As Reported by the Senate Insurance, Commerce and Labor Committee

124th General Assembly
Regular Session
2001-2002
Sub. S. B. No. 281


SENATORS Goodman, Coughlin, Randy Gardner, Nein, Wachtmann, Mead, Hottinger, Harris, Spada, Armbruster, Austria



A BILL
To amend sections 1751.67, 2117.06, 2305.11, 2305.15,1
2305.234, 2317.02, 2317.54, 2323.56, 2711.21,2
2711.22, 2711.23, 2711.24, 2743.02, 2743.43,3
2919.16, 3923.63, 3923.64, 3929.71, 4705.15, and4
5111.018, to enact sections 2305.113, 2323.41,5
2323.43, and 2323.55, and to repeal sections6
2305.27 and 2323.57 of the Revised Code relative to7
medical claims, dental claims, optometric claims,8
and chiropractic claims.9


BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

       Section 1. That sections 1751.67, 2117.06, 2305.11, 2305.15,10
2305.234, 2317.02, 2317.54, 2323.56, 2711.21, 2711.22, 2711.23,11
2711.24, 2743.02, 2743.43, 2919.16, 3923.63, 3923.64, 3929.71,12
4705.15, and 5111.018 be amended and sections 2305.113, 2323.41,13
2323.43, and 2323.55 of the Revised Code be enacted to read as14
follows:15

       Sec. 1751.67.  (A) Each individual or group health insuring16
corporation policy, contract, or agreement delivered, issued for17
delivery, or renewed in this state that provides maternity18
benefits shall provide coverage of inpatient care and follow-up19
care for a mother and her newborn as follows:20

       (1) The policy, contract, or agreement shall cover a minimum21
of forty-eight hours of inpatient care following a normal vaginal22
delivery and a minimum of ninety-six hours of inpatient care23
following a cesarean delivery. Services covered as inpatient care24
shall include medical, educational, and any other services that25
are consistent with the inpatient care recommended in the26
protocols and guidelines developed by national organizations that27
represent pediatric, obstetric, and nursing professionals.28

       (2) The policy, contract, or agreement shall cover a29
physician-directed source of follow-up care. Services covered as30
follow-up care shall include physical assessment of the mother and31
newborn, parent education, assistance and training in breast or32
bottle feeding, assessment of the home support system, performance33
of any medically necessary and appropriate clinical tests, and any34
other services that are consistent with the follow-up care35
recommended in the protocols and guidelines developed by national36
organizations that represent pediatric, obstetric, and nursing37
professionals. The coverage shall apply to services provided in a38
medical setting or through home health care visits. The coverage39
shall apply to a home health care visit only if the provider who40
conducts the visit is knowledgeable and experienced in maternity41
and newborn care.42

       When a decision is made in accordance with division (B) of43
this section to discharge a mother or newborn prior to the44
expiration of the applicable number of hours of inpatient care45
required to be covered, the coverage of follow-up care shall apply46
to all follow-up care that is provided within seventy-two hours47
after discharge. When a mother or newborn receives at least the48
number of hours of inpatient care required to be covered, the49
coverage of follow-up care shall apply to follow-up care that is50
determined to be medically necessary by the provider responsible51
for discharging the mother or newborn.52

       (B) Any decision to shorten the length of inpatient stay to53
less than that specified under division (A)(1) of this section54
shall be made by the physician attending the mother or newborn,55
except that if a nurse-midwife is attending the mother in56
collaboration with a physician, the decision may be made by the57
nurse-midwife. Decisions regarding early discharge shall be made58
only after conferring with the mother or a person responsible for59
the mother or newborn. For purposes of this division, a person60
responsible for the mother or newborn may include a parent,61
guardian, or any other person with authority to make medical62
decisions for the mother or newborn.63

       (C)(1) No health insuring corporation may do either of the64
following:65

       (a) Terminate the participation of a provider or health care66
facility in an individual or group health care plan solely for67
making recommendations for inpatient or follow-up care for a68
particular mother or newborn that are consistent with the care69
required to be covered by this section;70

       (b) Establish or offer monetary or other financial71
incentives for the purpose of encouraging a person to decline the72
inpatient or follow-up care required to be covered by this73
section.74

       (2) Whoever violates division (C)(1)(a) or (b) of this75
section has engaged in an unfair and deceptive act or practice in76
the business of insurance under sections 3901.19 to 3901.26 of the77
Revised Code.78

       (D) This section does not do any of the following:79

       (1) Require a policy, contract, or agreement to cover80
inpatient or follow-up care that is not received in accordance81
with the policy's, contract's, or agreement's terms pertaining to82
the providers and facilities from which an individual is83
authorized to receive health care services;84

       (2) Require a mother or newborn to stay in a hospital or85
other inpatient setting for a fixed period of time following86
delivery;87

       (3) Require a child to be delivered in a hospital or other88
inpatient setting;89

       (4) Authorize a nurse-midwife to practice beyond the90
authority to practice nurse-midwifery in accordance with Chapter91
4723. of the Revised Code;92

       (5) Establish minimum standards of medical diagnosis, care,93
or treatment for inpatient or follow-up care for a mother or94
newborn. A deviation from the care required to be covered under95
this section shall not, solely on the basis of this section, give96
rise to a medical claim or to derivative claims for relief, as97
those terms are defined in section 2305.112305.113 of the Revised98
Code.99

       Sec. 2117.06.  (A) All creditors having claims against an100
estate, including claims arising out of contract, out of tort, on101
cognovit notes, or on judgments, whether due or not due, secured102
or unsecured, liquidated or unliquidated, shall present their103
claims in one of the following manners:104

       (1) To the executor or administrator in a writing;105

       (2) To the executor or administrator in a writing, and to106
the probate court by filing a copy of the writing with it;107

       (3) In a writing that is sent by ordinary mail addressed to108
the decedent and that is actually received by the executor or109
administrator within the appropriate time specified in division110
(B) of this section. For purposes of this division, if an111
executor or administrator is not a natural person, the writing112
shall be considered as being actually received by the executor or113
administrator only if the person charged with the primary114
responsibility of administering the estate of the decedent115
actually receives the writing within the appropriate time116
specified in division (B) of this section.117

       (B) All claims shall be presented within one year after the118
death of the decedent, whether or not the estate is released from119
administration or an executor or administrator is appointed during120
that one-year period. Every claim presented shall set forth the121
claimant's address.122

       (C) A claim that is not presented within one year after the123
death of the decedent shall be forever barred as to all parties,124
including, but not limited to, devisees, legatees, and125
distributees. No payment shall be made on the claim and no action126
shall be maintained on the claim, except as otherwise provided in127
sections 2117.37 to 2117.42 of the Revised Code with reference to128
contingent claims.129

       (D) In the absence of any prior demand for allowance, the130
executor or administrator shall allow or reject all claims, except131
tax assessment claims, within thirty days after their132
presentation, provided that failure of the executor or133
administrator to allow or reject within that time shall not134
prevent the executor or administrator from doing so after that135
time and shall not prejudice the rights of any claimant. Upon the136
allowance of a claim, the executor or the administrator, on demand137
of the creditor, shall furnish the creditor with a written138
statement or memorandum of the fact and date of the allowance.139

       (E) If the executor or administrator has actual knowledge of140
a pending action commenced against the decedent prior to the141
decedent's death in a court of record in this state, the executor142
or administrator shall file a notice of his the appointment of the143
executor or administrator in the pending action within ten days144
after acquiring that knowledge. If the administrator or executor145
is not a natural person, actual knowledge of a pending suit146
against the decedent shall be limited to the actual knowledge of147
the person charged with the primary responsibility of148
administering the estate of the decedent. Failure to file the149
notice within the ten-day period does not extend the claim period150
established by this section.151

       (F) This section applies to any person who is required to152
give written notice to the executor or administrator of a motion153
or application to revive an action pending against the decedent at154
the date of the death of the decedent.155

       (G) Nothing in this section or in section 2117.07 of the156
Revised Code shall be construed to reduce the time mentioned in157
section 2125.02, 2305.09, 2305.10, 2305.11, 2305.113, or 2305.12158
of the Revised Code, provided that no portion of any recovery on a159
claim brought pursuant to any of those sections shall come from160
the assets of an estate unless the claim has been presented161
against the estate in accordance with Chapter 2117. of the Revised162
Code.163

       (H) Any person whose claim has been presented and has not164
been rejected after presentment is a creditor as that term is used165
in Chapters 2113. to 2125. of the Revised Code. Claims that are166
contingent need not be presented except as provided in sections167
2117.37 to 2117.42 of the Revised Code, but, whether presented168
pursuant to those sections or this section, contingent claims may169
be presented in any of the manners described in division (A) of170
this section.171

       (I) If a creditor presents a claim against an estate in172
accordance with division (A)(2) of this section, the probate court173
shall not close the administration of the estate until that claim174
is allowed or rejected.175

       (J) The probate court shall not require an executor or176
administrator to make and return into the court a schedule of177
claims against the estate.178

