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Bill would require network adequacy standards for commercial insurers, sponsors say
Summary
Representative Kelly Dieter told the House Insurance Committee that House Bill 219 would direct the Ohio Department of Insurance to adopt rules establishing time‑and‑distance standards, appointment wait times and provider‑to‑enrollee measures so insured Ohioans have realistic access to in‑network care.
Representative Kelly Dieter presented sponsor testimony before the House Insurance Committee for House Bill 219, which would require the Ohio Department of Insurance to adopt network adequacy standards for commercial health insurance plans in Ohio.
Dieter told the committee the bill aims to ensure “timely and reasonable access to in‑network healthcare providers” by establishing metrics such as time‑and‑distance standards, appointment wait times and provider‑to‑enrollee ratios. She said Ohio lacks commercial network adequacy standards and that only Medicaid plans in Ohio currently have such requirements.
Dieter said the standards would address problems including long wait times, missing specialists from insurer networks, and inaccurate provider directories that list retired or unavailable clinicians. “These standards ensure patients can realistically access in network providers without unreasonable travel or delay,” Dieter said, and she urged the committee to adopt a rulemaking directive to the Department of Insurance to implement the standards.
Committee members questioned whether the bill could force providers or hospital systems to join insurer networks; Dieter responded that the bill is not intended to require providers to sign contracts but to improve the contracting and oversight process. Representative Barhorst noted barriers to entry for new carriers when networks are difficult to assemble, and Dieter said the bill is intended to make network formation and monitoring more transparent and enforceable.
The committee took no final action; Dieter’s testimony represented the first hearing on HB 219. The bill would require rulemaking by the Ohio Department of Insurance to establish network adequacy plans, written agreements and ongoing monitoring requirements for insurers.
Background: Dieter cited national models and the National Conference of State Legislatures in describing which states currently have network adequacy standards for commercial plans. She called the bill a step toward consistency across the market and better protections for patients, especially in underserved urban and rural areas.
Next steps: The measure will remain in committee for further hearings and possible amendment.
