Consumers will pay only the actual cost of using non-network providers. For the first time, consumers will be able to learn the actual costs to an insurer of providing access to non-network providers. The PAI requires insurers to file data with the Ohio Department of Insurance that specifically details what those additional costs might be. Quality standards will remain the same. Non-network health care providers will have to follow the same strict quality care guidelines that the plan has established for their own network providers.
Insurers can still use limited provider networks.
Patient Access Initiative does not destroy a health plan's ability to formulate a provider network. This is not an any willing provider bill. This legislation does not require health plans to make non-network providers a permanent part of their provider networks. Insurers will not be mandated to cover any specific service. But insurers will not be allowed to discriminate against a class of providers.