OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
H.B. 597 Bill Analysis
135th General Assembly
Click here for H.B. 597’s Fiscal Note
Version: As Introduced
Primary Sponsor: Rep. Robinson
Effective date:
Austin C. Strohacker, Attorney
Erika Kramer, Attorney
SUMMARY
▪ Requires health benefit plans and the Medicaid program to cover medically necessary
epinephrine and glucagon, in all forms, for minors.
▪ Caps cost sharing for all forms of epinephrine and glucagon prescribed for minors.
DETAILED ANALYSIS
Health benefit plans
Coverage
Under the bill, all health benefit plans must cover glucagon and epinephrine, in any
form, prescribed to a covered person under age 18 if considered medically necessary by the
covered person’s medical provider.1
Cost sharing
The bill also places a cap on cost sharing for health benefit plans covering medically
necessary epinephrine or glucagon in any prescribed form for minors, regardless of any
deductible, copay, coinsurance, or other cost-sharing requirement that would otherwise apply
to the covered person. For epinephrine or glucagon autoinjectors, cost sharing must not exceed
$60 per package of two autoinjectors. For epinephrine or glucagon in any other prescribed
form, cost sharing must not exceed $60 per dose equivalent to the dose contained in two
1 R.C. 3902.64(B).
September 3, 2024
Office of Research and Drafting LSC Legislative Budget Office
autoinjectors. These caps apply regardless of the amount or type of epinephrine or glucagon
needed to fill the covered person’s prescription.2
The bill specifies that the cap on cost sharing does not prohibit an insurer from reducing
a covered person’s cost-sharing requirement for those drugs to an amount below the cap.3
Medicaid program
The bill imposes similar coverage requirements under the Medicaid program. Under the
bill, the Medicaid program must cover glucagon and epinephrine, in any form, prescribed to a
covered person under age 18 if considered medically necessary by the covered person’s
medical provider.4
To the current law requirement that the Department institute cost-sharing
requirements for covered drugs under the Medicaid program, the bill adds provisions specific to
epinephrine and glucagon. Specifically:
▪ The Department of Medicaid may not impose a cost-sharing requirement for a
prescribed form of epinephrine or glucagon that is greater than the cost-sharing
requirement for a different prescribed form of one of those drugs.
▪ Any cost-sharing requirement for those drugs must comply with the bill’s limitations on
cost-sharing requirements for those drugs by health benefit plans.5
HISTORY
Action Date
Introduced 05-15-24
an-hb0597in-135/ks
2 R.C. 3902.64(C) and (D).
3 R.C. 3902.64(E).
4 R.C. 5164.093(A) and 5167.12.
5 R.C. 5162.20 and 5164.093(B).
P a g e |2 H.B. 597
As Introduced


Statutes affected:
As Introduced: 5162.20, 5167.12