The proposed bill, H.B. No. 2025-2026, aims to establish network adequacy standards for health insurers in Ohio by enacting section 3901.93 of the Revised Code. It defines key terms such as "business day," "cost sharing," "covered benefit," and "network plan," among others. The bill mandates that health plan issuers maintain a network that provides sufficient access to a variety of providers, including those serving low-income and medically underserved populations, and ensures availability of emergency services at all times. The superintendent of insurance is tasked with setting criteria for evaluating network adequacy, which includes assessing provider ratios, geographic accessibility, waiting times, and the ability to meet the needs of diverse populations.

Additionally, the bill requires health plan issuers to have processes in place to ensure covered persons can access in-network benefits even when using out-of-network providers under certain conditions. It also mandates ongoing monitoring of provider capacity and the establishment of minimum provider numbers and travel limits. Health plan issuers must file their network plans and access arrangements with the department of insurance, and they are required to maintain a provider directory that accurately reflects network participation. The superintendent is authorized to adopt rules for the administration and enforcement of these standards.