Section 3901.93
(A) As used in this section:
(1) "Department" has the same meaning as in section 121.01 of the Revised Code.
(2) "Health plan issuer" has the same meaning as in section 3922.01 of the Revised Code.
(3) "Medicaid managed care organization" has the same meaning as in section 5167.01 of the Revised Code.
(4) "Payer" includes a health plan issuer, a medicaid managed care organization, the medicaid program, and the medicare program.
(B)(1) Not later than one year after the effective date of this section, the superintendent of insurance shall establish and administer an all-payer claims database.
(2) To the extent permitted by federal law and except as otherwise provided in this division, each payer shall submit its claims to the superintendent for inclusion in the database. Such claims shall be submitted in the format and according to the schedule prescribed by the superintendent in rule.
In the case of a payer that is a health plan issuer, the requirement to submit claims begins January 1, 2028.
(3) The superintendent shall include in the database each claim the superintendent receives.
(4) The superintendent shall make claims information included in the database available to any person or government entity. The superintendent may require a person to obtain a subscription with the department of insurance to access information included in the database in accordance with section 149.43 of the Revised Code.
(C) The superintendent shall adopt rules to implement this section, including rules establishing standards and procedures for the following:
(1) Submitting claims for inclusion in the database, including the prescribed format and schedule;
(2) Maintaining the privacy and security of personal and health information contained in claims;
(3) Making available to persons or government entities claims information from the database;
(4) Imposing penalties when claims are not submitted.
The superintendent may adopt any other rules the superintendent considers necessary to implement this section. All rules shall be adopted in accordance with Chapter 119. of the Revised Code.
(D) Notwithstanding any provision of section 121.95 of the Revised Code to the contrary, a regulatory restriction contained in a rule adopted under division (C) of this section is not subject to sections 121.95 to 121.953 of the Revised Code.
Last updated August 12, 2026 at 4:14 PM
Available Versions of this Section
- October 6, 2026 – Enacted by Senate Bill 315 - 136th General Assembly [ View October 6, 2026 Version ]