Section 3902.54 | Out-of-Network Care Arbitrator Requirements.
Effective: April 12, 2021 Latest Legislation: House Bill 388 – 133rd General Assembly (A)(1) The superintendent of insurance shall contract with a single arbitration entity to perform all arbitrations described in section 3902.52 of the Revised Code. The superintendent shall ensure that the arbitration entity, any arbitrators the arbitration entity designates to conduct an arbitration, […]
Section 3902.60 | Advanced Cancer Fail First Drug Coverage Definitions.
Effective: September 30, 2021 Latest Legislation: House Bill 110 – 134th General Assembly As used in sections 3902.60 and 3902.61 of the Revised Code: (A) “Associated conditions” means the symptoms or side effects of stage four advanced metastatic cancer, or the treatment thereof, which would, in the judgment of the health care practitioner in question, […]
Section 3902.61 | Advanced Cancer Fail First Drug Coverage Prohibitions.
Effective: March 24, 2021 Latest Legislation: Senate Bill 252 – 133rd General Assembly (A) Notwithstanding section 3901.71 and sections 3901.831 to 3901.833 of the Revised Code, a health benefit plan issued, delivered, or renewed in this state on or after the effective date of this section that directly or indirectly covers the treatment of stage […]
Section 3902.62 | Coverage for Drugs Refilled Without a Prescription.
Effective: June 1, 2022 Latest Legislation: House Bill 37 – 134th General Assembly (A) As used in this section, “licensed health professional authorized to prescribe drugs” has the same meaning as in section 4729.01 of the Revised Code. (B) Notwithstanding section 3901.71 of the Revised Code, if a health plan issuer covers a prescription drug […]
Section 3902.70 | Health Plan Issuer Contracts With 340b Program Participants Definitions.
Effective: September 30, 2021 Latest Legislation: House Bill 110 – 134th General Assembly As used in this section and section 3902.71 of the Revised Code: (A) “340B covered entity” and “third-party administrator” have the same meanings as in section 5167.01 of the Revised Code. (B) “Terminal distributor of dangerous drugs” has the same meaning as […]
Section 3902.71 | Health Plan Issuer Contracts With 340b Program Participants.
Effective: April 12, 2021 Latest Legislation: Senate Bill 263 – 133rd General Assembly (A) On and after the effective date of this section , a contract entered into between a health plan issuer, including a third-party administrator, and a 340B covered entity shall not contain any of the following provisions: (1) A reimbursement rate for […]
Section 3902.72 | Health Plan Issuer Disclosure of Drug Data.
Effective: January 1, 2022 Latest Legislation: House Bill 110 – 134th General Assembly (A) As used in this section, “health care provider” has the same meaning as in section 3701.74 of the Revised Code. (B) A health plan issuer, including a pharmacy benefit manager, shall, upon request of a covered person, the covered person’s health […]
Section 3902.04 | Requirements for Policy Forms.
Effective: January 9, 1980 Latest Legislation: Senate Bill 92 – 113th General Assembly (A) No policy forms, except as stated in section 3902.03 of the Revised Code, shall be delivered or issued for delivery in this state on or after the dates such forms must be approved under sections 3902.01 to 3902.08 of the Revised […]
Section 3902.51 | Out-of-Network Care Reimbursement Requirement, Negotiations.
Effective: April 12, 2021 Latest Legislation: House Bill 388 – 133rd General Assembly (A)(1)(a) A health plan issuer shall reimburse an out-of-network provider for unanticipated out-of-network care when both of the following apply: (i) The services are provided to a covered person at an in-network facility. (ii) The services would be covered if provided by […]
Section 3902.05 | Construction.
Effective: January 9, 1980 Latest Legislation: Senate Bill 92 – 113th General Assembly Nothing in sections 3902.01 to 3902.08 of the Revised Code shall be construed to negate any law of this state permitting the issuance of any policy form after it has been on file for the time period specified.