Bifurcated

Ohio No Surprises Act & IDR Rules

Last verified: July 2026 · For informational purposes only, not legal advice

Quick answer: Ohio is a bifurcated state. Some disputes are governed by Ohio's own specified state law, while others default to the federal No Surprises Act IDR process depending on the plan type and service involved.

How it works

Ohio's specified state law applies to "unanticipated out-of-network care" — emergency services and non-emergency services where the patient couldn't request an in-network provider. The federal IDR process applies to emergency and non-emergency claims valued under $750, plus air ambulance services.

Key dates

Federal No Surprises Act protections took effect January 1, 2022. State-specific protections vary — check the official source below for exact effective dates in this state.

Official source: Centers for Medicare & Medicaid Services — Ohio enforcement letter and specified state law documentation (cms.gov/nosurprises)

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