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Ohio Statutes, Title 17

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Title 17, Title 17. Corporations-Partnerships

41 chapters · 1,271 sections in this title.

All chapters in Title 171,271 Ch 1701, Chapter 1701 | General Corporation Law118 Ch 1706, Chapter 1706 | Ohio Revised Limited …92 Ch 1751, Chapter 1751 | Health Insuring Corpo…83 Ch 1707, Chapter 1707 | Securities77 Ch 1733, Chapter 1733 | Credit Unions77 Ch 1782, Chapter 1782 | Limited Partnerships76 Ch 1776, Chapter 1776 | Ohio Uniform Partners…73 Ch 1702, Chapter 1702 | Nonprofit Corporation Law67 Ch 1745, Chapter 1745 | Uniform Unincorporate…54 Ch 1729, Chapter 1729 | Ohio Cooperative Law53 Ch 1715, Chapter 1715 | Religious And Benevol…52 Ch 1713, Chapter 1713 | Educational Corporations50 Ch 1711, Chapter 1711 | Agricultural Societie…40 Ch 1703, Chapter 1703 | Foreign Corporations30

1,271 sections·Filtered byTitle 17✕

Ohio Rev. Code Ann. § 1751.46 Recommendations for expansion of service areas
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(A) The superintendent of insurance may contract with qualified persons to make recommendations concerning the determinations required to be made by the superintendent relative to an expansion of a service area pursuant to division (C) of section 1751.03 of the Revised Code, an a…
Ohio Rev. Code Ann. § 1751.47 Adopting forms, instructions and manuals for providing financial information
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(A) The superintendent of insurance shall adopt the forms, instructions, and manuals prescribed by the national association of insurance commissioners for the preparation and filing of statutory financial statements and other financial information. However, the superintendent may…
Ohio Rev. Code Ann. § 1751.48 Rules
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The superintendent of insurance may adopt rules as are necessary to carry out the provisions of this chapter. These rules shall be adopted in accordance with Chapter 119. of the Revised Code.
Ohio Rev. Code Ann. § 1751.51 Restrictions on choice of providers
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If a health care plan of a health insuring corporation covers health care services that may be legally performed by a class of providers referred to in section 3923.23 or 3923.231 of the Revised Code but would restrict an enrollee's ability to receive these health care services f…

Showing 1,001–1,050 of 1,271

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Ohio Rev. Code Ann. § 1751.52 Confidentiality of information

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(A) All applications, filings, and reports required under this chapter shall be treated as public documents after the date the application, filing, or report becomes effective, regardless of the application of the Uniform Trade Secrets Act set forth in sections 1333.61 to 1333.69…

Ohio Rev. Code Ann. § 1751.521 Medical information release

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If an enrollee signs a medical information release upon the request of a health insuring corporation, the release shall clearly explain what information may be disclosed under the terms of the release. If a health insuring corporation utilizes this release to request medical info…

Ohio Rev. Code Ann. § 1751.53 Continuing coverage after termination of employment

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(A) As used in this section: (1) "Group contract" means a group health insuring corporation contract covering employees that meets either of the following conditions:(a) The contract was issued by an entity that, on June 4, 1997, holds a certificate of authority or license to ope…

Ohio Rev. Code Ann. § 1751.54 Continuing coverage after reservist called to duty

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(A) As used in this section:(1) "Eligible person" means any person who, at the time a reservist is called or ordered to active duty, is covered under a group contract and is either of the following:(a) An employee who is a reservist called or ordered to active duty;(b) The spouse…

Ohio Rev. Code Ann. § 1751.55 Effect of workers compensation coverage

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A health insuring corporation policy, contract, or agreement shall not be construed to exclude illness or injury upon the ground that the subscriber might have elected to have such illness or injury covered by workers' compensation under Chapter 4123. of the Revised Code unless t…

Ohio Rev. Code Ann. § 1751.56 Effect of supplemental sickness and accident insurance policy

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(A) No individual or group health insuring corporation policy, contract, or agreement shall be delivered, issued for delivery, or renewed in this state, if the policy, contract, or agreement excludes or reduces the benefits payable to or on behalf of an insured because benefits a…

