The Ohio Legislature enacted a law that would have required healthcare providers to furnish patients with an estimate of their expected medical charges before receiving a medical service, but it enacted that statute as part of a larger legislative package that addressed other subjects. On February 7, 2020, the Ohio Court of Appeals upheld the trial court’s decision that the price transparency law, R.C. 5162.80, was unconstitutional, because it violated the Ohio Constitution’s one-subject and three-considerations rule. The Court of Appeals’ decision remains subject to possible review before the Ohio Supreme Court.

Article II, Section 15D of the Ohio Constitution requires that, when the legislature passes a bill, “[n]o bill shall contain more than one subject, which shall be clearly expressed in its title.” The purpose of the one-subject rule is to prevent logrolling, that is, the practice of several minorities combining separate proposals, no one of which could have obtained majority approval separately, so as to obtain the enactment of an omnibus bill. A bill may address multiple related topics, but a bill would fail the one-subject rule if it there is a “disunity of subjects” among its provisions.

In a last-minute addition, legislators added the Ohio Price Transparency Law, R.C. 5162.80, to a Workers’ Compensation bill, Amended Substitute House Bill No. 52 of Ohio’s 131st General Assembly. The Court reviewed the legislative history of the bill and found that the Workers’ Compensation bill was intended to make appropriations to the Bureau of Workers’ Compensation and place conditions on certain Bureau programs. The Court reasoned that the price transparency law was an unrelated add-on to the bill.

The proposed Ohio Price Transparency Law that was added to the bill would have required medical service providers to prepare cost estimates for services, products, and procedures. The Court noted that the Bureau is not a “provider of medical services” and there was no explanation, other than logrolling, for the addition of the Ohio Price Transparency Law to the bill.

The Court also held that the addition of the Ohio Price Transparency Law violated the three-considerations rule in the Ohio Constitution. The Ohio Constitution requires each house to consider a bill on three different days. Here, the Ohio Price Transparency Law was added after the legislature had already satisfied the three-considerations rule for the overall bill, and the legislature had not voted with a two-thirds majority to suspend the three-considerations rule.

The Court upheld the trial court’s grant of partial summary judgment in favor of appellees and severed the price transparency provision from the bill.