       (K) If the executor or administrator makes a distribution of179
the assets of the estate prior to the expiration of the time for180
the filing of claims as set forth in this section, the executor181
or administrator shall provide notice on the account delivered to182
each distributee that the distributee may be liable to the estate183
up to the value of the distribution and may be required to return184
all or any part of the value of the distribution if a valid claim185
is subsequently made against the estate within the time permitted186
under this section.187

       Sec. 2305.11.  (A) An action for libel, slander, malicious188
prosecution, or false imprisonment, an action for malpractice189
other than an action upon a medical, dental, optometric, or190
chiropractic claim, or an action upon a statute for a penalty or191
forfeiture shall be commenced within one year after the cause of192
action accrued, provided that an action by an employee for the193
payment of unpaid minimum wages, unpaid overtime compensation, or194
liquidated damages by reason of the nonpayment of minimum wages or195
overtime compensation shall be commenced within two years after196
the cause of action accrued.197

       (B)(1) Subject to division (B)(2) of this section, an action198
upon a medical, dental, optometric, or chiropractic claim shall be199
commenced within one year after the cause of action accrued,200
except that, if prior to the expiration of that one-year period, a201
claimant who allegedly possesses a medical, dental, optometric, or202
chiropractic claim gives to the person who is the subject of that203
claim written notice that the claimant is considering bringing an204
action upon that claim, that action may be commenced against the205
person notified at any time within one hundred eighty days after206
the notice is so given.207

       (2) Except as to persons within the age of minority or of208
unsound mind, as provided by section 2305.16 of the Revised Code:209

       (a) In no event shall any action upon a medical, dental,210
optometric, or chiropractic claim be commenced more than four211
years after the occurrence of the act or omission constituting the212
alleged basis of the medical, dental, optometric, or chiropractic213
claim.214

       (b) If an action upon a medical, dental, optometric, or215
chiropractic claim is not commenced within four years after the216
occurrence of the act or omission constituting the alleged basis217
of the medical, dental, optometric, or chiropractic claim, then,218
notwithstanding the time when the action is determined to accrue219
under division (B)(1) of this section, any action upon that claim220
is barred.221

       (C) A civil action for unlawful abortion pursuant to section222
2919.12 of the Revised Code, a civil action authorized by division223
(H) of section 2317.56 of the Revised Code, a civil action224
pursuant to division (B)(1) or (2) of section 2307.51 of the225
Revised Code for performing a dilation and extraction procedure or226
attempting to perform a dilation and extraction procedure in227
violation of section 2919.15 of the Revised Code, and a civil228
action pursuant to division (B)(1) or (2) of section 2307.52 of229
the Revised Code for terminating or attempting to terminate a230
human pregnancy after viability in violation of division (A) or231
(B) of section 2919.17 of the Revised Code shall be commenced232
within one year after the performance or inducement of the233
abortion, within one year after the attempt to perform or induce234
the abortion in violation of division (A) or (B) of section235
2919.17 of the Revised Code, within one year after the performance236
of the dilation and extraction procedure, or, in the case of a237
civil action pursuant to division (B)(2) of section 2307.51 of the238
Revised Code, within one year after the attempt to perform the239
dilation and extraction procedure.240

       (D)(C) As used in this section:241

       (1) "Hospital" includes any person, corporation, association,242
board, or authority that is responsible for the operation of any243
hospital licensed or registered in the state, including, but not244
limited to, those that are owned or operated by the state,245
political subdivisions, any person, any corporation, or any246
combination thereof. "Hospital" also includes any person,247
corporation, association, board, entity, or authority that is248
responsible for the operation of any clinic that employs a249
full-time staff of physicians practicing in more than one250
recognized medical specialty and rendering advice, diagnosis,251
care, and treatment to individuals. "Hospital" does not include252
any hospital operated by the government of the United States or253
any of its branches.254

       (2) "Physician" means a person who is licensed to practice255
medicine and surgery or osteopathic medicine and surgery by the256
state medical board or a person who otherwise is authorized to257
practice medicine and surgery or osteopathic medicine and surgery258
in this state.259

       (3) "Medical claim" means any claim that is asserted in any260
civil action against a physician, podiatrist, hospital, home, or261
residential facility, against any employee or agent of a262
physician, podiatrist, hospital, home, or residential facility,263
or against a registered nurse or physical therapist, and that264
arises out of the medical diagnosis, care, or treatment of any265
person. "Medical claim" includes the following:266

       (a) Derivative claims for relief that arise from the medical267
diagnosis, care, or treatment of a person;268

       (b) Claims that arise out of the medical diagnosis, care, or269
treatment of any person and to which either of the following270
apply:271

       (i) The claim results from acts or omissions in providing272
medical care.273

       (ii) The claim results from the hiring, training,274
supervision, retention, or termination of caregivers providing275
medical diagnosis, care, or treatment.276

       (c) Claims that arise out of the medical diagnosis, care, or277
treatment of any person and that are brought under section 3721.17278
of the Revised Code.279

       (4) "Podiatrist" means any person who is licensed to practice280
podiatric medicine and surgery by the state medical board.281

       (5) "Dentist" means any person who is licensed to practice282
dentistry by the state dental board.283

       (6) "Dental claim" means any claim that is asserted in any284
civil action against a dentist, or against any employee or agent285
of a dentist, and that arises out of a dental operation or the286
dental diagnosis, care, or treatment of any person. "Dental claim"287
includes derivative claims for relief that arise from a dental288
operation or the dental diagnosis, care, or treatment of a person.289

       (7) "Derivative claims for relief" include, but are not290
limited to, claims of a parent, guardian, custodian, or spouse of291
an individual who was the subject of any medical diagnosis, care,292
or treatment, dental diagnosis, care, or treatment, dental293
operation, optometric diagnosis, care, or treatment, or294
chiropractic diagnosis, care, or treatment, that arise from that295
diagnosis, care, treatment, or operation, and that seek the296
recovery of damages for any of the following:297

       (a) Loss of society, consortium, companionship, care,298
assistance, attention, protection, advice, guidance, counsel,299
instruction, training, or education, or any other intangible loss300
that was sustained by the parent, guardian, custodian, or spouse;301

       (b) Expenditures of the parent, guardian, custodian, or302
spouse for medical, dental, optometric, or chiropractic care or303
treatment, for rehabilitation services, or for other care,304
treatment, services, products, or accommodations provided to the305
individual who was the subject of the medical diagnosis, care, or306
treatment, the dental diagnosis, care, or treatment, the dental307
operation, the optometric diagnosis, care, or treatment, or the308
chiropractic diagnosis, care, or treatment.309

       (8) "Registered nurse" means any person who is licensed to310
practice nursing as a registered nurse by the state board of311
nursing.312

       (9) "Chiropractic claim" means any claim that is asserted in313
any civil action against a chiropractor, or against any employee314
or agent of a chiropractor, and that arises out of the315
chiropractic diagnosis, care, or treatment of any person. 316
"Chiropractic claim" includes derivative claims for relief that317
arise from the chiropractic diagnosis, care, or treatment of a318
person.319

       (10) "Chiropractor" means any person who is licensed to320
practice chiropractic by the chiropractic examining board.321

       (11) "Optometric claim" means any claim that is asserted in322
any civil action against an optometrist, or against any employee323
or agent of an optometrist, and that arises out of the optometric324
diagnosis, care, or treatment of any person. "Optometric claim"325
includes derivative claims for relief that arise from the326
optometric diagnosis, care, or treatment of a person.327

       (12) "Optometrist" means any person licensed to practice328
optometry by the state board of optometry.329

       (13) "Physical therapist" means any person who is licensed to330
practice physical therapy under Chapter 4755. of the Revised Code.331

       (14) "Home" has the same meaning as in section 3721.10 of332
the Revised Code.333

       (15) "Residential facility" means a facility licensed under334
section 5123.19 of the Revised Code, "medical claim," "dental335
claim," "optometric claim," and "chiropractic claim" have the same336
meanings as in section 2305.113 of the Revised Code.337

       Sec. 2305.113. (A) Except as otherwise provided in this338
section, an action upon a medical, dental, optometric, or339
chiropractic claim shall be commenced within one year after the340
cause of action accrued.341

       (B)(1) No action based upon a medical, dental, optometric,342
or chiropractic claim shall be commenced unless the person whose343
act or omission is the basis of that claim has been given at least344
ninety days' prior written notice of the intention to commence the345
action.346

       (2) The written notice required by division (B)(1) of this347
section shall notify the person whose act or omission is the basis348
of the claim of the legal basis of the claim, the type of loss349
sustained, and with specificity the nature of the injuries350
suffered.351

       (3) If the written notice required by division (B)(1) of352
this section is served within ninety days prior to the expiration353
of the statute of limitations described in division (A) of this354
section, the time for the commencement of the action shall be355
extended ninety days from the date of the service of the notice.356