Ohio Rev. Code Ann. § 1751.57 Conditions applying to all individual health insuring corporation contracts

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(A) The following conditions apply to all individual health insuring corporation contracts:(1) Except as provided in section 2742(b) to (e) of the "Health Insurance Portability and Accountability Act of 1996," Pub. L. No. 104-191, 110 Stat. 1955, 42 U.S.C.A. 300gg-42, as amended,…

Ohio Rev. Code Ann. § 1751.58 Conditions applying to all group health insuring corporation contracts sold in connection with employment-related group health care plan

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Except as otherwise provided in section 2721 of the "Health Insurance Portability and Accountability Act of 1996," Pub. L. No. 104-191, 110 Stat. 1955, 42 U.S.C.A. 300gg-21, as amended, the following conditions apply to all group health insuring corporation contracts that are sol…

Ohio Rev. Code Ann. § 1751.59 Coverage of adopted children

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No individual or group health insuring corporation policy, contract, or agreement that makes family coverage available may be delivered, issued for delivery, or renewed in this state, unless the policy, contract, or agreement covers adopted children of the subscriber on the same …

Ohio Rev. Code Ann. § 1751.60 Provider or facility limited to seek compensation for covered services solely from HIC

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(A) Except as provided for in divisions (E) and (F) of this section, every provider or health care facility that contracts with a health insuring corporation to provide health care services to the health insuring corporation's enrollees or subscribers shall seek compensation for …

Ohio Rev. Code Ann. § 1751.61 Coverage for newly born child

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(A) Each individual or group evidence of coverage that is delivered, issued for delivery, or renewed by a health insuring corporation in this state, and that makes coverage available for family members of a subscriber, also shall provide that coverage applicable to children is pa…

Ohio Rev. Code Ann. § 1751.62 Screening mammography - cytologic screening for cervical cancer

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(A) As used in this section: (1) "Screening mammography" means a radiologic examination utilized to detect unsuspected breast cancer at an early stage in an asymptomatic woman and includes the x-ray examination of the breast using equipment that is dedicated specifically for mamm…

Ohio Rev. Code Ann. § 1751.63 Long-term care insurance

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Sections 3923.41 to 3923.48 of the Revised Code apply to every health insuring corporation that offers long-term care and that holds a certificate of authority under this chapter.

Ohio Rev. Code Ann. § 1751.65 Health insuring corporation - prohibited activities

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(A) As used in this section, "genetic screening or testing" means a laboratory test of a person's genes or chromosomes for genotypes, mutations, or chromosomal changes, including carrier status, that are linked to physical or mental disorders or impairments, or that indicate a su…

Ohio Rev. Code Ann. § 1751.66 Prescription drugs

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(A) No individual or group health insuring corporation policy, contract, or agreement that provides coverage for prescription drugs shall limit or exclude coverage for any drug approved by the United States food and drug administration on the basis that the drug has not been appr…

Ohio Rev. Code Ann. § 1751.67 Maternity benefits

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(A) Each individual or group health insuring corporation policy, contract, or agreement delivered, issued for delivery, or renewed in this state that provides maternity benefits shall provide coverage of inpatient care and follow-up care for a mother and her newborn as follows:(1…

Ohio Rev. Code Ann. § 1751.68 Provisions for medication synchronization for enrollees

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(A) As used in this section:(1) "Cost-sharing" means the cost to an enrollee under an individual or group health insuring corporation policy, contract, or agreement according to any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket expense requirements im…

Ohio Rev. Code Ann. § 1751.69 Cancer chemotherapy; coverage for orally and intravenously administered treatments

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(A) As used in this section, "cost sharing" means the cost to an individual insured under an individual or group health insuring corporation policy, contract, or agreement according to any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket expense requirem…

Ohio Rev. Code Ann. § 1751.691 Prior authorization requirements or other utilization review measures as conditions of providing coverage of an opioid analgesic

