Balance Billing Laws in Ohio
Your medical billing rights and protections in Ohio.
Ohio enacted HB 388 (2020), the 'Surprise Billing and Consumer Protection Act,' which became effective January 1, 2022. The law prohibits balance billing for emergency services and for non-emergency services at in-network facilities when patients have no meaningful choice of provider, and establishes a dispute resolution process for provider-insurer payment disagreements.
Key Protections in Ohio
Emergency services: Balance billing prohibited for emergency services; patients pay in-network cost-sharing amounts
Non-emergency care at in-network facilities: Out-of-network providers cannot balance bill when patient had no meaningful choice
Dispute resolution: Ohio has a state-administered arbitration process for provider-insurer payment disputes
Disclosure: Out-of-network providers must give patients advance written notice and cost estimates before non-emergency services
Filing Information
Within 2 years of the date of service for state-level complaints
Additional Notes
Ohio's Surprise Billing and Consumer Protection Act aligns with the federal No Surprises Act. Consumers with state-regulated plans should file with ODI; federal complaints go to CMS.
How to File a Complaint in Ohio
Gather Your Documentation
Collect your itemized medical bill, Explanation of Benefits (EOB) from your insurer, any prior authorization documents, and written communications with the provider or insurance company.
File with the State Regulator
Submit your complaint to the Ohio Department of Insurance. Include all supporting documents and a clear description of the billing dispute.
File complaint with Ohio Department of InsuranceFile with CMS if Federal Protections Apply
If your dispute involves the No Surprises Act (emergency care or out-of-network providers at in-network facilities), you can also file directly with the Centers for Medicare & Medicaid Services.
File with CMS No Surprises Help DeskRelated Articles
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