Ohio surprise billing law set to take effect next year

January 11, 2021

On Friday, Jan. 8, Ohio Gov. Mike DeWine signed new surprise billing legislation into effect that pays for out-of-network (OON) services at 100% of the Medicare rate or the median in-network rate. Unlike the new federal No Surprises Act that was passed by Congress as part of the latest Covid relief package, the Ohio law goes a step further by regulating when there’s a surprise bill related to an ambulance ride.

However, the Ohio law was opposed by CAP because it allows the payer to determine a rate without the use of a transparent database or IDR. As it stands, the law will take effect in January 2022.

Ohio now joins Michigan as the two latest states to pass their own surprise billing laws, although Michigan’s is a bit more favorable for providers. The Michigan law instead compensates OON providers at 150% of Medicare or the median in-network rate.

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