Effective: September 29, 2013
Latest Legislation: House Bill 59 - 130th General Assembly
(A) Each health insuring corporation that provides coverage to medicaid recipients shall post a performance bond in the amount of three million dollars as security to fulfill the obligations of the health insuring corporation to pay claims of contracted providers for covered health care services provided to medicaid recipients. The bond shall be payable to the department of insurance in the event that the health insuring corporation is placed in rehabilitation or liquidation proceedings under Chapter 3903. of the Revised Code, and shall become a special deposit subject to section 3903.14 or 3903.421 of the Revised Code, as applicable. In lieu of the performance bond, a medicaid health insuring corporation may deposit securities with the superintendent of insurance, acceptable to the superintendent, in the amount of three million dollars, to satisfy the bonding requirements of this section. Upon rehabilitation or liquidation, the securities shall become a special deposit subject to sections 3903.14 and 3903.421 of the Revised Code, as applicable. The health insuring corporation shall receive the interest on the deposited securities as long as the health insuring corporation remains solvent.
(B) The bond shall be issued by a surety company licensed with the department of insurance. The bond or deposit, or any replacement bond or deposit, shall be in a form acceptable to the superintendent, and shall remain in effect during the duration of the medicaid health insuring corporation's license and thereafter until all claims against the medicaid health insuring corporation have been paid in full.
(C) Documentation of the bond acceptable to the superintendent of insurance shall be filed with the superintendent prior to the issuance of a certificate of authority. Annually, thirty days prior to the renewal of its certificate of authority, every medicaid health insuring corporation shall furnish the superintendent of insurance with evidence that the required bond is still in effect.
(D) As used in this section:
(1) "Contracted provider" means a provider that has a contract with a medicaid health insuring corporation to provide covered health care services to medicaid recipients.
(2) "Medicaid health insuring corporation" means a health insuring corporation that provides health insurance coverage or otherwise assumes claims liabilities for medicaid recipients.
(3) "Medicaid recipient" means a person enrolled in the medicaid program.
Structure Ohio Revised Code
Title 17 | Corporations-Partnerships
Chapter 1751 | Health Insuring Corporation Law
Section 1751.01 | Health Insuring Corporation Law Definitions.
Section 1751.02 | Applying for Certificate of Authority.
Section 1751.03 | Verification of Application.
Section 1751.04 | Review of Application and Documents by Superintendent.
Section 1751.05 | Issuance or Denial of Certificate of Authority.
Section 1751.06 | Powers Upon Obtaining Certificate.
Section 1751.07 | Responsibility for Funds.
Section 1751.08 | Inapplicability of Insurance Laws.
Section 1751.11 | Evidence of Coverage.
Section 1751.12 | Contractual Periodic Prepayment or Premium Rate.
Section 1751.13 | Contracts With Providers and Health Care Facilities.
Section 1751.14 | Termination of Coverage of Child.
Section 1751.18 | Cancelling or Failing to Renew Coverage.
Section 1751.19 | Complaint System.
Section 1751.20 | Unfair, Untrue, Misleading, or Deceptive Acts.
Section 1751.21 | Peer Review Committee.
Section 1751.25 | Investment of Funds.
Section 1751.26 | Investments in Real Estate.
Section 1751.27 | Deposit of Securities With Superintendent or Custodian.
Section 1751.271 | Medicaid Providers - Performance Bond.
Section 1751.31 | Changes in Corporation's Solicitation Document.
Section 1751.32 | Annual Report.
Section 1751.321 | Audit Report Filed Annually.
Section 1751.33 | Information to Be Provided to Subscribers.
Section 1751.34 | Examinations by Superintendent and Director.
Section 1751.35 | Suspension or Revocation of Certificate of Authority.
Section 1751.38 | Applicability of Other Laws.
Section 1751.40 | Insurance Companies Operating as Health Insuring Corporations.
Section 1751.42 | Rehabilitation, Liquidation, Supervision or Conservation of Corporation.
Section 1751.44 | Fees Paid to Superintendent of Insurance.
Section 1751.45 | Administrative Penalties - Violations.
Section 1751.46 | Recommendations for Expansion of Service Areas.
Section 1751.47 | Adopting Forms, Instructions and Manuals for Providing Financial Information.
Section 1751.51 | Restrictions on Choice of Providers.
Section 1751.52 | Confidentiality of Information.
Section 1751.521 | Medical Information Release.
Section 1751.53 | Continuing Coverage After Termination of Employment.
Section 1751.54 | Continuing Coverage After Reservist Called to Duty.
Section 1751.55 | Effect of Workers Compensation Coverage.
Section 1751.56 | Effect of Supplemental Sickness and Accident Insurance Policy.
Section 1751.57 | Conditions Applying to All Individual Health Insuring Corporation Contracts.
Section 1751.59 | Coverage of Adopted Children.
Section 1751.61 | Coverage for Newly Born Child.
Section 1751.62 | Screening Mammography - Cytologic Screening for Cervical Cancer.
Section 1751.63 | Long-Term Care Insurance.
Section 1751.65 | Health Insuring Corporation - Prohibited Activities.
Section 1751.66 | Prescription Drugs.
Section 1751.67 | Maternity Benefits.
Section 1751.68 | Provisions for Medication Synchronization for Enrollees.
Section 1751.70 | Authorization of Payroll Deductions for Public Employees.
Section 1751.71 | Accepting Payments for Cost of Policies, Contracts, and Agreements.
Section 1751.72 | Policy, Contract, or Agreement Containing a Prior Authorization Requirement.
Section 1751.73 | Implementing Quality Assurance Programs.
Section 1751.74 | Quality Assurance Program Requirements.
Section 1751.75 | Determination That Accreditation Constitutes Compliance.
Section 1751.77 | Utilization Review, Internal and External Review Procedure Definitions.
Section 1751.78 | Application of Provisions.
Section 1751.79 | Utilization Review Program Requirements.
Section 1751.80 | Implementing Utilization Review Programs.
Section 1751.811 | Internal and External Reviews.
Section 1751.82 | Reconsideration of Adverse Determination.
Section 1751.821 | Determination That Accreditation Constitutes Compliance.
Section 1751.822 | Cooperation With Utilization Review Program.
Section 1751.823 | Filing Certificate of Compliance.
Section 1751.83 | Maintaining Internal Review System.
Section 1751.84 | Coverage for Autism Spectrum Disorder.
Section 1751.85 | Information for Vision Care Services or Materials.
Section 1751.86 | Violation Deemed Unfair and Deceptive Act or Practice.
Section 1751.87 | Cause of Action Not Created.
Section 1751.89 | Medicare and Medicaid Exceptions.
Section 1751.90 | Coverage for Teledentistry.
Section 1751.91 | Reimbursement for Pharmacists Providing Health Care.