HB 682

As Introduced
136th General Assembly
   Regular Session  H. B. No. 682
       2025-2026
  Representatives Craig, Manning
  To enact section 3902.65 of the Revised Code to  1
  prohibit certain insurance practices related to  2
  physician-administered drugs for patients with  3
  chronic, complex, rare, or life-threatening  4
  medical conditions.  5
 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
     Section 1. That section 3902.65 of the Revised Code be  6
enacted to read as follows:  7
     Sec. 3902.65. (A) As used in this section:  8
     (1) "Administer" means to directly apply a drug to the  9
body of a patient by injection, inhalation, ingestion, or any  10
other means.  11
     (2) "Health care provider" means an individual who is  12
licensed, certified, or otherwise authorized to provide health  13
care services in this state.  14
     (3) "Independent hospital" means a hospital, or group of  15
hospitals, that files jointly one hospital financial statement  16
as required by section 5168.05 of the Revised Code, or if not  17
filing pursuant to that section, a similar financial statement,  18
and that has an annual patient service revenue derived in this  19
state of less than two billion dollars based on the financial  20
H. B. No. 682  Page 2
As Introduced
statement.  21
       (4) "Pharmacy" includes a pharmacy located in or  22
affiliated with an independent hospital.  23
       (5) "Physician" means a person licensed under Chapter  24
4731. of the Revised Code to practice medicine or surgery or  25
osteopathic medicine and surgery.  26
       (6) "Physician-administered drug" means a drug, other than  27
a vaccine, to which both of the following apply:  28
       (a) The drug cannot reasonably be self-administered by the  29
patient to whom the drug is prescribed or by an individual  30
assisting the patient with the self-administration.  31
       (b) The drug is typically administered by a physician or  32
other health care provider, including when acting under a  33
physician's delegation and supervision.  34
       (7) "Specified location" means a physician's office or  35
independent hospital. "Specified location" does not include  36
either of the following:  37
       (a) A hospital that is not an independent hospital;  38
       (b) A hospital that is part of a group of hospitals that  39
are not independent hospitals.  40
       (B) Notwithstanding section 3901.71 of the Revised Code,  41
but subject to division (C) of this section, a health benefit  42
plan issued, amended, or renewed on or after January 1, 2027,  43
shall not do any of the following with respect to physician-  44
administered drugs when the administration occurs on an  45
outpatient basis in a specified location:  46
       (1) Require physician-administered drugs to be dispensed  47
H. B. No. 682  Page 3
As Introduced
only by certain pharmacies or only by pharmacies participating  48
in the health plan issuer's network;  49
       (2) If a physician-administered drug is otherwise covered,  50
limit or exclude coverage for the drug based on the covered  51
person's choice of pharmacy or because the drug is not dispensed  52
by a pharmacy that participates in the health plan issuer's  53
network;  54
       (3) Require a physician or other health care provider  55
participating in the health plan issuer's network to bill or be  56
reimbursed for the delivery and administration of physician-  57
administered drugs under the pharmacy benefit instead of the  58
medical benefit without both of the following:  59
       (a) Informed consent from the covered person;  60
       (b) A written attestation by the covered person's  61
physician or other health care provider that a delay in the  62
drug's administration will not place the covered person at an  63
increased health risk.  64
       (4) Require that a covered person pay an additional fee or  65
impose increased cost-sharing requirements for physician-  66
administered drugs based on the covered person's choice of  67
pharmacy or because the drug was not dispensed by a pharmacy  68
that participates in the health plan issuer's network.  69
       (C) This section applies only with respect to covered  70
persons with a chronic, complex, rare, or life-threatening  71
medical condition and whose physician or other health care  72
provider determines any of the following:  73
       (1) A delay of care would make disease progression  74
probable.  75
H. B. No. 682  Page 4
As Introduced
       (2) The use of a pharmacy within the health plan issuer's  76
network would make death or patient harm probable or potentially  77
cause a barrier to the covered person's compliance with the plan  78
of care.  79
       (3) It is necessary to have the drug dispensed by a  80
different pharmacy based on the timeliness of the delivery or on  81
dosage requirements.  82
       (D) Nothing in this section shall be construed to do  83
either of the following:  84
       (1) Authorize a person to administer a drug when otherwise  85
prohibited under the laws of this state;  86
       (2) Modify drug administration requirements under the laws  87
of this state, including any requirements related to delegation  88
and supervision of drug administration.  89