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(A) As used in this section: (1) "Benzodiazepine" has the same meaning as in section 3719.01 of the Revised Code. (2) "Chronic pain" has the same meaning as in section 4731.052 of the Revised Code. (3) "Hospice care program" and "hospice patient" have the same meanings as in sect…

Ohio Rev. Code Ann. § 1751.70 Authorization of payroll deductions for public employees

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(A) An employee of the state, of any political subdivision of the state, or of any institution supported in whole or in part by the state, may authorize the deduction from the employee's salary or wages of the amount of the employee's premium rate to any health insuring corporati…

Ohio Rev. Code Ann. § 1751.71 Accepting payments for cost of policies, contracts, and agreements

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Each health insuring corporation subject to this chapter may accept from governmental agencies, or from private persons, payments covering all or part of the cost of policies, contracts, and agreements entered into between the health insuring corporation and its subscribers or gr…

Ohio Rev. Code Ann. § 1751.72 Policy, contract, or agreement containing a prior authorization requirement

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(A) As used in this section:(1) "Chronic condition" means a medical condition that has persisted after reasonable efforts have been made to relieve or cure its cause and has continued, either continuously or episodically, for longer than six continuous months.(2) "Clinical peer" …

Ohio Rev. Code Ann. § 1751.73 Implementing quality assurance programs

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Each health insuring corporation providing basic health care services shall implement a quality assurance program for use in connection with those policies, contracts, and agreements providing basic health care services. Each health insuring corporation required to implement a qu…

Ohio Rev. Code Ann. § 1751.74 Quality assurance program requirements

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(A) To implement a quality assurance program required by section 1751.73 of the Revised Code, a health insuring corporation shall do both of the following: (1) Develop and maintain the appropriate infrastructure and disclosure systems necessary to measure and report, on a regular…

Ohio Rev. Code Ann. § 1751.75 Determination that accreditation constitutes compliance

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A health insuring corporation may present evidence of compliance with the requirements of sections 1751.73 and 1751.74 of the Revised Code by submitting certification to the superintendent of insurance of its accreditation by an independent, private accrediting organization, such…

Ohio Rev. Code Ann. § 1751.77 Utilization review, internal and external review procedure definitions

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As used in sections 1751.77 to 1751.87 of the Revised Code, unless otherwise specifically provided or as otherwise required pursuant to applicable federal law or regulations: (A) "Adverse determination" means a determination by a health insuring corporation or its designee utiliz…

Ohio Rev. Code Ann. § 1751.78 Application of provisions

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(A)(1) Sections 1751.77 to 1751.87 and Chapter 3922. of the Revised Code apply to any health insuring corporation that provides or performs utilization review services in connection with its policies, contracts, and agreements covering basic health care services and to any design…

Ohio Rev. Code Ann. § 1751.79 Utilization review program requirements

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A health insuring corporation that conducts utilization review shall prepare a written utilization review program that describes all review activities, both delegated and nondelegated, for covered health care services provided, including the following:(A) Procedures to evaluate t…

Ohio Rev. Code Ann. § 1751.80 Implementing utilization review programs

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The utilization review program of a health insuring corporation shall be implemented in accordance with all of the following:(A) The program shall use documented clinical review criteria that are based on sound clinical evidence and are evaluated periodically to assure ongoing ef…

Ohio Rev. Code Ann. § 1751.81 Maintaining written procedures for determining whether requested service is covered

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(A) As used in this section, "necessary information" includes the results of any face-to-face clinical evaluation or second opinion that may be required(B) A health insuring corporation shall maintain written procedures for determining whether a requested service is a service cov…

Ohio Rev. Code Ann. § 1751.811 Internal and external reviews

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In lieu of conducting a prospective, concurrent, or retrospective review under section 1751.81 of the Revised Code, providing a reconsideration under section 1751.82 of the Revised Code, or conducting an internal review under section 1751.83 of the Revised Code, a health insuring…

Ohio Rev. Code Ann. § 1751.82 Reconsideration of adverse determination

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(A) In a case involving a prospective determination or a concurrent review determination, a health insuring corporation shall give the provider or health care facility rendering the health care service an opportunity to request in writing on behalf of the enrollee a reconsiderati…

