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Surprise Medical Bill? There’s an Ohio Law for That

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Wednesday, January 12, 2022   

Ohio patients have new protections to help prevent the sticker shock of surprise medical bills.

In a recent poll, nearly one in three privately insured Ohio adults said they have received an unexpected bill for health-care services. Typically, it's for treatment they got from an out-of-network provider not of their choice - such as a consulting physician or radiologist during a hospital visit.

Carrie Haughawout, deputy director of the Ohio Department of Insurance, said consumers have been on the hook for those charges, until now.

"The goal is to take the patient out of the middle of this, period," she said, "and so the bill kind of puts the responsibility on negotiating appropriate reimbursement strictly between the provider and the health plan."

The Ohio Department of Insurance developed the framework for the law and is tasked with enforcing it. Meanwhile, a federal No Surprises Act took effect Jan. 1 and includes additional patient protections beyond the new Ohio law.

Haughawout sai it's important that people understand what services are covered by their health insurance provider, and to reach out to the provider if they have questions about a bill.

"The normal things that consumers are used to paying when they go see a doctor - co-pays, potentially co-insurance, deductibles - those things still need to be paid by the consumer," she said. "It's these surprise situations where those bills won't be sent."

She added that the department is available to help people, and can assist with policy disputes. In polling, about one in five Ohioans expressed little confidence in their ability to dispute a medical bill.


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