        (C) Except as to persons within the age of minority or of357
unsound mind, as provided by section 2305.16 of the Revised Code,358
both of the following apply:359

        (1) No action upon a medical, dental, optometric, or360
chiropractic claim shall be commenced more than four years after361
the occurrence of the act or omission constituting the alleged362
basis of the medical, dental, optometric, or chiropractic claim.363

       (2) If an action upon a medical, dental, optometric, or364
chiropractic claim is not commenced within four years after the365
occurrence of the act or omission constituting the alleged basis366
of the medical, dental, optometric, or chiropractic claim, then,367
notwithstanding the time when the action is determined to accrue368
under division (A) or (B) of this section, any action upon that369
claim is barred.370

        (D) As used in this section:371

        (1) "Hospital" includes any person, corporation,372
association, board, or authority that is responsible for the373
operation of any hospital licensed or registered in the state,374
including, but not limited to, those that are owned or operated by375
the state, political subdivisions, any person, any corporation, or376
any combination of the state, political subdivisions, persons, and377
corporations. "Hospital" also includes any person, corporation,378
association, board, entity, or authority that is responsible for379
the operation of any clinic that employs a full-time staff of380
physicians practicing in more than one recognized medical381
specialty and rendering advice, diagnosis, care, and treatment to382
individuals. "Hospital" does not include any hospital operated by383
the government of the United States or any of its branches.384

       (2) "Physician" means a person who is licensed to practice385
medicine and surgery or osteopathic medicine and surgery by the386
state medical board or a person who otherwise is authorized to387
practice medicine and surgery or osteopathic medicine and surgery388
in this state.389

        (3) "Medical claim" means any claim that is asserted in any390
civil action against a physician, podiatrist, hospital, home, or391
residential facility, against any employee or agent of a392
physician, podiatrist, hospital, home, or residential facility, or393
against a licensed practical nurse, registered nurse, advanced394
practice nurse, physical therapist, physician assistant, emergency395
medical technician-basic, emergency medical396
technician-intermediate, or emergency medical397
technician-paramedic, and that arises out of the medical398
diagnosis, care, or treatment of any person. "Medical claim"399
includes the following:400

       (a) Derivative claims for relief that arise from the medical401
diagnosis, care, or treatment of a person;402

       (b) Claims that arise out of the medical diagnosis, care, or403
treatment of any person and to which either of the following404
applies:405

        (i) The claim results from acts or omissions in providing406
medical care.407

        (ii) The claim results from the hiring, training,408
supervision, retention, or termination of caregivers providing409
medical diagnosis, care, or treatment.410

        (c) Claims that arise out of the medical diagnosis, care,411
or treatment of any person and that are brought under section412
3721.17 of the Revised Code.413

       (4) "Podiatrist" means any person who is licensed to practice414
podiatric medicine and surgery by the state medical board.415

        (5) "Dentist" means any person who is licensed to practice416
dentistry by the state dental board.417

        (6) "Dental claim" means any claim that is asserted in any418
civil action against a dentist, or against any employee or agent419
of a dentist, and that arises out of a dental operation or the420
dental diagnosis, care, or treatment of any person. "Dental claim"421
includes derivative claims for relief that arise from a dental422
operation or the dental diagnosis, care, or treatment of a person.423

       (7) "Derivative claims for relief" include, but are not424
limited to, claims of a parent, guardian, custodian, or spouse of425
an individual who was the subject of any medical diagnosis, care,426
or treatment, dental diagnosis, care, or treatment, dental427
operation, optometric diagnosis, care, or treatment, or428
chiropractic diagnosis, care, or treatment, that arise from that429
diagnosis, care, treatment, or operation, and that seek the430
recovery of damages for any of the following:431

       (a) Loss of society, consortium, companionship, care,432
assistance, attention, protection, advice, guidance, counsel,433
instruction, training, or education, or any other intangible loss434
that was sustained by the parent, guardian, custodian, or spouse;435

        (b) Expenditures of the parent, guardian, custodian, or436
spouse for medical, dental, optometric, or chiropractic care or437
treatment, for rehabilitation services, or for other care,438
treatment, services, products, or accommodations provided to the439
individual who was the subject of the medical diagnosis, care, or440
treatment, the dental diagnosis, care, or treatment, the dental441
operation, the optometric diagnosis, care, or treatment, or the442
chiropractic diagnosis, care, or treatment.443

        (8) "Registered nurse" means any person who is licensed to444
practice nursing as a registered nurse by the state board of445
nursing.446

       (9) "Chiropractic claim" means any claim that is asserted in447
any civil action against a chiropractor, or against any employee448
or agent of a chiropractor, and that arises out of the449
chiropractic diagnosis, care, or treatment of any person.450
"Chiropractic claim" includes derivative claims for relief that451
arise from the chiropractic diagnosis, care, or treatment of a452
person.453

        (10) "Chiropractor" means any person who is licensed to454
practice chiropractic by the chiropractic examining board.455

        (11) "Optometric claim" means any claim that is asserted in456
any civil action against an optometrist, or against any employee457
or agent of an optometrist, and that arises out of the optometric458
diagnosis, care, or treatment of any person. "Optometric claim"459
includes derivative claims for relief that arise from the460
optometric diagnosis, care, or treatment of a person.461

       (12) "Optometrist" means any person licensed to practice462
optometry by the state board of optometry.463

       (13) "Physical therapist" means any person who is licensed to464
practice physical therapy under Chapter 4755. of the Revised Code.465

       (14) "Home" has the same meaning as in section 3721.10 of466
the Revised Code.467

       (15) "Residential facility" means a facility licensed under468
section 5123.19 of the Revised Code.469

       (16) "Advanced practice nurse" means any certified nurse470
practitioner, clinical nurse specialist, or certified registered471
nurse anesthetist, or a certified nurse-midwife certified by the472
board of nursing under section 4723.41 of the Revised Code.473

       Sec. 2305.15.  (A) When a cause of action accrues against a474
person, if hethe person is out of the state, has absconded, or475
conceals himselfself, the period of limitation for the476
commencement of the action as provided in sections 2305.04 to477
2305.14, 1302.98, and 1304.35 of the Revised Code does not begin478
to run until hethe person comes into the state or while hethe479
person is so absconded or concealed. After the cause of action480
accrues if hethe person departs from the state, absconds, or481
conceals himselfself, the time of histhe person's absence or482
concealment shall not be computed as any part of a period within483
which the action must be brought.484

       (B) When a person is imprisoned for the commission of any485
offense, the time of histhe person's imprisonment shall not be486
computed as any part of any period of limitation, as provided in487
section 2305.09, 2305.10, 2305.11, 2305.113, or 2305.14 of the488
Revised Code, within which any person must bring any action489
against the imprisoned person.490

       Sec. 2305.234.  (A) As used in this section:491

       (1) "Chiropractic claim," "medical claim," and "optometric492
claim" have the same meanings as in section 2305.112305.113 of493
the Revised Code.494

       (2) "Dental claim" has the same meaning as in section 2305.11495
2305.113 of the Revised Code, except that it does not include any496
claim arising out of a dental operation or any derivative claim497
for relief that arises out of a dental operation.498

       (3) "Governmental health care program" has the same meaning499
as in section 4731.65 of the Revised Code.500

       (4) "Health care professional" means any of the following who501
provide medical, dental, or other health-related diagnosis, care,502
or treatment:503

       (a) Physicians authorized under Chapter 4731. of the Revised504
Code to practice medicine and surgery or osteopathic medicine and505
surgery;506

       (b) Registered nurses, advanced practice nurses, and507
licensed practical nurses licensed under Chapter 4723. of the508
Revised Code;509

       (c) Physician assistants authorized to practice under510
Chapter 4730. of the Revised Code;511

       (d) Dentists and dental hygienists licensed under Chapter512
4715. of the Revised Code;513

       (e) Physical therapists licensed under Chapter 4755. of the514
Revised Code;515

       (f) Chiropractors licensed under Chapter 4734. of the516
Revised Code;517

       (g) Optometrists licensed under Chapter 4725. of the Revised518
Code;519

       (h) Podiatrists authorized under Chapter 4731. of the520
Revised Code to practice podiatry;521

       (i) Dietitians licensed under Chapter 4759. of the Revised522
Code;523

       (j) Pharmacists licensed under Chapter 4729. of the Revised524
Code;525

       (k) Emergency medical technicians-basic, emergency medical526
technicians-intermediate, and emergency medical527
technicians-paramedic, certified under Chapter 4765. of the528
Revised Code.529

       (5) "Health care worker" means a person other than a health530
care professional who provides medical, dental, or other531
health-related care or treatment under the direction of a health532
care professional with the authority to direct that individual's533
activities, including medical technicians, medical assistants,534
dental assistants, orderlies, aides, and individuals acting in535
similar capacities.536

       (6) "Indigent and uninsured person" means a person who meets537
all of the following requirements:538

