2006 Ohio Revised Code - 1753.05. Economic profiling of provider.

§ 1753.05. Economic profiling of provider.
 

(A)  A health insuring corporation may use economic profiling as a factor in credentialing a provider, however, such economic profiling shall take into consideration the case mix, severity of illness, and age of patients. 

(B)  For an initial applicant, a health insuring corporation may request information necessary to perform an economic profile. If information on case mix, severity of illness, and age of patients is requested by a health insuring corporation and not produced by the applicant, the health insuring corporation is not required to take these factors into consideration in its economic profile of the provider. 

(C)  Nothing in this section prohibits a health insuring corporation from taking into consideration the quality and appropriateness of care provided by a provider when deciding whether to employ, contract with, or terminate the provider. 
 

HISTORY: 147 v H 361. Eff 10-1-98.
 

The effective date is set by section 3 of HB 361.