Ohio Rev. Code Ann. § 1751.821 Determination that accreditation constitutes compliance

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A health insuring corporation may present evidence of compliance with the requirements of sections 1751.77 to 1751.82 of the Revised Code by submitting evidence to the superintendent of insurance of its accreditation by an independent, private accrediting organization, such as th…

Ohio Rev. Code Ann. § 1751.822 Cooperation with utilization review program

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Each participating provider or health care facility submitting a claim shall cooperate with the utilization review program of a health insuring corporation or utilization review organization and shall provide the health insuring corporation or its designee access to an enrollee's…

Ohio Rev. Code Ann. § 1751.823 Filing certificate of compliance

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A health insuring corporation shall annually file a certificate with the superintendent of insurance certifying its compliance with sections 1751.77 to 1751.82 of the Revised Code.

Ohio Rev. Code Ann. § 1751.83 Maintaining internal review system

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A health insuring corporation shall establish and maintain an internal review system that has been approved by the superintendent of insurance. The system shall provide for review by a clinical peer and include adequate and reasonable procedures for review and resolution of appea…

Ohio Rev. Code Ann. § 1751.84 Coverage for autism spectrum disorder

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(A) Notwithstanding section 3901.71 of the Revised Code, each individual and group health insuring corporation policy, contract, or agreement providing basic health care services that is delivered, issued for delivery, or renewed in this state shall provide coverage for the scree…

Ohio Rev. Code Ann. § 1751.85 Information for vision care services or materials

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(A) As used in this section, "covered dental services," "covered vision services," "dental care provider," "vision care materials," and "vision care provider" have the same meanings as in section 3963.01 of the Revised Code. (B) A health insuring corporation shall provide the inf…

Ohio Rev. Code Ann. § 1751.86 Violation deemed unfair and deceptive act or practice

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(A) No health insuring corporation shall fail to comply with sections 1751.77 to 1751.82 of the Revised Code.(B) Whoever violates division (A) of this section is deemed to have engaged in an unfair and deceptive act or practice in the business of insurance under sections 3901.19 …

Ohio Rev. Code Ann. § 1751.87 Cause of action not created

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Nothing in sections 1751.77 to 1751.83 of the Revised Code shall be construed to create a cause of action against an employer that provides health care benefits to employees through a health insuring corporation.

Ohio Rev. Code Ann. § 1751.89 Medicare and medicaid exceptions

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Sections 1751.77 to 1751.83 of the Revised Code do not apply to either of the following: (A) Coverage provided to beneficiaries enrolled in the medicare+choice program operated under Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended;(B) Co…

Ohio Rev. Code Ann. § 1751.90 Coverage for teledentistry

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(A) As used in this section, "teledentistry" has the same meaning as in section 4715.43 of the Revised Code. (B) No individual or group health insuring corporation policy, contract, or agreement shall deny coverage for the costs of any services provided to an insured through tele…

Ohio Rev. Code Ann. § 1751.91 Reimbursement for pharmacists providing health care

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A health insuring corporation may provide payment or reimbursement to a pharmacist for providing a health care service to a patient if both of the following are the case: (A) The pharmacist provided the health care service to the patient in accordance with Chapter 4729. of the Re…

Ohio Rev. Code Ann. § 1751.92 Compliance cost-sharing provisions

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Each health insuring corporation shall comply with the requirements of section 3957.26 of the Revised Code as they pertain to health plan issuers. As used in this section, "health plan issuer" has the same meaning as in section 3922.01 of the Revised Code. Last updated April 13, …

Ohio Rev. Code Ann. § 1753.01 Physician-health plan partnership act definitions

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As used in this chapter, "basic health care services," "enrollee," "health care facility," "health care services," "health insuring corporation," "medical record," "person," "primary care provider," "provider," "specialty health care services," "subscriber," and "supplemental hea…

Ohio Rev. Code Ann. § 1753.06 Notice of status of the provider's application

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A health insuring corporation shall notify a provider seeking to enter into a participation contract with the health insuring corporation of the status of the provider's application within one hundred twenty days after the health insuring corporation's receipt of the provider's c…