       (a) The person's income is not greater than one hundred539
fifty per cent of the current poverty line as defined by the540
United States office of management and budget and revised in541
accordance with section 673(2) of the "Omnibus Budget542
Reconciliation Act of 1981," 95 Stat. 511, 42 U.S.C. 9902, as543
amended.544

       (b) The person is not eligible to receive medical assistance545
under Chapter 5111., disability assistance medical assistance546
under Chapter 5115. of the Revised Code, or assistance under any547
other governmental health care program.548

       (c) Either of the following applies:549

       (i) The person is not a policyholder, certificate holder,550
insured, contract holder, subscriber, enrollee, member,551
beneficiary, or other covered individual under a health insurance552
or health care policy, contract, or plan.553

       (ii) The person is a policyholder, certificate holder,554
insured, contract holder, subscriber, enrollee, member,555
beneficiary, or other covered individual under a health insurance556
or health care policy, contract, or plan, but the insurer, policy,557
contract, or plan denies coverage or is the subject of insolvency558
or bankruptcy proceedings in any jurisdiction.559

       (7) "Operation" means any procedure that involves cutting or560
otherwise infiltrating human tissue by mechanical means, including561
surgery, laser surgery, ionizing radiation, therapeutic562
ultrasound, or the removal of intraocular foreign bodies.563
"Operation" does not include the administration of medication by564
injection, unless the injection is administered in conjunction565
with a procedure infiltrating human tissue by mechanical means566
other than the administration of medicine by injection.567

       (8) "Nonprofit shelter or health care facility" means a568
charitable nonprofit corporation organized and operated pursuant569
to Chapter 1702. of the Revised Code, or any charitable570
organization not organized and not operated for profit, that571
provides shelter, health care services, or shelter and health care572
services to indigent and uninsured persons, except that "shelter573
or health care facility" does not include a hospital as defined in574
section 3727.01 of the Revised Code, a facility licensed under575
Chapter 3721. of the Revised Code, or a medical facility that is576
operated for profit.577

       (9) "Tort action" means a civil action for damages for578
injury, death, or loss to person or property other than a civil579
action for damages for a breach of contract or another agreement580
between persons or government entities.581

       (10) "Volunteer" means an individual who provides any582
medical, dental, or other health-care related diagnosis, care, or583
treatment without the expectation of receiving and without receipt584
of any compensation or other form of remuneration from an indigent585
and uninsured person, another person on behalf of an indigent and586
uninsured person, any shelter or health care facility, or any587
other person or government entity.588

       (B)(1) Subject to divisions (E) and (F)(3) of this section,589
a health care professional who is a volunteer and complies with590
division (B)(2) of this section is not liable in damages to any591
person or government entity in a tort or other civil action,592
including an action on a medical, dental, chiropractic,593
optometric, or other health-related claim, for injury, death, or594
loss to person or property that allegedly arises from an action or595
omission of the volunteer in the provision at a nonprofit shelter596
or health care facility to an indigent and uninsured person of597
medical, dental, or other health-related diagnosis, care, or598
treatment, including the provision of samples of medicine and599
other medical products, unless the action or omission constitutes600
willful or wanton misconduct.601

       (2) To qualify for the immunity described in division (B)(1)602
of this section, a health care professional shall do all of the603
following prior to providing diagnosis, care, or treatment:604

       (a) Determine, in good faith, that the indigent and605
uninsured person is mentally capable of giving informed consent to606
the provision of the diagnosis, care, or treatment and is not607
subject to duress or under undue influence;608

       (b) Inform the person of the provisions of this section;609

       (c) Obtain the informed consent of the person and a written610
waiver, signed by the person or by another individual on behalf of611
and in the presence of the person, that states that the person is612
mentally competent to give informed consent and, without being613
subject to duress or under undue influence, gives informed consent614
to the provision of the diagnosis, care, or treatment subject to615
the provisions of this section.616

       (3) A physician or podiatrist who is not covered by medical617
malpractice insurance, but complies with division (B)(2) of this618
section, is not required to comply with division (A) of section619
4731.143 of the Revised Code.620

       (C) Subject to divisions (E) and (F)(3) of this section,621
health care workers who are volunteers are not liable in damages622
to any person or government entity in a tort or other civil623
action, including an action upon a medical, dental, chiropractic,624
optometric, or other health-related claim, for injury, death, or625
loss to person or property that allegedly arises from an action or626
omission of the health care worker in the provision at a nonprofit627
shelter or health care facility to an indigent and uninsured628
person of medical, dental, or other health-related diagnosis,629
care, or treatment, unless the action or omission constitutes630
willful or wanton misconduct.631

       (D) Subject to divisions (E) and (F)(3) of this section and632
section 3701.071 of the Revised Code, a nonprofit shelter or633
health care facility associated with a health care professional634
described in division (B)(1) of this section or a health care635
worker described in division (C) of this section is not liable in636
damages to any person or government entity in a tort or other637
civil action, including an action on a medical, dental,638
chiropractic, optometric, or other health-related claim, for639
injury, death, or loss to person or property that allegedly arises640
from an action or omission of the health care professional or641
worker in providing for the shelter or facility medical, dental,642
or other health-related diagnosis, care, or treatment to an643
indigent and uninsured person, unless the action or omission644
constitutes willful or wanton misconduct.645

       (E)(1) Except as provided in division (E)(2) of this646
section, the immunities provided by divisions (B), (C), and (D) of647
this section are not available to an individual or to a nonprofit648
shelter or health care facility if, at the time of an alleged649
injury, death, or loss to person or property, the individuals650
involved are providing one of the following:651

       (a) Any medical, dental, or other health-related diagnosis,652
care, or treatment pursuant to a community service work order653
entered by a court under division (F) of section 2951.02 of the654
Revised Code as a condition of probation or other suspension of a655
term of imprisonment or imposed by a court as a community control656
sanction pursuant to sections 2929.15 and 2929.17 of the Revised657
Code.658

       (b) Performance of an operation.659

       (c) Delivery of a baby.660

       (2) Division (E)(1) of this section does not apply to an661
individual who provides, or a nonprofit shelter or health care662
facility at which the individual provides, diagnosis, care, or663
treatment that is necessary to preserve the life of a person in a664
medical emergency.665

       (F)(1) This section does not create a new cause of action or666
substantive legal right against a health care professional, health667
care worker, or nonprofit shelter or health care facility.668

       (2) This section does not affect any immunities from civil669
liability or defenses established by another section of the670
Revised Code or available at common law to which an individual or671
a nonprofit shelter or health care facility may be entitled in672
connection with the provision of emergency or other diagnosis,673
care, or treatment.674

       (3) This section does not grant an immunity from tort or675
other civil liability to an individual or a nonprofit shelter or676
health care facility for actions that are outside the scope of677
authority of health care professionals or health care workers.678

       (4) This section does not affect any legal responsibility of679
a health care professional or health care worker to comply with680
any applicable law of this state or rule of an agency of this681
state.682

       (5) This section does not affect any legal responsibility of683
a nonprofit shelter or health care facility to comply with any684
applicable law of this state, rule of an agency of this state, or685
local code, ordinance, or regulation that pertains to or regulates686
building, housing, air pollution, water pollution, sanitation,687
health, fire, zoning, or safety.688

       Sec. 2317.02.  The following persons shall not testify in689
certain respects:690

       (A) An attorney, concerning a communication made to the691
attorney by a client in that relation or the attorney's advice to692
a client, except that the attorney may testify by express consent693
of the client or, if the client is deceased, by the express694
consent of the surviving spouse or the executor or administrator695
of the estate of the deceased client and except that, if the696
client voluntarily testifies or is deemed by section 2151.421 of697
the Revised Code to have waived any testimonial privilege under698
this division, the attorney may be compelled to testify on the699
same subject;700

       (B)(1) A physician or a dentist concerning a communication701
made to the physician or dentist by a patient in that relation or702
the physician's or dentist's advice to a patient, except as703
otherwise provided in this division, division (B)(2), and division704
(B)(3) of this section, and except that, if the patient is deemed705
by section 2151.421 of the Revised Code to have waived any706
testimonial privilege under this division, the physician may be707
compelled to testify on the same subject.708

       The testimonial privilege established under this division709
does not apply, and a physician or dentist may testify or may be710
compelled to testify, in any of the following circumstances:711

       (a) In any civil action, in accordance with the discovery712
provisions of the Rules of Civil Procedure in connection with a713
civil action, or in connection with a claim under Chapter 4123. of714
the Revised Code, under any of the following circumstances:715

       (i) If the patient or the guardian or other legal716
representative of the patient gives express consent;717

       (ii) If the patient is deceased, the spouse of the patient718
or the executor or administrator of the patient's estate gives719
express consent;720

       (iii) If a medical claim, dental claim, chiropractic claim,721
or optometric claim, as defined in section 2305.112305.113 of the722
Revised Code, an action for wrongful death, any other type of723
civil action, or a claim under Chapter 4123. of the Revised Code724
is filed by the patient, the personal representative of the estate725
of the patient if deceased, or the patient's guardian or other726
legal representative.727

