Ohio Revised Code Search

...s, the superintendent may determine accounting practices and methods for purposes of preparing statutory financial statements and other financial information. (C) The superintendent shall furnish each domestic insurance company the forms for the filing of statutory financial statements and other financial information required to be made by it.

...any other circumstance that the superintendent of insurance determines to be appropriate, the superintendent may issue certificates of compliance to insurance companies and associations authorized to do business in this state, which shall be on either forms established by the national association of insurance commissioners or on such other forms as the superintendent may prescribe.

...of the Revised Code. (D) The superintendent of insurance may adopt rules as necessary to carry out the requirements of this section.

... week excluding Saturday, Sunday, and a legal holiday, as defined in section 1.14 of the Revised Code. (C) "Concurrent review" means a claims review within five business days of submission of claims for payment for the provision of dangerous drugs for which the payer or the auditing entity does not impose a penalty or demand to recoup money from the pharmacy in any amount. (D) "Dangerous drug," "pharmacy," "practic...

...that is the subject of the audit any amount that the pharmacy audit identifies as being the result of clerical or recordkeeping errors in the absence of financial harm. For purposes of this provision, an error in the dispensing of a drug is any of the following: selecting an incorrect drug, issuing incorrect directions, or dispensing a drug to the incorrect patient. (4) The auditing entity shall not use the account...

..., and the record a pharmacist maintains under section 4729.37 of the Revised Code documenting a prescription received by telephone. (C) Resubmit a disputed or denied claim for payment using any commercially reasonable method of resubmission, including resubmission by facsimile, mail, or electronic means, as long as the time period for resubmissions established by the relevant payer has not expired.

...ure the auditing entity has established under section 3901.814 of the Revised Code. (4)(a) An auditing entity shall deliver a final audit report to the pharmacy that was the subject of the audit. Except as provided in division (A)(4)(b) of this section, the report shall be delivered not later than one hundred twenty business days after the pharmacy's receipt of a preliminary audit report. (b) If an auditing entity ...

...gs in a preliminary audit report issued under section 3901.813 of the Revised Code.

...sed Code shall not apply to an auditing entity that is a medicaid managed care organization if application of those sections to the entity would be in violation of federal law.

...The "Restatement of the Law, Liability Insurance" that was approved at the 2018 annual meeting of the American law institute does not constitute the public policy of this state and is not an appropriate subject of notice.

...e for a particular patient are covered, under either a medical or prescription drug benefit, by a health benefit plan, including both self- administered and physician-administered drugs. (G) "Urgent care services" has the same meaning as in section 3923.041 of the Revised Code. (H) "Utilization review organization" has the same meaning as in section 1751.77 of the Revised Code.

...w organization shall also take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria. (C) This section shall not be construed as requiring either a health plan issuer or the state to set up a new entity to develop clinical review criteria for step therapy protocols.

...practice under sections 3901.19 to 3901.26 of the Revised Code.

...superintendent of insurance may adopt rules as necessary to enforce sections 3901.83 to 3901.833 of the Revised Code.

...wenty per cent of the amount that is collected under division (A) of this section from foreign insurance companies that sell fire insurance to residents of this state shall be paid into the state fire marshal's fund created under section 3737.71 of the Revised Code. The director of commerce, with the approval of the director of budget and management, may increase the percentage described in this division so that it w...

... this state through an exchange created under that act.

... et seq. This study shall be delivered electronically to the governor, the senate president, and the speaker of the house not later than two years after the effective date of this section .

...practice under sections 3901.19 to 3901.26 of the Revised Code. (I) Nothing in this section shall be construed as prohibiting a health plan issuer from disclosing additional claims information beyond what is required by this section.

... collect information and help consumers understand and access their insurance benefits. The department of insurance and the department of behavioral health shall jointly report annually on the department's efforts, which shall include information on consumer and payer outreach activities and identification of trends and barriers to access and coverage in this state. The departments shall submit the report to the ge...

... the superintendent's duties and powers under Chapters 1751. and 1753. and Title XXXIX of the Revised Code or a rule related to an "insurance rating agency" as defined by section 1.65 of the Revised Code, the superintendent shall give consideration to the inclusion in the rule of the definition of "insurance rating agency" found in section 1.65 of the Revised Code.

...the health care services to be provided under the agreement and the basis on which a periodic fee is to be paid in exchange for those services. (H) It specifies the periodic fee required and any additional fees that may be charged. (I) It authorizes the periodic fee and any additional fees to be paid by a third party. (J) It prohibits the health services provider from charging or receiving any fee other than th...

...l of the following is not subject to Title XXXIX or Chapter 1739., 1751., or 1753. of the Revised Code and shall not be considered insurance under any law of this state: (1) The healthcare benefit coverage is provided by a nonprofit agricultural membership organization to the organization's members; (2) The application for healthcare benefit coverage and any contract provided to a member is in writing; (3) The ...

...ss than twenty-five nor more than five hundred dollars. (B) Whoever violates any law relating to the superintendent of insurance, or any law of this state relating to insurance as defined in division (A)(1) of section 3901.04 of the Revised Code, for the violation of which no penalty is otherwise provided in the Revised Code, shall be fined not more than twenty-five thousand dollars, imprisoned not more than six mon...

...r commit an insurer. (I) "Limited line credit insurance" means credit life, credit disability, credit property, credit unemployment, involuntary unemployment, mortgage life, mortgage guaranty, mortgage disability, guaranteed automobile protection insurance, or any other form of insurance offered in connection with an extension of credit that is limited to partially or wholly extinguishing that credit obligation and ...

...e in this state unless the person is licensed for that line of authority in accordance with this chapter.