Effective: March 24, 2021
Latest Legislation: Senate Bill 284 - 133rd General Assembly
(A) As used in this section:
(1) "Health benefit plan" and "health plan issuer" have the same meanings as in section 3922.01 of the Revised Code.
(2) "Mental Health Parity and Addiction Equity Act" means the federal "Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008," Pub. L. No. 110-343, as amended, and any federal regulations implementing that act.
(B) Each health plan issuer and health benefit plan subject to the Mental Health Parity and Addiction Equity Act shall comply with all applicable requirements of that act. The requirements of this section do not apply to a health plan issuer or a health benefit plan that is exempt from the requirements of that act by operation of law or other federal guidance.
(C) The superintendent of insurance shall implement and enforce all applicable provisions of the Mental Health Parity and Addiction Equity Act and shall do all of the following:
(1) Proactively ensure compliance by health plan issuers;
(2) Evaluate all consumer and provider complaints regarding mental health and substance use disorder benefits for possible parity violations;
(3) Adopt rules in accordance with Chapter 119. of the Revised Code as necessary to do both of the following:
(a) Effectuate any provisions of the Mental Health Parity and Addiction Equity Act that relate to the business of insurance;
(b) Enforce, monitor compliance with, and ensure continued compliance with this section.
(D) Nothing in this section is subject to the requirements of section 3901.71 of the Revised Code.
Structure Ohio Revised Code
Chapter 3902 | Insurance Policies and Contracts
Section 3902.01 | Purpose of Sections.
Section 3902.02 | Insurance Policy and Contract Definitions.
Section 3902.03 | Policies to Which Sections Apply - Exceptions - Non-English Language Policies.
Section 3902.04 | Requirements for Policy Forms.
Section 3902.05 | Construction.
Section 3902.06 | Superintendent May Authorize Lower Test Score.
Section 3902.07 | Approval of Policy Form Notwithstanding Provisions of Other Laws.
Section 3902.08 | Policy Forms Compliance Date.
Section 3902.11 | Coordination of Benefits Definitions.
Section 3902.12 | Primary or Secondary Health Coverage.
Section 3902.13 | Order of Benefits for Health Coverage Plan.
Section 3902.21 | Standard Claim Form Definitions.
Section 3902.22 | Superintendent to Develop Standard Claim Form.
Section 3902.23 | Use of Form Mandatory.
Section 3902.30 | Coverage for Telehealth Services.
Section 3902.31 | Void Contracts.
Section 3902.36 | Compliance With Federal Mental Health and Addiction Parity Laws.
Section 3902.50 | Definitions for r.c. 3902.50 to 3902.72.
Section 3902.51 | Out-of-Network Care Reimbursement Requirement, Negotiations.
Section 3902.52 | Out-of-Network Care Arbitration.
Section 3902.53 | Out-of-Network Care Rules, Prompt Pay Requirements, Violations.
Section 3902.54 | Out-of-Network Care Arbitrator Requirements.
Section 3902.60 | Advanced Cancer Fail First Drug Coverage Definitions.
Section 3902.61 | Advanced Cancer Fail First Drug Coverage Prohibitions.
Section 3902.62 | Coverage for Drugs Refilled Without a Prescription.
Section 3902.70 | Health Plan Issuer Contracts With 340b Program Participants Definitions.
Section 3902.71 | Health Plan Issuer Contracts With 340b Program Participants.
Section 3902.72 | Health Plan Issuer Disclosure of Drug Data.