Ohio Revised Code Chapter 1753 - Physician-health Plan Partnership Act; Risk-based Capital For Insurers Model Act

• Section 1753.01 - Physician-health Plan Partnership Act Definitions.
  As used in this chapter "basic health care services," "enrollee," "health care facility," "health care services," "health insuring corporation," "medical record," "person," "primary care...
• Section 1753.03 - [Repealed].
  Effective Date: 10-01-1998; 2008 HB125 06-25-2008
• Section 1753.04 - [Repealed].
  Effective Date: 10-01-1998; 2008 HB125 06-25-2008
• Section 1753.05 - [Repealed].
  Effective Date: 10-01-1998; 2008 HB125 06-25-2008
• Section 1753.06 - Notice Of Status Of The Provider's Application.
  A health insuring corporation shall notify a provider seeking to enter into a participation contract with the health insuring corporation of the status of...
• Section 1753.07 - Information Given To Provider.
  (A) (1) Prior to entering into a participation contract with a provider under section 1751.13 of the Revised Code, a health insuring corporation shall...
• Section 1753.08 - [Repealed].
  Effective Date: 10-01-1998; 2008 HB125 06-25-2008
• Section 1753.09 - Terminating Participation Of Provider.
  (A) Except as provided in division (D) of this section, prior to terminating the participation of a provider on the basis of the participating...
• Section 1753.10 - Categories Of Providers.
  Nothing in this chapter or Chapter 1751. of the Revised Code requires a health insuring corporation to employ or contract with, or prohibits a...
• Section 1753.13 - Obtaining Covered Obstetric And Gynecological Services Without Referral.
  Every individual or group health insuring corporation policy, contract, or agreement that provides basic health care services but does not allow direct access to...
• Section 1753.14 - Procedures For Standing Referrals To Specialists.
  (A) A health insuring corporation that does not allow direct access to all specialists shall establish and implement a procedure by which an enrollee...
• Section 1753.16 - Retroactively Denying Authorization.
  A health insuring corporation or utilization review organization that authorizes a proposed admission, treatment, or health care service by a participating provider based upon...
• Section 1753.21 - Prescription Drugs.
  (A) If a policy, contract, or agreement of a health insuring corporation uses a restricted formulary of prescription drugs, the health insuring corporation shall...
• Section 1753.23 - Internal Technology Assessment Process.
  A health insuring corporation that provides basic health care services shall establish or use an internal technology assessment process for assessing whether a drug,...
• Section 1753.24 - Amended And Renumbered Rc 1751.85.
  Effective Date: 05-01-2000
• Section 1753.28 - Emergency Services Coverage.
  (A) As used in this section: (1) "Emergency medical condition" means a medical condition that manifests itself by such acute symptoms of sufficient severity,...
• Section 1753.281 - [Repealed].
  Effective Date: 03-31-2005; 03-30-2005
• Section 1753.30 - Other Insurance Provisions.
  Nothing in this chapter shall prevent or otherwise affect the application to any health care plan of those provisions of Title XVII [17] or...
• Section 1753.31 - Risk-based Capital For Insurers Model Act Definitions.
  As used in sections 1753.31 to 1753.43 of the Revised Code: (A) "Adjusted RBC report" means an RBC report that has been adjusted by...
• Section 1753.32 - Annual Report.
  (A) Each domestic health insuring corporation shall, on or prior to the first day of March of every year, prepare and submit to the...
• Section 1753.33 - Company Action Level Event.
  (A) For purposes of sections 1753.31 to 1753.43 of the Revised Code, a "company action level event" is any of the following events: (1)...
• Section 1753.34 - Regulatory Action Level Event.
  (A) For purposes of sections 1753.31 to 1753.43 of the Revised Code, a "regulatory action level event" is any of the following events: (1)...
• Section 1753.35 - Authorized Control Level Event.
  (A) For purposes of sections 1753.31 to 1753.43 of the Revised Code, an "authorized control level event" is any of the following events: (1)...
• Section 1753.36 - Mandatory Control Level Event.
  (A) For purposes of sections 1753.31 to 1753.43 of the Revised Code, a "mandatory control level event" is any of the following events: (1)...
• Section 1753.37 - Right To Confidential Hearing - Request For Hearing - Challenge To Determination Or Action.
  (A) A health insuring corporation has the right to a confidential hearing upon receiving any of the following from the superintendent of insurance: (1)...
• Section 1753.38 - Confidentiality.
  (A) The superintendent of insurance shall keep all of the following confidential: (1) An RBC report, to the extent that information contained in the...
• Section 1753.39 - Foreign Health Insuring Corporation.
  (A) Each foreign health insuring corporation shall submit to the superintendent of insurance, upon receiving the superintendent's written request, an RBC report for the...
• Section 1753.40 - Immunity.
  There shall be no liability on the part of, and no cause of action shall arise against, the superintendent of insurance, or the department...
• Section 1753.41 - When Notices Are Effective.
  Unless otherwise provided, all notices sent to a health insuring corporation by the superintendent of insurance that may result in regulatory action under sections...
• Section 1753.42 - Requirements For Exemption Of Domestic Corporation.
  The superintendent of insurance may exempt any domestic health insuring corporation from the application of sections 1753.31 to 1753.43 of the Revised Code, if...
• Section 1753.43 - Rules.
  The superintendent of insurance may adopt rules in accordance with Chapter 119. of the Revised Code as are reasonably necessary for the implementation and...

Last modified: October 10, 2016