expansion if federal funding is cut. This would put healthcare coverage at risk for nearly 800,000 Ohioans and especially impact children, children’s hospitals, and rural hospitals.

Take Action Today

The budget is now in the hands of the Ohio Senate. We ask that our members and partners reach out to their Senators today to ask that they remove this provision to ensure Ohio’s most vulnerable are protected. Find your Ohio Senator and call their office today!

Insurance Reform Legislation

There is positive news to report. Legislators in the 136th General Assembly have recently introduced a slew of legislation aimed at insurance reform in Ohio. Find a summary of the legislation below, and please consider contacting your representatives in support of these issues.

House Bill 214 - Prior Authorization “Gold Card”

•  Sponsor(s): Rep. Kevin Miller, (R) Newark
• Status: In the House Insurance Committee
• This bill would create a system that rewards healthcare providers who consistently receive a prior authorization approval rate for a specific service or treatment in a 12-month period by establishing a “gold card” exemption from prior authorization requirements. It also contains data sharing requirements which mirror federal CMS requirements set to go into effect in 2027. Insurers would be required to share certain program metrics, such as rates of approval/denial/approval after appeal of urgent and non-urgent requests, with the Ohio Department of Insurance and publicly on their websites.

Senate Bill 160 – Non-Medical Switching

• Sponsor(s): Sen. Beth Liston, MD, (D) Dublin, Sen. Terry Johnson, (R) McDermott
• Status: In the Senate Financial Institutions, Insurance, and Technology Committee
• This legislation would prohibit insurers from non-medical switching or making mid-year drug formulary changes which force patients to undergo abrupt and unwarranted treatment changes.

Senate Bill 165 – Automatic Downcoding

• Sponsor(s): Sen. Susan Manchester – (R) Waynesfield
• Status: In the Senate Financial Institutions, Insurance, and Technology Committee
• SB 165 contains prohibitions on downcoding for all providers, including prohibitions on limitations on reimbursement for time spent with patients. It would also strengthen Ohio’s prudent layperson standard in order to protect Ohioans from unexpected medical bills due to their insurer denying claims for emergency care after the care has been sought and provided.

House Bill 219 – Network Adequacy

• Sponsor(s): Rep. Kellie Deeter, (R) Norwalk
• Status: In the House Insurance Committee
• This bill would require the Ohio Department of Insurance to create network adequacy standards for commercial plans.

Senate Bill 162 – Takebacks/Clawbacks

• Sponsor(s): Sen. Bill Blessing, (R) Colerain Twp.
• Status: In the Senate Financial Institutions, Insurance, and Technology Committee
• This Senate bill would change Ohio’s current 24-month insurer takeback timeframe, decreasing it to the same timeframe given to a provider to submit a claim, and also prohibit insurers from changing these timeframes during a contract period. It would also prohibit insurers from charging a provider for appealing a determination of overpayment.

Senate Bill 166 – No Fees for EFTs

• Sponsors(s): Sen. Nathan Manning, (R) North Ridgeville
• Status: In the Senate Medicaid Committee
• SB 166 would prohibit insurers from imposing any charge, fee, or other payment requirement (including through withholding from payment), on any healthcare provider for electronic fund transfers or remittance advice transactions.

House Bill 220 – Prior Authorization

• Sponsor(s): Rep. Heidi Workman, (R) Rootstown
• Status: In the House Insurance Committee
• HB 220 would strengthen existing Ohio prior authorization laws passed in 2018 by ensuring retroactive denials only occur in the event of non-covered benefits or lack of coverage at the time of service, requiring identification of clinical peer conducting peer review in adverse determinations, prohibiting insurers from charging providers for appeals, and requiring insurers to account for dosage adjustments in drug prior authorizations to treat chronic conditions.

Senate Bill 164 – Transparency in Health Plan Use of AI

• Sponsor(s): Sen. Al Cutrona, (R) Canfield
• Status: In the Senate Financial Institutions, Insurance, and Technology Committee
• This proposed legislation would require insurer transparency in their use of AI tools in prior authorization determinations, specifically by requiring insurers to disclose use of AI and ensuring that prior authorization determinations are made through review of individual merits of claims by licensed clinical professionals.

Get Involved

The role of our Public Policy Committee and Advocacy Community is to monitor legislation that impacts physicians and assist them in getting their voices heard on the issues that matter most. If you’d like to get involved, go to the Advocacy page on our website and watch for updates on upcoming policy meetings.