Effective: December 26, 2011
Latest Legislation: House Bill 218 - 129th General Assembly
Consistent with the Rules of Evidence, a written decision or opinion prepared by an independent review organization under this chapter shall be admissible in any civil action related to the coverage decision that was the subject of the decision or opinion. The independent review organization's decision or opinion shall be presumed to be a scientifically valid and accurate description of the state of medical knowledge at the time it was written.
Consistent with the Rules of Evidence, any party to a civil action related to a plan's decision involving an investigational or experimental drug, device, or treatment may introduce into evidence any applicable medicare reimbursement standards established under Title XVIII of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended.
Structure Ohio Revised Code
Chapter 3922 | External Review
Section 3922.01 | Definitions.
Section 3922.02 | Request for Review of Adverse Benefit Determination.
Section 3922.03 | Internal Appeal Processes; Review of Final Determination.
Section 3922.04 | Exhaustion of Issuer's Internal Appeal Process.
Section 3922.05 | Opportunities for External Review by Independent Review Organization.
Section 3922.06 | Reconsideration by Issuer.
Section 3922.07 | Information Considered for Review.
Section 3922.08 | Provisions Applicable to Standard Reviews; Timing;.
Section 3922.09 | Request for Expedited External Review.
Section 3922.11 | Review by Superintendent of Insurance.
Section 3922.12 | Effect of Decision.
Section 3922.13 | Accreditation of Independent Review Organizations.
Section 3922.14 | Additional Actions for Accreditation.
Section 3922.15 | Qualifications for Clinical Reviewers.
Section 3922.16 | Construction of Chapter; Limitations on Liability.
Section 3922.17 | Maintenance of Records; Reports.
Section 3922.18 | Payment of Costs.
Section 3922.19 | Disclosure of External Review Procedures.
Section 3922.20 | Admissibility of Written Decision or Medicare Reimbursement Standards.
Section 3922.21 | Confidentiality.