State Law

Ohio Revised Code-Title XVII-Chapter 1753. Physician-Health Plan Partnership Act; Risk-Based Capital for Insurers Model Act

08/17/2023 Ohio Section 1753.16

Retroactively denying authorization

Retroactive Denial

A health insuring corporation or utilization review organization that authorizes a proposed admission, treatment, or health care service by a participating provider based upon the complete and accurate submission of all necessary information relative to an eligible enrollee shall not retroactively deny this authorization if the provider renders the health care service in good faith and pursuant to the authorization and all of the terms and conditions of the provider’s contract with the health insuring corporation.