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- Ohio Pathologists Force Favorable Vote at State HOD
The Ohio Society of Pathologists (OSP), with CAP support, successfully argued for passage of a Ohio State Medical Association (OSMA) House of Delegates (HOD) resolution to compel that organization to reconsider their past support for an Ohio out-of-network payment law in light of the enactment of the federal "No Surprises Act." Working with state societies, the CAP advocates for state laws to require health plans to have adequate networks of hospital-based physicians, including pathologists. The CAP’s strong partnerships with societies like the OSP bolsters advocacy efforts at the state level.
On April 10, the OSMA House of Delegates, in a final vote, while not endorsing the original OSP resolution, voted to direct and authorize the establishment of a multi-specialty working group of physicians to include all impacted specialties. The working group is charged to report back to the OSMA on the effects of the Ohio out-of-network law and "evaluate recommendations for further legislative advocacy." The OSP leadership crafted the authorizing language during HOD deliberations as a substitute amendment.
The vote on the final resolution was contentious, with some within OSMA arguing against consideration of any legislative action to repeal or revise the Ohio out-of-network law that ties payment to the median in-network rate of the health plan payer, or 100% of Medicare, whichever is greater. By contrast, the recently enacted federal No Surprises Act law contains no adverse payment formula. Moreover, the 100% Medicare benchmark in the Ohio law is the lowest nationwide and was opposed by the OSP and CAP. The OSP is looking forward to participating in the newly created OSMA working group.