Senate Passes Johnson Bill Protecting Patients From Mid-Year Medication Changes

COLUMBUS—The Ohio Senate passed Senate Bill 160, sponsored by Senators Terry Johnson (R-McDermott) and Beth Liston (D-Dublin), which would prohibit health insurers from enacting policy changes that require a patient to switch medication mid-year for non-medical reasons.

"For many people, switching medication without proper notice can cause an unnecessary burden," said Senator Johnson. "The changes made in this legislation would prevent health insurance companies from forcing patients to change the medication they were promised."

SB 160 prohibits health insurers from enacting policy changes in the middle of a plan year which would impact a patient's access to medication previously approved by their health insurer. The prohibited changes include:

• Increasing cost-sharing between the insurer and patient;
• Removing the medication from the plan's coverage; and
• Other changes which limit or reduce coverage of the drug.

This legislation also provides a carve out for health insurers who need to switch medication during a plan year only if the costs of that specific medication increases by more than 5% plus the rate of inflation. This provides the necessary mechanisms for health insurers to remain competitive while still protecting the patient’s health first and foremost.

"Insurers are not experts on medication, but doctors are," added Senator Johnson. "Their choice of prescription is purposeful, and being forced to change treatment without a medical reason can cause patients undue stress or potentially negatively impact their health. Patients need stability, and I was happy to offer this legislation to ensure this."

The Ohio Senate sent SB 160 to the Ohio House for further consideration.

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