LUGPA Policy Brief – Ohio H.B. 390: Shifting Cost-Sharing Collection to Health Plan Issuers

January 2026 

At-a-Glance Essentials

What’s Changing:
Ohio H.B. 390 would prohibit insurers from requiring physicians to collect patient cost-sharing (copays, deductibles, coinsurance) for covered services.

Why It Matters:
Shifts administrative and bad-debt risk from practices to insurers, significantly reducing revenue cycle complexity.

Who Is Affected:
Health plan issuers, physicians and other providers, and patients enrolled in Ohio-regulated plans.

Key Date:
Applies to new, amended, or renewed contracts on or after January 1, 2027 (if enacted).

Overview

Introduced in July 2025 by Rep. Jean Schmidt (R-Loveland), Ohio H.B. 390 would prohibit health plan issuers from requiring or inducing providers to collect patient cost-sharing. Instead, insurers would be responsible for billing enrollees directly, representing a significant shift in current payment and contracting practices.

Key Provisions (Effective January 1, 2027, if enacted)

• Full Provider Reimbursement: Insurers must pay the full allowed amount without deducting patient cost-sharing.
• Insurer Collection Responsibility: Health plans collect cost-sharing directly from patients.
• Contract Scope: Applies to new or renewed contracts; existing contracts are grandfathered unless modified.
• Preserved Provider Rights: Providers may still collect for non-covered services and accept voluntary cash payments.

Current Status

Referred to the Ohio House Insurance Committee. As of December 30, 2025, no hearings or votes have occurred.

Why This Matters for LUGPA Members

Independent urology practices face a disproportionate administrative burden from frequent visits, procedures, and benefit verification. Cost-sharing collection drives staffing costs, bad debt, and strained patient interactions—pressures compounded by stagnant Medicare payment and consolidation trends. H.B. 390 directly addresses these challenges by removing a major non-clinical function from practices.

Potential Impact on Urology Practices

Benefits

• Lower administrative and staffing costs
• More predictable cash flow
• Reduced bad debt exposure
• Improved patient experience

Challenges

• Possible insurer pressure on negotiated rates
• Contracting and implementation complexities
• Potential utilization increases

Broader Significance

H.B. 390 is a first-of-its-kind state proposal. If enacted, it could serve as a model for reducing physician burnout, supporting the sustainability of independent practice, and complementing broader burden-reduction reforms.

LUGPA Position

LUGPA supports policies that meaningfully reduce administrative burden while protecting reimbursement adequacy and patient access. We will continue to monitor and engage on H.B. 390.