       (b) In any civil action concerning court-ordered treatment728
or services received by a patient, if the court-ordered treatment729
or services were ordered as part of a case plan journalized under730
section 2151.412 of the Revised Code or the court-ordered731
treatment or services are necessary or relevant to dependency,732
neglect, or abuse or temporary or permanent custody proceedings733
under Chapter 2151. of the Revised Code.734

       (c) In any criminal action concerning any test or the735
results of any test that determines the presence or concentration736
of alcohol, a drug of abuse, or alcohol and a drug of abuse in the737
patient's blood, breath, urine, or other bodily substance at any738
time relevant to the criminal offense in question.739

       (d) In any criminal action against a physician or dentist.740
In such an action, the testimonial privilege established under741
this division does not prohibit the admission into evidence, in742
accordance with the Rules of Evidence, of a patient's medical or743
dental records or other communications between a patient and the744
physician or dentist that are related to the action and obtained745
by subpoena, search warrant, or other lawful means. A court that746
permits or compels a physician or dentist to testify in such an747
action or permits the introduction into evidence of patient748
records or other communications in such an action shall require749
that appropriate measures be taken to ensure that the750
confidentiality of any patient named or otherwise identified in751
the records is maintained. Measures to ensure confidentiality752
that may be taken by the court include sealing its records or753
deleting specific information from its records.754

       (2)(a) If any law enforcement officer submits a written755
statement to a health care provider that states that an official756
criminal investigation has begun regarding a specified person or757
that a criminal action or proceeding has been commenced against a758
specified person, that requests the provider to supply to the759
officer copies of any records the provider possesses that pertain760
to any test or the results of any test administered to the761
specified person to determine the presence or concentration of762
alcohol, a drug of abuse, or alcohol and a drug of abuse in the763
person's blood, breath, or urine at any time relevant to the764
criminal offense in question, and that conforms to section765
2317.022 of the Revised Code, the provider, except to the extent766
specifically prohibited by any law of this state or of the United767
States, shall supply to the officer a copy of any of the requested768
records the provider possesses. If the health care provider does769
not possess any of the requested records, the provider shall give770
the officer a written statement that indicates that the provider771
does not possess any of the requested records.772

       (b) If a health care provider possesses any records of the773
type described in division (B)(2)(a) of this section regarding the774
person in question at any time relevant to the criminal offense in775
question, in lieu of personally testifying as to the results of776
the test in question, the custodian of the records may submit a777
certified copy of the records, and, upon its submission, the778
certified copy is qualified as authentic evidence and may be779
admitted as evidence in accordance with the Rules of Evidence.780
Division (A) of section 2317.422 of the Revised Code does not781
apply to any certified copy of records submitted in accordance782
with this division. Nothing in this division shall be construed783
to limit the right of any party to call as a witness the person784
who administered the test to which the records pertain, the person785
under whose supervision the test was administered, the custodian786
of the records, the person who made the records, or the person787
under whose supervision the records were made.788

       (3)(a) If the testimonial privilege described in division789
(B)(1) of this section does not apply as provided in division790
(B)(1)(a)(iii) of this section, a physician or dentist may be791
compelled to testify or to submit to discovery under the Rules of792
Civil Procedure only as to a communication made to the physician793
or dentist by the patient in question in that relation, or the794
physician's or dentist's advice to the patient in question, that795
related causally or historically to physical or mental injuries796
that are relevant to issues in the medical claim, dental claim,797
chiropractic claim, or optometric claim, action for wrongful798
death, other civil action, or claim under Chapter 4123. of the799
Revised Code.800

       (b) If the testimonial privilege described in division801
(B)(1) of this section does not apply to a physician or dentist as802
provided in division (B)(1)(c) of this section, the physician or803
dentist, in lieu of personally testifying as to the results of the804
test in question, may submit a certified copy of those results,805
and, upon its submission, the certified copy is qualified as806
authentic evidence and may be admitted as evidence in accordance807
with the Rules of Evidence. Division (A) of section 2317.422 of808
the Revised Code does not apply to any certified copy of results809
submitted in accordance with this division. Nothing in this810
division shall be construed to limit the right of any party to811
call as a witness the person who administered the test in812
question, the person under whose supervision the test was813
administered, the custodian of the results of the test, the person814
who compiled the results, or the person under whose supervision815
the results were compiled.816

       (4) The testimonial privilege described in division (B)(1)817
of this section is not waived when a communication is made by a818
physician to a pharmacist or when there is communication between a819
patient and a pharmacist in furtherance of the physician-patient820
relation.821

       (5)(a) As used in divisions (B)(1) to (4) of this section,822
"communication" means acquiring, recording, or transmitting any823
information, in any manner, concerning any facts, opinions, or824
statements necessary to enable a physician or dentist to diagnose,825
treat, prescribe, or act for a patient. A "communication" may826
include, but is not limited to, any medical or dental, office, or827
hospital communication such as a record, chart, letter,828
memorandum, laboratory test and results, x-ray, photograph,829
financial statement, diagnosis, or prognosis.830

       (b) As used in division (B)(2) of this section, "health care831
provider" means a hospital, ambulatory care facility, long-term832
care facility, pharmacy, emergency facility, or health care833
practitioner.834

       (c) As used in division (B)(5)(b) of this section:835

       (i) "Ambulatory care facility" means a facility that provides836
medical, diagnostic, or surgical treatment to patients who do not837
require hospitalization, including a dialysis center, ambulatory838
surgical facility, cardiac catheterization facility, diagnostic839
imaging center, extracorporeal shock wave lithotripsy center, home840
health agency, inpatient hospice, birthing center, radiation841
therapy center, emergency facility, and an urgent care center.842
"Ambulatory health care facility" does not include the private843
office of a physician or dentist, whether the office is for an844
individual or group practice.845

       (ii) "Emergency facility" means a hospital emergency846
department or any other facility that provides emergency medical847
services.848

       (iii) "Health care practitioner" has the same meaning as in849
section 4769.01 of the Revised Code.850

       (iv) "Hospital" has the same meaning as in section 3727.01 of851
the Revised Code.852

       (v) "Long-term care facility" means a nursing home,853
residential care facility, or home for the aging, as those terms854
are defined in section 3721.01 of the Revised Code; an adult care855
facility, as defined in section 3722.01 of the Revised Code; a856
nursing facility or intermediate care facility for the mentally857
retarded, as those terms are defined in section 5111.20 of the858
Revised Code; a facility or portion of a facility certified as a859
skilled nursing facility under Title XVIII of the "Social Security860
Act," 49 Stat. 286 (1965), 42 U.S.C.A. 1395, as amended.861

       (vi) "Pharmacy" has the same meaning as in section 4729.01 of862
the Revised Code.863

       (6) Divisions (B)(1), (2), (3), (4), and (5) of this section864
apply to doctors of medicine, doctors of osteopathic medicine,865
doctors of podiatry, and dentists.866

       (7) Nothing in divisions (B)(1) to (6) of this section867
affects, or shall be construed as affecting, the immunity from868
civil liability conferred by section 307.628 or 2305.33 of the869
Revised Code upon physicians who report an employee's use of a870
drug of abuse, or a condition of an employee other than one871
involving the use of a drug of abuse, to the employer of the872
employee in accordance with division (B) of that section. As used873
in division (B)(7) of this section, "employee," "employer," and874
"physician" have the same meanings as in section 2305.33 of the875
Revised Code.876

       (C) A member of the clergy, rabbi, priest, or regularly877
ordained, accredited, or licensed minister of an established and878
legally cognizable church, denomination, or sect, when the member879
of the clergy, rabbi, priest, or minister remains accountable to880
the authority of that church, denomination, or sect, concerning a881
confession made, or any information confidentially communicated,882
to the member of the clergy, rabbi, priest, or minister for a883
religious counseling purpose in the member of the clergy's,884
rabbi's, priest's, or minister's professional character; however,885
the member of the clergy, rabbi, priest, or minister may testify886
by express consent of the person making the communication, except887
when the disclosure of the information is in violation of a sacred888
trust;889

       (D) Husband or wife, concerning any communication made by890
one to the other, or an act done by either in the presence of the891
other, during coverture, unless the communication was made, or act892
done, in the known presence or hearing of a third person competent893
to be a witness; and such rule is the same if the marital relation894
has ceased to exist;895

       (E) A person who assigns a claim or interest, concerning any896
matter in respect to which the person would not, if a party, be897
permitted to testify;898

       (F) A person who, if a party, would be restricted under899
section 2317.03 of the Revised Code, when the property or thing is900
sold or transferred by an executor, administrator, guardian,901
trustee, heir, devisee, or legatee, shall be restricted in the902
same manner in any action or proceeding concerning the property or903
thing.904

