[Enforcement suspended pending legal challenge]

Healthcare Price Transparency Law: This law mandates providers to provide patients, before beginning treatment, with a “good faith” estimate of how much non-emergency, elective health care services would cost after accounting for health insurance.

• The amount the provider will charge the patient or the consumer’s health plan issuer for the product, service, or procedure;
• The amount the health plan issuer intends to pay for the product, service, or procedure; and
• The difference, if any, that the consumer or other party responsible for the consumer’s care would be required to pay to the provider for the product, service, or procedure.

The act requires any health plan issuer contacted by a provider to provide the cost information to the provider within a “reasonable time.” The act required the appointment of a “Health Services Price Disclosure Study Committee to work with the Medicaid Director to adopt rules for the implementation of the act’s requirements related to health services cost estimates. The rules, which have not been adopted, were required to address both of the following: (1) How a cost estimate is to be provided to a consumer;  and (2) The definition of “emergency products, services, or procedures.

Ohio has not enforced this law because of an ongoing legal challenge from health care providers. Providers argued that the law’s requirements are too broad and would delay patient care by requiring physicians to make cost estimates before beginning treatment.