Ohio Revised Code Search

...biologics compendium. (2) The best practices for the treatment of stage four advanced metastatic cancer, as supported by peer-reviewed medical literature. (C) A violation of this section is an unfair and deceptive practice in the business of insurance under sections 3901.19 to 3901.26 of the Revised Code.

...(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 under a health benefit plan, the health plan issuer shall also provide coverage for that drug when it is dispensed by a pharmacist to a covered person in ac...

...r 4755. of the Revised Code or a chiropractor licensed under Chapter 4734. of the Revised Code shall not be greater than the cost-sharing requirement imposed by the plan for an office visit to a primary care physician or primary care osteopath physician licensed pursuant to Chapter 4731. of the Revised Code. (B) A health plan issuer shall clearly state on its web site and on all relevant literature that coverage f...

...ogist" means a licensed physician who practices otolaryngology. (3) "Related services" means services necessary to assess, select, and appropriately adjust or fit a hearing aid to ensure optimal performance. (B) On and after the effective date of this section, and notwithstanding section 3901.71 of the Revised Code, a health benefit plan shall provide coverage for the full cost of both of the following: (1) One...

...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 in section 4729.01 of the Revised Code.

...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 a prescription drug that is less than the national average drug acquisition cost rate for that drug as determined by the United States centers for medicare and medicaid services, measure...

...rt programs whether sponsored by a manufacturer, foundation, or other entity. (2) Except as may be required by law, interfere with, prevent, or materially discourage access, exchange, or use of the data required under division (B) of this section, including any of the following: (a) Charging fees; (b) Not responding to a request at the time the request is made, if such a response is reasonably possible; (c) I...

...h agencies, hospitals, medical clinics, public health agencies, rehabilitation agencies, and skilled nursing facilities. (P) "Medical professional" means any person licensed or certified to provide health care services to natural persons, including a chiropractor, clinical dietitian, clinical psychologist, dentist, nurse, occupational therapist, optometrist, pharmacist, physical therapist, physician, podiatrist, ps...

... known mailing address, as shown in the records of the insurance institution, agent, or insurance support organization, is located in this state.

...on in connection with an insurance transaction. However, a pretext interview may be undertaken to obtain information from a person or institution that does not have a generally or statutorily recognized privileged relationship with the person about whom the information relates for the purpose of investigating a claim where, based upon specific information available for review by the superintendent of insurance, there...

... only from the applicant or from public records; (b) At the time the collection of personal information is initiated when personal information is collected from a source other than the applicant or public records. (2) In the case of a policy renewal, a notice shall be provided no later than the policy renewal date, except that no notice shall be required in connection with a policy renewal if either of the followin...

...al in connection with an insurance transaction.

... form in connection with insurance transactions a form or statement that authorizes the disclosure of personal or privileged information about an individual to the insurance institution, agent, or insurance support organization, unless the form or statement: (A) Is written in plain language; (B) Is dated; (C) Specifies the types of persons authorized to disclose information about the individual; (D) Specifies the...

...al in connection with an insurance transaction involving an application for insurance, a policy renewal, a policy reinstatement, or a change in insurance benefits unless the insurance institution or agent informs the individual that he may request to be interviewed in connection with the preparation of the investigative consumer report, and that upon a request under section 3904.08 of the Revised Code, he is entitled...

...ance institution or agent authorized to act on its behalf. With respect to the copying and disclosure of recorded personal information pursuant to a request under division (A) of this section, an insurance institution, agent, or insurance support organization may make arrangements with an insurance support organization or a consumer reporting agency to copy and disclose recorded personal information on its behalf. ...

... furnish the correction, amendment, or fact of deletion to all of the following: (1) Any person specifically designated by the individual that may have, within the preceding two years, received such recorded personal information; (2) Any insurance support organization whose primary source of personal information is insurance institutions if the insurance support organization has systematically received such recorde...

...ed for coverage has engaged in criminal activity, fraud, material misrepresentation, or material nondisclosure; (b) Specific items of medical record information supplied by a medical care institution or medical professional shall be disclosed either directly to the individual about whom the information relates or to a medical professional designated by the individual and licensed to provide medical care with respect...

...on in connection with an insurance transaction concerning any previous adverse underwriting decision experienced by an individual, unless such inquiry also requests the reasons for any previous adverse underwriting decision.

...n either of the following: (A) On the fact of a previous adverse underwriting decision. However, an insurance institution or agent may base an adverse underwriting decision on further information obtained from an insurance institution or agent responsible for a previous adverse underwriting decision. (B) On personal information received from an insurance support organization whose primary source of information is i...

...e, lessor, or other person shown on the records of an insurance institution or agent as having a legal or beneficial interest in a policy of insurance, provided the following conditions are met: (1) No medical record information is disclosed unless the disclosure would otherwise be permitted by this section; (2) The information disclosed is limited to that which is reasonably necessary to permit such person to pr...

...(A) No person shall knowingly obtain information under false pretenses about an individual from an insurance institution, agent, or insurance support organization. (B) Whoever violates division (A) of this section is guilty of a felony of the fourth degree.

...of every insurance support organization acting on behalf of an insurance institution or agent that either transacts business in this state or transacts business outside this state that has an effect on a person residing in this state to determine whether such insurance support organization has been or is engaged in any conduct in violation of sections 3904.01 to 3904.22 of the Revised Code.

...e may be served by anyone authorized to act on behalf of the superintendent. Service of process may be completed in the manner provided by law for service of process in civil actions or by registered mail. A copy of the statement of charges, notice, order or other process shall be provided to the person or persons whose rights under these sections have been allegedly violated. A verified return setting forth the mann...

... an insurance support organization transacting business outside this state that has an effect on a person residing in this state is deemed to have appointed the superintendent of insurance to accept service of process on its behalf, provided the superintendent causes a copy of such service to be mailed forthwith by registered mail to the insurance support organization at its last known principal place of business. Th...

...ct or law warrant such action or if the public interest so requires.