       (G)(1) A school guidance counselor who holds a valid905
educator license from the state board of education as provided for906
in section 3319.22 of the Revised Code, a person licensed under907
Chapter 4757. of the Revised Code as a professional clinical908
counselor, professional counselor, social worker, or independent909
social worker, or registered under Chapter 4757. of the Revised910
Code as a social work assistant concerning a confidential911
communication received from a client in that relation or the912
person's advice to a client unless any of the following applies:913

       (a) The communication or advice indicates clear and present914
danger to the client or other persons. For the purposes of this915
division, cases in which there are indications of present or past916
child abuse or neglect of the client constitute a clear and917
present danger.918

       (b) The client gives express consent to the testimony.919

       (c) If the client is deceased, the surviving spouse or the920
executor or administrator of the estate of the deceased client921
gives express consent.922

       (d) The client voluntarily testifies, in which case the923
school guidance counselor or person licensed or registered under924
Chapter 4757. of the Revised Code may be compelled to testify on925
the same subject.926

       (e) The court in camera determines that the information927
communicated by the client is not germane to the counselor-client928
or social worker-client relationship.929

       (f) A court, in an action brought against a school, its930
administration, or any of its personnel by the client, rules after931
an in-camera inspection that the testimony of the school guidance932
counselor is relevant to that action.933

       (g) The testimony is sought in a civil action and concerns934
court-ordered treatment or services received by a patient as part935
of a case plan journalized under section 2151.412 of the Revised936
Code or the court-ordered treatment or services are necessary or937
relevant to dependency, neglect, or abuse or temporary or938
permanent custody proceedings under Chapter 2151. of the Revised939
Code.940

       (2) Nothing in division (G)(1) of this section shall relieve941
a school guidance counselor or a person licensed or registered942
under Chapter 4757. of the Revised Code from the requirement to943
report information concerning child abuse or neglect under section944
2151.421 of the Revised Code.945

       (H) A mediator acting under a mediation order issued under946
division (A) of section 3109.052 of the Revised Code or otherwise947
issued in any proceeding for divorce, dissolution, legal948
separation, annulment, or the allocation of parental rights and949
responsibilities for the care of children, in any action or950
proceeding, other than a criminal, delinquency, child abuse, child951
neglect, or dependent child action or proceeding, that is brought952
by or against either parent who takes part in mediation in953
accordance with the order and that pertains to the mediation954
process, to any information discussed or presented in the955
mediation process, to the allocation of parental rights and956
responsibilities for the care of the parents' children, or to the957
awarding of parenting time rights in relation to their children;958

       (I) A communications assistant, acting within the scope of959
the communication assistant's authority, when providing960
telecommunications relay service pursuant to section 4931.35 of961
the Revised Code or Title II of the "Communications Act of 1934,"962
104 Stat. 366 (1990), 47 U.S.C. 225, concerning a communication963
made through a telecommunications relay service. Nothing in this964
section shall limit the obligation of a communications assistant965
to divulge information or testify when mandated by federal law or966
regulation or pursuant to subpoena in a criminal proceeding.967

       Nothing in this section shall limit any immunity or privilege968
granted under federal law or regulation.969

       (J)(1) A chiropractor in a civil proceeding concerning a970
communication made to the chiropractor by a patient in that971
relation or the chiropractor's advice to a patient, except as972
otherwise provided in this division. The testimonial privilege973
established under this division does not apply, and a chiropractor974
may testify or may be compelled to testify, in any civil action,975
in accordance with the discovery provisions of the Rules of Civil976
Procedure in connection with a civil action, or in connection with977
a claim under Chapter 4123. of the Revised Code, under any of the978
following circumstances:979

       (a) If the patient or the guardian or other legal980
representative of the patient gives express consent.981

       (b) If the patient is deceased, the spouse of the patient or982
the executor or administrator of the patient's estate gives983
express consent.984

       (c) If a medical claim, dental claim, chiropractic claim, or985
optometric claim, as defined in section 2305.112305.113 of the986
Revised Code, an action for wrongful death, any other type of987
civil action, or a claim under Chapter 4123. of the Revised Code988
is filed by the patient, the personal representative of the estate989
of the patient if deceased, or the patient's guardian or other990
legal representative.991

       (2) If the testimonial privilege described in division992
(J)(1) of this section does not apply as provided in division993
(J)(1)(c) of this section, a chiropractor may be compelled to994
testify or to submit to discovery under the Rules of Civil995
Procedure only as to a communication made to the chiropractor by996
the patient in question in that relation, or the chiropractor's997
advice to the patient in question, that related causally or998
historically to physical or mental injuries that are relevant to999
issues in the medical claim, dental claim, chiropractic claim, or1000
optometric claim, action for wrongful death, other civil action,1001
or claim under Chapter 4123. of the Revised Code.1002

       (3) The testimonial privilege established under this1003
division does not apply, and a chiropractor may testify or be1004
compelled to testify, in any criminal action or administrative1005
proceeding.1006

       (4) As used in this division, "communication" means1007
acquiring, recording, or transmitting any information, in any1008
manner, concerning any facts, opinions, or statements necessary to1009
enable a chiropractor to diagnosisdiagnose, treat, or act for a1010
patient. A communication may include, but is not limited to, any1011
chiropractic, office, or hospital communication such as a record,1012
chart, letter, memorandum, laboratory test and results, x-ray,1013
photograph, financial statement, diagnosis, or prognosis.1014

       Sec. 2317.54.  No hospital, home health agency, ambulatory1015
surgical facility, or provider of a hospice care program shall be1016
held liable for a physician's failure to obtain an informed1017
consent from the physician's patient prior to a surgical or1018
medical procedure or course of procedures, unless the physician is1019
an employee of the hospital, home health agency, ambulatory1020
surgical facility, or provider of a hospice care program.1021

       Written consent to a surgical or medical procedure or course1022
of procedures shall, to the extent that it fulfills all the1023
requirements in divisions (A), (B), and (C) of this section, be1024
presumed to be valid and effective, in the absence of proof by a1025
preponderance of the evidence that the person who sought such1026
consent was not acting in good faith, or that the execution of the1027
consent was induced by fraudulent misrepresentation of material1028
facts, or that the person executing the consent was not able to1029
communicate effectively in spoken and written English or any other1030
language in which the consent is written. Except as herein1031
provided, no evidence shall be admissible to impeach, modify, or1032
limit the authorization for performance of the procedure or1033
procedures set forth in such written consent.1034

       (A) The consent sets forth in general terms the nature and1035
purpose of the procedure or procedures, and what the procedures1036
are expected to accomplish, together with the reasonably known1037
risks, and, except in emergency situations, sets forth the names1038
of the physicians who shall perform the intended surgical1039
procedures.1040

       (B) The person making the consent acknowledges that such1041
disclosure of information has been made and that all questions1042
asked about the procedure or procedures have been answered in a1043
satisfactory manner.1044

       (C) The consent is signed by the patient for whom the1045
procedure is to be performed, or, if the patient for any reason1046
including, but not limited to, competence, infancy, or the fact1047
that, at the latest time that the consent is needed, the patient1048
is under the influence of alcohol, hallucinogens, or drugs, lacks1049
legal capacity to consent, by a person who has legal authority to1050
consent on behalf of such patient in such circumstances.1051

       Any use of a consent form that fulfills the requirements1052
stated in divisions (A), (B), and (C) of this section has no1053
effect on the common law rights and liabilities, including the1054
right of a physician to obtain the oral or implied consent of a1055
patient to a medical procedure, that may exist as between1056
physicians and patients on July 28, 1975.1057

       As used in this section the term "hospital" has the same1058
meaning set forthas in division (D) of section 2305.112305.1131059
of the Revised Code; "home health agency" has the same meaning1060
set forthas in division (A) of former section 3701.885101.61 of1061
the Revised Code; "ambulatory surgical facility" has the meaning1062
as in division (A) of section 3702.30 of the Revised Code; and1063
"hospice care program" has the same meaning set forthas in1064
division (A) of section 3712.01 of the Revised Code. The1065
provisions of this division apply to hospitals, doctors of1066
medicine, doctors of osteopathic medicine, and doctors of1067
podiatric medicine.1068

       Sec. 2323.41. (A) In any civil action upon a medical,1069
dental, optometric, or chiropractic claim, the defendant may1070
introduce evidence of any amount payable as a benefit to the1071
plaintiff as a result of the damages that result from an injury,1072
death, or loss to person or property that is the subject of the1073
claim from the following sources:1074

        (1) The United States Social Security Act, 42 U.S.C.A.1075
section 301 et seq.;1076

        (2) Any state or federal income disability or workers'1077
compensation act;1078

        (3) Any health, sickness or income-disability insurance,1079
accident insurance that provides health benefits, or1080
income-disability coverage;1081

        (4) Any contract or agreement of any group, organization,1082
partnership, or corporation to provide, pay for, or reimburse the1083
cost of medical, hospital, dental, or other health care services.1084

        (B) If the defendant elects to introduce evidence1085
described in division (A) of this section, the plaintiff may1086
introduce evidence of any amount that the plaintiff has paid or1087
contributed to secure the plaintiff's right to receive the1088
insurance benefits of which the defendant has introduced evidence.1089

