Bill > HB767

This bill, titled the Ohio Menopause, Perimenopause, and Hormone Therapy Coverage Act, mandates that both private health insurance plans and the state's Medicaid program must cover the diagnosis and treatment of menopause, perimenopause, and their associated symptoms, which can include hot flashes, sleep disturbances, and mood changes. This coverage extends to various services such as doctor visits, diagnostic tests, and approved hormone and non-hormonal therapies, even if they are not FDA-approved when other approved treatments are ineffective or contraindicated, as determined by a prescriber (a licensed medical professional authorized to prescribe medication). The bill also prohibits insurance plans from imposing cost-sharing or utilization management requirements (like prior authorization) that are more restrictive than those applied to other medical benefits, and ensures that these conditions are not considered elective or cosmetic. The intent of this legislation is to align state coverage with current federal guidance and clinical standards regarding menopausal hormone therapy.

Business and Industry

https://www.legislature.ohio.gov/legislation/136/hb767