Ohio Revised Code
Chapter 3902 | Insurance Policies and Contracts
Section 3902.71 | Health Plan Issuer Contracts With 340b Program Participants.

Effective: April 12, 2021
Latest Legislation: Senate Bill 263 - 133rd General Assembly
(A) On and after the effective date of this section , a contract entered into between a health plan issuer, including a third-party administrator, and a 340B covered entity shall not contain any of the following provisions:
(1) A reimbursement rate for a prescription drug that is less than the national average drug acquisition cost rate for that drug as determined by the United States centers for medicare and medicaid services, measured at the time the drug is administered or dispensed, or, if no such rate is available at that time, a reimbursement rate that is less than the wholesale acquisition cost of the drug, as defined in 42 U.S.C. 1395w-3a(c)(6)(B);
(2) A dispensing fee reimbursement amount that is less than the reimbursement amount provided to a terminal distributor of dangerous drugs under section 5164.753 of the Revised Code;
(3) A fee that is not imposed on a health care provider that is not a 340B covered entity;
(4) A fee amount that exceeds the fee amount for a health care provider that is not a 340B covered entity.
(B) No health plan issuer or third-party administrator making payments pursuant to a health benefit plan shall discriminate against a 340B covered entity in a manner that prevents or interferes with an enrollee's choice to receive a prescription drug from a 340B covered entity or its contracted pharmacies.
(C) Any provision of a contract entered into between a health plan issuer and a 340B covered entity that is contrary to division (A) of this section is unenforceable and shall be replaced with the dispensing fee or reimbursement rate that applies for health care providers that are not 340B covered entities.

Structure Ohio Revised Code

Ohio Revised Code

Title 39 | Insurance

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 3902.14 | Rules.

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.