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Executive Order 2019-18D

Improving Price Transparency in Healthcare

WHEREAS, patients cannot make the best decisions about their healthcare without knowing the price and quality of a treatment in advance; and

WHEREAS, 45% of Americans report they would have to struggle to pay an unexpected $500 medical bill. A surprise medical bill can happen when a patient gets a bill from a health care provider who isn't paii of a health plan's network. Often, patients are not notified they are getting care from out-of-network providers; and

WHEREAS, one in ten adults report that they delayed or did not get medical care because of its cost; and

WHEREAS, per capita health spending in the United States exceeds that of all other countries; and

WHEREAS, national health care spending reached $3.5 trillion or $10,739 per person in 2017;and

WHEREAS, the Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States was issued on June 24, 2019, which called for new federal regulations and rules addressing surprise medical billing and the need for transparency in health care pricing;

NOW THEREFORE, I, Mike De Wine, Governor qf the State of Ohio, by value of the authority vested in me by the Constitution and laws of this State do hereby order and direct that:

  1. Every State Cabinet Agency, Board or Commission ("Executive Agency") shall seek to adopt or implement the rules regulations and recommendations which result from the Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States and which address surprise medical billing, transparency in health care costs, and access to de-identified claims data.
  2. This Executive Order applies to every State Cabinet Agency, Board or Commission ("Executive Agency") which uses any funds within its control to reimburse or otherwise pay the cost of health care.
  3. This Executive Order will be personally provided, by the Director, Chair or other chief executive official of each Executive Agency, to the Chief Procurement Officer or other individual at that entity responsible for contracts for services.
  4. Nothing in this Order shall be interpreted or construed to supersede any other controlling State or federal law. 
  5. Nothing in this Order is intended to create any third party right of action or to give standing to any person, group, official or entity that is not a party to the contract.
  6. Nothing is this Order is intended to limit or restrict any legal defenses that Executive Agencies may raise. 
  7. In the unlikely event that a waiver to this executive order is in the compelling interests of the State of Ohio, a waiver may be sought by the Chief Legal Counsel of the Executive Agency communicating the compelling reasons in a privileged manner with my Chief Legal Counsel and his staff. Should such a waiver be granted, a public notice will be made and the Auditor, Speaker of the House, and President of the Senate will be notified in writing of the granting of the waiver.

I signed this Executive Order on July 18, 2019 in Columbus, Ohio and it will not expire unless it is rescinded.


Mike DeWine, Governor



Frank LaRose, Secretary of State