The Health Insurance Denial Resolution Program

BACKGROUND: Health care costs keep climbing, and too many Ohio families pay their premiums every month only to open a denial letter when they get hurt or sick and need care most. The medical claim denial process is confusing, time-consuming, and like trying to see inside a black box. Most patients never think to appeal a denial, even though Ohio law already gives them the right to an internal appeal and an independent external review. Furthermore, appeals frequently succeed. But what happens most often is that families give up, pay out of pocket, or go without the treatment they’ve already paid for through their premiums. That’s an affordability and fairness problem the Attorney General can do something about.

POLICY SOLUTION: As Attorney General, Keith Faber will launch a first-in-Ohio initiative: the Health Insurance Denial Resolution Program. Housed in the Attorney General’s Consumer Protection Section and coordinated with staff from the office’s Health Care Fraud Section, the program will educate and assist Ohioans in navigating the medical claims denial process. The program will also cooperate with the Ohio Department of Insurance. The program will:

  1. Educate. Free online resources will walk consumers step by step through the typical process of appealing a medical insurance claim denial in Ohio.

  2. Advocate. A dedicated helpline staffed with trained advocates will assist some consumers finish the internal appeal and external review process and get the documentation right.

  3. Resolve. Where patterns of wrongful denials emerge, the Attorney General will put Keith Faber’s decades of mediation and alternative dispute resolution experience to work, intervening with insurers on behalf of groups of consumers to resolve disputes quickly and, when possible, using the office’s enforcement authority.

This approach has been successful in some other states. Similar programs in New York and Maryland saved consumers millions of dollars in 2025. Ohio can deliver similar results for its families.

The program requires no new legislation, no new mandates, and no new bureaucracy. It uses authority, personnel, and resources the Attorney General already has, so it can get off the ground quickly.

Health insurance is a business, and Keith Faber believes that profit isn’t a dirty word in Ohio. However, Ohioans also deserve to get what they pay for. Keith Faber will make sure the Attorney General’s office is in their corner when an insurer improperly says no.