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Sponsor outlines changes to prior authorization process in House Bill 220 to limit retroactive denials and strengthen peer review
Summary
Representative Heidi Workman told the House Insurance Committee that House Bill 220 would clarify Ohio prior‑authorization rules to prevent retroactive denials, require same‑specialty peer reviewers, preserve 12‑month prior authorizations for chronic medications including dose changes, and bar insurers from charging providers to appeal denials.
Representative Heidi Workman presented sponsor testimony on House Bill 220, describing the legislation as clarifying and strengthening existing Ohio law governing prior authorization for health care services.
Representative Heidi Workman said the bill “tightens Ohio's retroactive denial law to ensure that once a prior authorization is approved and the care is delivered, insurers cannot later deny payment,” and that it would “strengthen peer to peer review standards so that only appropriately credentialed physicians in the same specialty can conduct reviews and must respond promptly.” She said…
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