        (C) A source of collateral benefits of which evidence is1090
introduced pursuant to division (A) of this section shall not1091
recover any amount against the plaintiff nor shall it be1092
subrogated to the rights of the plaintiff against a defendant.1093

        (D) As used in this section, "medical claim," "dental1094
claim," "optometric claim," and "chiropractic claim" have the same1095
meanings as in section 2305.113 of the Revised Code.1096

       Sec. 2323.43. (A) In a civil action upon a medical, dental,1097
optometric, or chiropractic claim to recover damages for injury,1098
death, or loss to person or property, all of the following apply:1099

       (1) There shall not be any limitation on compensatory damages1100
that represent the economic loss of the person who is awarded the1101
damages in the civil action.1102

       (2)(a) Except as otherwise provided in divisions (A)(2)(b)1103
and (c) of this section, the amount of compensatory damages that1104
represents damages for noneconomic loss that is recoverable in a1105
tort action shall not exceed the greater of two hundred fifty1106
thousand dollars or an amount that is equal to three times the1107
plaintiff's economic loss, as determined by the trier of fact, to1108
a maximum of five hundred thousand dollars.1109

       (b) The amount recoverable for noneconomic losses may exceed1110
the amount described in division (A)(2)(a) of this section but1111
shall not exceed the greater of seven hundred fifty thousand1112
dollars or thirty-five thousand dollars times the number of years1113
remaining in the plaintiff's expected life if the noneconomic1114
losses of the plaintiff are for either of the following:1115

        (i) Permanent and substantial physical deformity, loss of1116
use of a limb, or loss of a bodily organ system;1117

        (ii) Permanent physical functional injury that permanently1118
prevents the injured person from being able to independently care1119
for self and perform life sustaining activities.1120

        (c) Division (A)(2) of this section does not apply to1121
wrongful death actions brought pursuant to Chapter 2125. of the1122
Revised Code. 1123

       (3) Noneconomic damages allocated to an immune tortfeasor or1124
to a tortfeasor whose liability is limited by law shall not be1125
reallocated to any other tortfeasor.1126

        (B) This section does not apply to either of the following:1127

        (1) Civil actions upon a medical, dental, optometric, or1128
chiropractic claim that are brought against the state in the court1129
of claims, including, but not limited to, those actions in which a1130
state university or college is a defendant and to which division1131
(B)(3) of section 3345.40 of the Revised Code applies;1132

        (2) Civil actions upon a medical, dental, optometric, or1133
chiropractic claim that are brought against political subdivisions1134
of this state and that are commenced under or are subject to1135
Chapter 2744. of the Revised Code. Division (C) of section1136
2744.05 of the Revised Code applies to recoverable damages in1137
those actions.1138

        (C) As used in this section:1139

        (1) "Economic loss" means any of the following types of1140
pecuniary harm:1141

        (a) All wages, salaries, or other compensation lost as a1142
result of an injury, death, or loss to person or property that is1143
a subject of a civil action upon a medical, dental, optometric, or1144
chiropractic claim;1145

        (b) All expenditures for medical care or treatment,1146
rehabilitation services, or other care, treatment, services,1147
products, or accommodations as a result of an injury, death, or1148
loss to person or property that is a subject of a civil action1149
upon a medical, dental, optometric, or chiropractic claim;1150

        (c) Any other expenditures incurred as a result of an1151
injury, death, or loss to person or property that is a subject of1152
a civil action upon a medical, dental, optometric, or chiropractic1153
claim, other than attorney's fees incurred in connection with that1154
action.1155

        (2) "Dental claim," "optometric claim," and "chiropractic1156
claim" have the same meanings as in section 2305.113 of the1157
Revised Code.1158

        (3) "Noneconomic loss" means nonpecuniary harm that results1159
from an injury, death, or loss to person or property that is a1160
subject of a civil action upon a medical, dental, optometric, or1161
chiropractic claim, including, but not limited to, pain and1162
suffering, loss of society, consortium, companionship, care,1163
assistance, attention, protection, advice, guidance, counsel,1164
instruction, training, or education, disfigurement, mental1165
anguish, and any other intangible loss.1166

       (4) "Medical claim" means any claim that is asserted in any1167
civil action against a physician, podiatrist, or hospital, against1168
any employee or agent of a physician, podiatrist, or hospital, or1169
against a licensed practical nurse, registered nurse, advanced1170
practice nurse, physical therapist, physician assistant, or1171
emergency medical technician, and that arises out of the medical1172
diagnosis, care, or treatment of any person. "Medical claim"1173
includes derivative claims for relief that arise from the medical1174
diagnosis, care, or treatment of a person.1175

       Sec. 2323.55. (A) As used in this section:1176

        (1) "Economic loss" means any of the following types of1177
pecuniary harm:1178

        (a) All wages, salaries, or other compensation lost as a1179
result of an injury, death, or loss to person or property that is1180
a subject of a civil action upon a medical, dental, optometric, or1181
chiropractic claim;1182

        (b) All expenditures for medical care or treatment,1183
rehabilitation services, or other care, treatment, services,1184
products, or accommodations as a result of an injury, death, or1185
loss to person or property that is a subject of a civil action1186
upon a medical, dental, optometric, or chiropractic claim;1187

        (c) Any other expenditures incurred as a result of an1188
injury, death, or loss to person or property that is a subject of1189
a civil action upon a medical, dental, optometric, or chiropractic1190
claim, other than attorney's fees incurred in connection with that1191
action.1192

        (2) "Future damages" means any damages that result from an1193
injury, death, or loss to person or property that is a subject of1194
a civil action upon a medical, dental, optometric, or chiropractic1195
claim and that will accrue after the verdict or determination of1196
liability is rendered in that action by the trier of fact. "Future1197
damages" includes both economic and noneconomic loss.1198

        (3) "Medical claim," "dental claim," "optometric claim," and1199
"chiropractic claim" have the same meanings as in section 2305.1131200
of the Revised Code.1201

        (4) "Noneconomic loss" means nonpecuniary harm that results1202
from an injury, death, or loss to person or property that is a1203
subject of a civil action upon a medical, dental, optometric, or1204
chiropractic claim, including, but not limited to, pain and1205
suffering, loss of society, consortium, companionship, care,1206
assistance, attention, protection, advice, guidance, counsel,1207
instruction, training, or education, disfigurement, mental1208
anguish, and any other intangible loss.1209

        (5) "Past damages" means any damages that result from an1210
injury, death, or loss to person or property that is a subject of1211
a civil action upon a medical, dental, optometric, or chiropractic1212
claim and that have accrued by the time that the verdict or1213
determination of liability is rendered in that action by the trier1214
of fact.1215

        (6) "Trier of fact" means the jury or, in a nonjury action,1216
the court.1217

        (B) In any civil action upon a medical, dental, optometric,1218
or chiropractic claim in which a plaintiff makes a good faith1219
claim against the defendant for future damages that exceed fifty1220
thousand dollars, upon motion of that plaintiff or the defendant,1221
the trier of fact shall return a general verdict and, if that1222
verdict is in favor of that plaintiff, answers to interrogatories1223
or findings of fact that specify both of the following:1224

        (1) The past damages recoverable by that plaintiff;1225

        (2) The future damages recoverable by that plaintiff.1226

        (C) If answers to interrogatories are returned or findings1227
of fact are made pursuant to division (B) of this section and if1228
the future damages recoverable by that plaintiff exceeds fifty1229
thousand dollars, the plaintiff or defendant may file a motion1230
with the court that seeks a determination under division (D) of1231
this section. The plaintiff or defendant shall file the motion at1232
any time after the verdict or determination in favor of the1233
plaintiff is rendered by the trier of fact but prior to the entry1234
of judgment in accordance with Civil Rule 58.1235

        (D)(1) Upon the filing of a motion pursuant to division (C)1236
of this section and prior to the entry of judgment in accordance1237
with Civil Rule 58, the court shall do all of the following:1238

        (a) Set a date for a hearing to address whether all or any1239
part of the future damages recoverable by the plaintiff shall be1240
received by the plaintiff in a series of periodic payments rather1241
than in a lump sum;1242

        (b) Give notice of the date of the hearing described in1243
division (D)(1)(a) of this section to the parties involved and1244
their counsel of record;1245

        (c) Conduct the hearing described in division (D)(1)(a) of1246
this section, allow the parties involved to present any relevant1247
evidence at the hearing, consider the factors described in1248
division (D)(2) of this section in making its determination, and1249
make its determination in accordance with division (D)(3) of this1250
section.1251

        (2) In determining whether all or any part of the future1252
damages recoverable by the plaintiff shall be received by the1253
plaintiff in a series of periodic payments rather than in a lump1254
sum, the court shall consider all of the following factors:1255

        (a) The purposes for which those portions of the future1256
damages were awarded to that plaintiff;1257

