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Read. Follow. Verify.Ohio enacts the Fair Health Claims Act to penalize improper claim denials and establish a consumer assistance program
Last action · May 20, 2026: Referred to InsuranceSponsors: Derrick Hall and 4 others
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What This Bill Would Do
Health insurers in Ohio are prohibited from wrongfully denying, reducing, or terminating covered health care services or payments under the Fair Health Claims Act. The legislation establishes a medical claims consumer assistance program within the Department of Insurance, requires insurers to place prominent notices about the program on plan communications, and mandates annual reporting on s.
Covered persons can receive double damages plus expert expenses from insurers for wrongful claim denials, and courts may impose civil penalties up to $25,000 per violation.
- The Patient Protection and Affordable Care Act of 2010 established federal guidelines and grant programs to support state-level consumer assistance programs for health insurance policyholders. context
Who It Would Affect
Groups the bill's text would affect if enacted, as described in the record. Being affected is not a position for or against it.
covered persons
Covered persons gain protections against wrongful claim denials, are eligible for double damages and expert expenses upon court order, and receive assistance through the newly established consumer assistance program.
health plan issuers
Health plan issuers face strict prohibitions against wrongful claim denials, mandatory data reporting requirements, civil penalties, and the obligation to include program notices on all plan communications.
Key Facts
You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.
Frequently Asked Questions
What happens if a health insurer wrongfully denies a covered medical claim?
What is the purpose of the medical claims consumer assistance program?
Are health plan issuers required to notify consumers about the consumer assistance program?
What else do you want to know?
News Coverage
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Votes, people, money & the original sourceWhere This Stands
Currently in committee. The next step in the legislative lifecycle is Floor Vote.
Procedural history
2 actions- May 20, 2026HouseCommitteeReferred to Insurance
- May 12, 2026HouseIntroducedIntroduced
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Establishment of Direct Financial Penalties for Wrongful Claim Denials
The bill shifts enforcement by allowing courts to award double damages directly to covered persons alongside civil penalties up to $25,000 per violation.
Connected Entities
Sources
www.legislature.ohio.gov
Analysis Score
0–100- Significance85How much this matters to a regular citizen
- Controversy60Intensity of disagreement among stakeholders
- Entertainment10Compellingness for a non-policy-wonk reader
- Buzz45Current news / social attention level
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