Insurers and small-business advocates tell Senate panel House Bill 24 could raise costs and strip medical-necessity discretion

Summary

Witnesses from the Ohio Association of Health Plans and the NFIB offered opponent testimony on House Bill 24, saying the bill would require coverage for biomarker testing, limit insurers' ability to apply medical-necessity criteria, risk higher test prices and premiums, and create inequities because many self-insured ERISA plans are exempt.

The Senate Insurance Committee held a third hearing on House Bill 24, which would require health plans to cover biomarker testing. Two opponent witnesses — Megan Richwine, Director of Government Affairs for the Ohio Association of Health Plans (OAHP), and Chris Feruso, state director for NFIB — told senators they support access to clinically appropriate testing but urged caution about a blanket coverage mandate.

Megan Richwine said many health plans already cover biomarker tests that meet a health plan's medical-necessity criteria and warned the bill, as drafted, could strip plans of the ability to apply those criteria. "Today health plans cover biomarker tests that meet the health plan's medical necessity criteria," she told the committee, while also arguing that removing that discretion "can no longer effectively manage the care rendered to its members."…

Insurers and small-business advocates tell Senate panel House Bill 24 could raise costs and strip medical-necessity discretion

Summary

Subscribe to keep reading