OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
H.B. 156 Bill Analysis
135th General Assembly
Click here for H.B. 156’s Fiscal Note
Version: As Introduced
Primary Sponsors: Reps. Manning and Oelslager
Effective Date:
Logan Briggs, Attorney
SUMMARY
 Allows a health benefit plan to offer to dispense physician-administered drugs or
medications to covered individuals at specified or affiliated pharmacies under certain
conditions.
 Prohibits a health benefit plan from requiring or incentivizing dispensing of physician-
administered drugs or medications by a pharmacy or affiliated pharmacy, limiting
coverage when such drugs are not dispensed in that manner, or covering such drugs
with higher cost-sharing if dispensed in a setting other than a pharmacy.
DETAILED ANALYSIS
Physician-administered drugs
The bill authorizes a health benefit plan to offer to dispense physician-administered
drugs or medications to covered individuals at a specific pharmacy or an affiliated pharmacy
under certain specified conditions. However, the bill prohibits a health benefit plan from
disfavoring administration of such drugs or medications in other contexts, such as a physician’s
office. Under the bill, a “physician-administered drug or medication” is an outpatient drug,
other than a vaccine, that cannot reasonably be self-administered by the patient or by an
individual assisting the patient, and that is typically administered by a health care provider.1
Authorization
Under the bill, a health benefit plan may offer physician-administered drugs or
medications to be dispensed by a pharmacy or affiliated pharmacy under any of the following
conditions:
1 R.C. 3902.63(A)(3).
September 7, 2023
Office of Research and Drafting LSC Legislative Budget Office
 The choice of drug, strength, or dose depends on the covered person’s clinical
presentation, including weight changes, lab results, or adverse event grading;
 The drug requires compounding;
 The covered person, or the covered person’s legal representative, has not consented in
writing to the offered dispensing arrangement for a specified course of treatment.2
Prohibitions
The bill prohibits a health benefit plan from doing any of the following:
 Requiring that physician-administered drugs or medications be dispensed by a
pharmacy or affiliated pharmacy or incentivizing such an arrangement;
 Limiting or excluding coverage for a physician-administered drug or medication when it
is not dispensed by a pharmacy or affiliated pharmacy, if the drug is otherwise covered
under the health benefit plan;
 Covering the physician-administered drug or medication at a different benefits tier or
with cost-sharing requirements that impose greater expense for a covered individual if it
is dispensed or administered at the physician’s office, hospital outpatient infusion
center, or other outpatient clinical setting rather than a pharmacy.3
Application
The bill’s authorizations and prohibitions apply to health benefit plans issued, amended,
or renewed on or after the bill’s effective date. The bill defines “health benefit plan” similarly to
how the term is defined in other contexts under continuing law – an agreement offered by a
health plan issuer to provide or reimburse the costs of health care services, including a limited
benefit plan, except for a policy that provides only specified types of coverage (e.g., dental,
vision care, or disability income). “Health benefit plan” does not include a Medicare, Medicaid,
or federal employee plans. Under the bill, “health benefit plan” also includes any pharmacy or
drug benefit plan managed or administered by a pharmacy benefits manager.4
Pharmacies
The bill defines “pharmacy” as any area, room, rooms, place of business, department, or
portion of any of those places where the practice of pharmacy is conducted.5 An “affiliated
pharmacy,” is a pharmacy that controls, is controlled by, or is under common control with a
pharmacy benefit manager.6
2 R.C. 3902.63(B).
3 R.C. 3902.63(B) and (C).
4 R.C. 3902.50 and 3902.63(A)(2); R.C. 3922.01, not in the bill.
5 R.C. 3902.50; R.C. 4729.01, not in the bill.
6 R.C. 3902.63(A)(1).
P a g e |2 H.B. 156
As Introduced
Office of Research and Drafting LSC Legislative Budget Office
HISTORY
Action Date
Introduced 04-25-23
ANHB0156IN-135/ar
P a g e |3 H.B. 156
As Introduced


Statutes affected:
As Introduced: 3902.50