There is a newer version of the Ohio Revised Code
2006 Ohio Revised Code - 1751. Health Insuring Corporation Law.
- 1751.01. Definitions; basic health care service coverage; open panel plans.
- 1751.02. Application for certificate of authority; prohibitions; operation in compliance; exceptions.
- 1751.03. Verification, format of application; accompanying information; notice of changes; expansion of service area.
- 1751.04. Review of application and documents by director of health.
- 1751.05. Issuance or denial of certificate.
- 1751.06. Powers of HIC upon obtaining certificate.
- 1751.07. Fiduciary responsibility for funds.
- 1751.08. Application of insurance laws generally; solicitation of enrollees; HIC not deemed to be practicing medicine.
- 1751.11. Subscriber entitled to evidence of coverage and identification card or document; prior approval of forms by superintendent.
- · · · [1751.11.1] 1751.111.Standardized identification card or electronic technology used for prescription drug claims to contain uniform information.
- 1751.12. Contractual periodic prepayment or premium rate; copayments.
- 1751.13. Contracts with providers and facilities or alternative arrangements; contracts with intermediary organizations; notice of termination.
- 1751.14. When attainment of age limit does not terminate coverage of child.
- · · · [1751.14.1] 1751.141.Dependent children living outside approved service area.
- 1751.15. Annual open enrollment period; transplant coverage; reinsurance program.
- 1751.16. Option for conversion from group to individual contract.
- 1751.17. Nongroup contract option for conversion to direct payment contract.
- 1751.18. Restrictions on canceling or failing to renew coverage; discrimination prohibited; appeals.
- 1751.19. Complaint system.
- 1751.20. Unfair or deceptive acts; use of name in documents and advertising.
- 1751.21. Peer review committees.
- 1751.25. Investment of funds.
- 1751.26. Investments in real estate.
- 1751.27. Deposit of securities with superintendent or custodian.
- · · · [1751.27.1] 1751.271.Medicaid HIC to post performance bond.
- 1751.28. Minimum total admitted assets and net worth requirements.
- 1751.31. Filing of changes in solicitation document; contents and delivery; improper acts to induce enrollment; right to cancel; healthy lifestyle programs.
- 1751.32. Annual report to superintendent and director.
- · · · [1751.32.1] 1751.321.Annual audit report.
- 1751.33. Information to be provided to subscribers.
- 1751.34. Examinations by superintendent and director.
- 1751.35. Suspension or revocation of certificate.
- 1751.36. Notice of grounds for denial, suspension or revocation; hearing.
- 1751.38. Application of insurance agent laws.
- 1751.40. Insurance companies or related entities may operate HIC or serve as reinsurers.
- 1751.42. Rehabilitation, liquidation, supervision or conservation.
- 1751.44. Fees paid to superintendent.
- 1751.45. Administrative penalties; conference concerning suspected violation; cease and desist order or prosecution of action.
- 1751.46. Superintendent and director may contract for recommendations.
- 1751.47. Forms, instructions and manuals for providing financial information.
- 1751.48. Rules.
- 1751.51. Notice of restrictions on choice of providers.
- 1751.52. Access to documents; disclosure of enrollee or applicant information.
- · · · [1751.52.1] 1751.521.Medical information releases.
- 1751.53. Employee's right to continue coverage after termination.
- 1751.54. Continuation of coverage after reservist is called or ordered to active duty.
- 1751.55. Workers' compensation exclusions.
- 1751.56. Supplemental sickness and accident policies.
- 1751.57. Conditions applicable to individual contracts; group contracts unrelated to employment.
- 1751.58. Conditions applicable to employment-related group contracts.
- 1751.59. Coverage of adopted children.
- 1751.60. Provider or facility to seek compensation for covered services solely from HIC.
- 1751.61. Coverage for newly born child.
- 1751.62. Coverage for screening mammography; cytologic screening for cervical cancer.
- 1751.63. Long-term care insurance.
- 1751.64. This version, HB 374 (147 v - ), in effect until 2-9-2014. See following Repeal effective 2-9-2014.
- 1751.64. This version, SB 67 (147 v - ), as amended by HB 95 (150 v - ), in effect 2-9-2014. See preceding section for the version effective until 2-9-2014.
- 1751.65. Prohibitions upon repeal of RC 1751.64
- 1751.66. Prescription drug limitations or exclusions.
- 1751.67. Maternity benefits to include inpatient and follow-up care minimums; early discharge decisions; prohibitions.
- 1751.68. [Repealed]
- 1751.70. Payroll deductions for public employees.
- 1751.71. Public or private subsidies.
Quality Assurance Programs.
- 1751.73. Duty to implement quality assurance program; filing of certificate.
- 1751.74. Contents of program.
- 1751.75. Accreditation of program.
Utilization Review, Internal Review and External Review Procedures.
- 1751.77. Definitions.
- 1751.78. Scope of provisions; monitoring of utilization review activities.
- 1751.79. Contents of utilization review program.
- 1751.80. Implementation of program; delegation; prohibited incentives.
- 1751.81. Procedures for making determinations and providing notice.
- · · · [1751.81.1] 1751.811.Opportunity for external review.
- 1751.82. Provider or facility may request reconsideration of adverse determination; request for internal review.
- · · · [1751.82.1] 1751.821.Accreditation as evidence of compliance.
- · · · [1751.82.2] 1751.822.Cooperation by provider or facility.
- · · · [1751.82.3] 1751.823.Filing of certificate.
- 1751.83. Internal review system; response to request; superintendent's right to inspect documents.
- · · · [1751.83.1] 1751.831.Superintendent's review of determination that service is not covered.
- 1751.84. Opportunity to request external review; decision of independent review organization.
- 1751.85. External, independent review of coverage of enrollees with terminal conditions.
- 1751.86. Violations.
- 1751.87. Causes of action not created.
- 1751.88. Independent review organization's decision or opinion and medicare reimbursement standards as evidence.
- 1751.89. Medicare and medicaid exceptions.
Disclaimer: These codes may not be the most recent version. Ohio may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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