Ohio Revised Code Search

...other information presented to the PAMR board, as well as all statements made by board members during board meetings, all work products of the board, and data submitted to the department of health by the board, other than the biennial reports described in section 3738.08 of the Revised Code, are confidential and not a public record under section 149.43 of the Revised Code. Such materials shall be used by the board an...

...ports, or other information to the PAMR board is immune from any civil liability for injury, death, or loss to person or property that otherwise might be incurred or imposed as a result of providing the records, documents, reports, or information to the board. (B) Each board member is immune from any civil liability for injury, death, or loss to person or property that might otherwise be incurred or imposed as a re...

...(A) The PAMR board shall prepare a biennial report that does all of the following: (1) Summarizes the board's findings from the reviews completed in the immediately preceding two calendar years, including any trends or patterns identified by the board; (2) Makes recommendations on how pregnancy-associated deaths may be prevented, including changes that should be made to policies and laws; (3) Includes any other...

... (A) Establish a procedure for the PAMR board to follow in conducting pregnancy-associated death reviews; (B) Specify the data and other relevant information the board must use when conducting pregnancy-associated death reviews; (C) Establish guidelines for the board to follow to prevent an unauthorized dissemination of confidential information in violation of division (B) of section 3738.06 of the Revised Code. ...

...er, managed care organization, or other third-party payer to provide pharmacy health benefit services or administration. "Pharmacy benefit manager" includes the state pharmacy benefit manager selected under section 5167.24 of the Revised Code. (O) "Plan" means any arrangement in written form for the payment of life, dental, health, or disability benefits to covered persons defined by the summary plan description a...

...(A) Administrators may be tested and shall be licensed by the superintendent of insurance in accordance with rules adopted by the superintendent. (B) An administrator who has been licensed or certified by the state of the administrator's domicile under a statute or rule similar to sections 3959.01 to 3959.16 of the Revised Code shall, upon application, be licensed without testing, provided the state of domicile reco...

...No person shall solicit a plan or sponsor of a plan to act as an administrator for, or provide administrative services to, a plan or sponsor of a plan that is either domiciled in this state or has its principal headquarters or principal administrative office in this state unless the person is duly licensed under sections 3959.01 to 3959.16 of the Revised Code.

...(A) An administrator shall file with the superintendent of insurance an application for a license on a form prescribed by the superintendent. (B) All applications for a license shall be accompanied by a nonrefundable filing fee of two hundred dollars per application made payable to the department of insurance. (C) All fees collected under this section and under section 3959.10 of the Revised Code shall be paid into...

...The superintendent of insurance shall act on all applications submitted for a license within thirty days after receipt.

...If the superintendent of insurance denies the application for license, the superintendent shall promptly notify the applicant of the denial and the reasons for the denial within thirty days of the date the application is denied by the superintendent. The notice shall advise the applicant of the applicant's right to request a hearing within thirty days from the date of the mailing of the notice.

...on is approved by the superintendent or board, or both, for a term expiring on the following June 30. The license may be renewed annually for a period of one year commencing July 1.

...(A) The superintendent of insurance shall, at least sixty days before the expiration of the administrators license granted by the superintendent, provide a renewal notice on a form approved by the superintendent. (B) The renewal application shall require the payment of a renewal fee of three hundred dollars and the payment shall be made prior to the expiration date of the license. Failure to make the renewal payment...

...(A) No person may act as an administrator without a written agreement between the administrator and the plan sponsor. Such written agreement shall be retained as part of the official records of the administrator for the duration of the agreement and for five years thereafter. Each such agreement shall contain, at a minimum, all of the following information: (1) The term of the agreement; (2) An explanation of the s...

...(A)(1)(a) In each contract between a pharmacy benefit manager and a pharmacy, the pharmacy shall be given the right to obtain from the pharmacy benefit manager, within ten days after any request, a current list of the sources used to determine maximum allowable cost pricing. In each contract between a pharmacy benefit manager and a pharmacy, the pharmacy benefit manager shall be obligated to update and implement the ...

...(A) Any license issued under sections 3959.01 to 3959.16 of the Revised Code may be suspended for a period not to exceed two years, revoked, or not renewed by the superintendent of insurance after notice to the licensee and hearing in accordance with Chapter 119. of the Revised Code. The superintendent may suspend, revoke, or refuse to renew a license if upon investigation and proof the superintendent finds that the ...

...Any person who, while licensed as an administrator, is convicted of a felony, shall report the conviction to the superintendent of insurance within thirty days of the entry date of the judgment of conviction. Within that thirty-day period, the person shall also provide the superintendent with a copy of the judgment, the commitment order or the order imposing a community control sanction, and any other relevant docu...

...No administrator shall do any of the following: (A) Use plan sponsor funds for any purpose or purposes not specifically set forth in written form by the administrator; (B) Fail to disclose in written solicitation material and on an on-going basis, at least once annually, to the plan sponsor all of the following: (1) All fixed plan costs, identifying what each fixed cost includes; (2) Levels of the specific excess...

...(A) Administrators shall maintain detailed books and records that reflect all administered transactions specifically in regard to premiums or contributions received and deposited and claims and authorized expenses paid. (B) The detailed preparation, journalizing, and posting of such books and records shall be made in accordance with the terms and conditions of the service agreement between the administrator and the ...

...Sections 3959.01 to 3959.16 of the Revised Code do not apply to an employer's self-insurance plan to the extent that federal law supersedes, preempts, prohibits, or otherwise precludes the application of any provisions of those sections to such plan.

...On receipt of a notice pursuant to section 3123.43 of the Revised Code, the superintendent of insurance shall comply with sections 3123.41 to 3123.50 of the Revised Code and any applicable rules adopted under section 3123.63 of the Revised Code with respect to a license issued pursuant to this chapter.

...(A) As used in this section: (1) "Cost-sharing" means the cost to an individual insured under a health benefit plan according to any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket expense requirements imposed by the plan. (2) "Health benefit plan" and "health plan issuer" have the same meanings as in section 3922.01 of the Revised Code. (3) "Pharmacy audit" has the same meaning as in...

...No health plan issuer, pharmacy benefit manager, or any other administrator shall prohibit a pharmacy from mailing or delivering drugs to patients as an ancillary service.

...A person who violates section 3959.05 of the Revised Code is guilty of a misdemeanor of the fourth degree.

...hed by rules adopted by the accountancy board. (B) "Public accounting firm" means a sole proprietorship, a partnership, a limited liability company, a professional association, a corporation-for-profit, or any other business organization that is engaged in the practice of public accounting in this state. (C) "Opinion report" means any opinion on a financial statement that is expressed in accordance with generally...

...There is hereby created the accountancy board, consisting of nine members appointed by the governor with the advice and consent of the senate. Eight of the members shall be certified public accountants of whom: (A) At least two shall be in active public accounting practice in public accounting firms having offices only in this state; (B) At least two shall be in active public accounting practice in public accountin...