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Surprise Billing Law

Surprise Billing Law

Ohio's Surprise Billing Law

House Bill 388 of the 133rd General Assembly

Governor Mike DeWine signed Ohio's surprise billing law, House Bill 388 of the 133rd General Assembly, on January 7, 2021. 

The law, which became effective on January 12, 2022, protects patients from receiving and paying surprise medical bills above the patient's in-network rate from health care providers for emergency care or, in certain circumstances, unanticipated out-of-network care. Cost sharing amounts, which include coinsurance, copayments, and deductibles, are limited to the patient’s in-network amounts.

Before the law, patients were responsible for paying surprise medical bills, oftentimes ranging hundreds to thousands of dollars above the in-network rate, arising from these unanticipated out-of-network situations. Price and payment reconciliation is now solely between the patient's health care provider and health insurer. 

The law requires the Ohio Department of Insurance to administer and enforce many of the law's provisions. It also gave the department authority to adopt rules to establish the law's operational framework. The department completed this important task, involving stakeholder input, to produce Ohio Administrative Code rule 3901-8-17, which implemented sections 3902.50 to 3902.54 of the Ohio Revised Code.

Federal Surprise Billing Law

The No Surprises Act

There is also a federal surprise billing law, called the No Surprises Act, which became effective on January 1, 2022. It is similar to Ohio’s law and will provide Ohioans with additional protections against surprise billing, including for services provided by air ambulances.