        (b) The business or occupational experience of that1258
plaintiff;1259

        (c) The age of that plaintiff;1260

        (d) The physical and mental condition of that plaintiff;1261

        (e) Whether that plaintiff or the parent, guardian, or1262
custodian of that plaintiff is able to competently manage the1263
future damages;1264

        (f) Any other circumstance that relates to whether the1265
injury sustained by that plaintiff would be better compensated by1266
the payment of the future damages in a lump sum or by their1267
receipt in a series of periodic payments.1268

        (3) After the hearing described in division (D)(1) of this1269
section and prior to the entry of judgment in accordance with1270
Civil Rule 58, the court shall determine, in its discretion,1271
whether all or any part of the future damages recoverable by the1272
plaintiff shall be received by the plaintiff in a series of1273
periodic payments rather than in a lump sum. If the court1274
determines that a plaintiff shall receive the future damages1275
recoverable by the plaintiff in a series of periodic payments, it1276
may order the payments only as to the amount of the future damages1277
recoverable by the plaintiff that exceeds fifty thousand dollars.1278
If the court determines that the plaintiff shall receive the1279
future damages recoverable by the plaintiff in a lump sum, the1280
future damages shall be paid in a lump sum.1281

        (E) If the court determines pursuant to division (D) of1282
this section that a plaintiff shall receive the future damages1283
recoverable by the plaintiff in a series of periodic payments,1284
both of the following apply:1285

        (1) Within twenty days after the court makes that1286
determination, the plaintiff shall submit a periodic payments plan1287
to the court. The plan may include, but is not limited to, a1288
provision for a trust or an annuity and may be submitted by that1289
plaintiff alone or by that plaintiff and the defendant.1290

        (2) Within twenty days after the court makes that1291
determination, the defendant may submit to the court, alone or1292
jointly with the plaintiff, a periodic payments plan. If the1293
defendant submits a periodic payments plan, the plan may include,1294
but is not limited to, a provision for a trust or an annuity.1295

        (F)(1) If the defendant and plaintiff do not jointly submit1296
a periodic payments plan and if the defendant does not separately1297
submit a periodic payments plan, then, within ten days after that1298
plaintiff submits a plan, the defendant may submit to the court1299
written comments relative to the periodic payments plan of the1300
plaintiff.1301

        (2) If the defendant and plaintiff do not jointly submit1302
a periodic payments plan and if the defendant separately submits a1303
periodic payments plan, then, within ten days after the defendant1304
submits the plan, the plaintiff may submit to the court written1305
comments relative to the periodic payments plan of the defendant.1306

        (G)(1) The court, in its discretion, may modify, approve,1307
or reject any submitted periodic payments plan. In approving any1308
periodic payments plan, the court shall take into consideration1309
interest on the judgment in question in accordance with section1310
1343.03 of the Revised Code. Additionally, in approving any1311
periodic payments plan, the court is not required to ensure that1312
payments under the periodic payments plan are equal in amount or1313
that the total amount paid each year under the periodic payments1314
plan is equal in amount to the total amount paid in other years1315
under the plan; rather, a periodic payments plan may provide for1316
payments to be made in irregular or varied amounts, or to be1317
graduated upward or downward in amount over the duration of the1318
periodic payments plan.1319

        (2) The court shall include in any approved periodic1320
payments plan adequate security to insure that the plaintiff will1321
receive all of the periodic payments under that plan. If the1322
approved periodic payments plan includes a provision for an1323
annuity as the adequate security or otherwise, the defendant shall1324
purchase the annuity from either of the following types of1325
insurance companies:1326

        (a) An insurance company that the A.M. Best Company, in its1327
most recently published rating guide of life insurance companies,1328
has rated A or better and has rated XII or higher as to financial1329
size or strength;1330

        (b) An insurance company that the superintendent of1331
insurance, under rules adopted pursuant to Chapter 119. of the1332
Revised Code for purposes of implementing this division,1333
determines is licensed to do business in this state and,1334
considering the factors described in this division, is a stable1335
insurance company that issues annuities that are safe and1336
desirable. In making determinations as described in this1337
division, the superintendent shall be guided by the principle that1338
annuities should be safe and desirable for plaintiffs who are1339
awarded damages. In making those determinations, the1340
superintendent shall consider the financial condition, general1341
standing, operating results, profitability, leverage, liquidity,1342
amount and soundness of reinsurance, adequacy of reserves, and the1343
management of any insurance company in question and also may1344
consider ratings, grades, and classifications of any nationally1345
recognized rating services of insurance companies and any other1346
factors relevant to the making of such determinations.1347

        (3) If a periodic payments plan provides for periodic1348
payments over a period of five years or more to the plaintiff, the1349
court, in its discretion, may include in the approved periodic1350
payments plan a provision in which it reserves to itself1351
continuing jurisdiction over that plan, including jurisdiction to1352
review and modify that plan.1353

        (4) The court shall specify in the entry of judgment in the1354
tort action the determination made pursuant to division (D) of1355
this section and, if applicable, the terms of any approved1356
periodic payments plan.1357

        (H) After a periodic payments plan is approved, the future1358
damages that are to be received in periodic payments shall be paid1359
in accordance with the plan, including, if applicable, payment1360
over to a trust or annuity provided for in the plan.1361

        (I) If a court orders a series of periodic payments of1362
future damages in accordance with this section and the plaintiff1363
dies prior to the receipt of all of the future damages, the1364
liability for the unpaid portion of those damages that is not yet1365
due at the time of the death of that plaintiff shall continue, but1366
the payments shall be paid to the heirs of that plaintiff as1367
scheduled in and otherwise in accordance with the approved1368
periodic payments plan or, if the plan does not contain a relevant1369
provision, as the court shall order.1370

        (J)(1) Nothing in this section precludes a plaintiff and a1371
defendant from mutually agreeing to a settlement of the action.1372

        (2) Except as otherwise provided in this section, nothing in1373
this section increases the time for filing any motion or notice of1374
appeal or taking any other action relative to a civil action upon1375
a medical, dental, optometric, or chiropractic claim, alters the1376
amount of any verdict or determination of damages by the trier of1377
fact in a civil action upon a medical, dental, optometric, or1378
chiropractic claim, or alters the liability of any party to pay or1379
satisfy the verdict or determination.1380

        (K) This section does not apply to tort actions that are1381
brought against political subdivisions of this state and that are1382
commenced under or are subject to Chapter 2744. of the Revised1383
Code or to tort actions brought against the state in the court of1384
claims.1385

       Sec. 2323.56.  (A) As used in this section:1386

       (1) "Economic loss" means any of the following types of1387
pecuniary harm:1388

       (a) All wages, salaries, or other compensation lost as a1389
result of an injury to person that is a subject of a tort action;1390

       (b) All expenditures for medical care or treatment,1391
rehabilitation services, or other care, treatment, services,1392
products, or accommodations as a result of an injury to person1393
that is a subject of a tort action;1394

       (c) Any other expenditures incurred as a result of an injury1395
to person that is a subject of a tort action.1396

       (2) "Future damages" means any damages that result from an1397
injury to person that is a subject of a tort action and that will1398
accrue after the verdict or determination of liability by the1399
trier of fact is rendered in that tort action.1400

       (3) "Medical claim," "dental claim," "optometric claim," and1401
"chiropractic claim" have the same meanings as in section 2305.111402
2305.113 of the Revised Code.1403

       (4) "Noneconomic loss" means nonpecuniary harm that results1404
from an injury to person that is a subject of a tort action,1405
including, but not limited to, pain and suffering, loss of1406
society, consortium, companionship, care, assistance, attention,1407
protection, advice, guidance, counsel, instruction, training, or1408
education, mental anguish, and any other intangible loss.1409

       (5) "Past damages" means any damages that result from an1410
injury to person that is a subject of a tort action and that have1411
accrued by the time that the verdict or determination of liability1412
by the trier of fact is rendered in that tort action, and any1413
punitive or exemplary damages awarded.1414

       (6) "Tort action" means a civil action for damages for1415
injury to person. "Tort action" includes a product liability1416
claim for damages for injury to person that is subject to sections1417
2307.71 to 2307.80 of the Revised Code, but does not include a1418
civil action for damages for a breach of contract or another1419
agreement between persons.1420

       (7) "Trier of fact" means the jury or, in a nonjury action,1421
the court.1422

       (B)(1) In any tort action that is tried to a jury and in1423
which a plaintiff makes a good faith claim against the defendant1424
in question for future damages that exceed two hundred thousand1425
dollars, upon motion of that plaintiff or the defendant in1426
question, the court shall instruct the jury to return, and the1427
jury shall return, a general verdict and, if that verdict is in1428
favor of that plaintiff, answers to interrogatories that shall1429
specify all of the following:1430

       (a) The past damages recoverable by that plaintiff;1431

       (b) The future damages recoverable by that plaintiff, and1432
the portions of those future damages that represent each of the1433
following:1434

       (i) Noneconomic loss;1435

       (ii) Economic loss;1436

       (iii) Economic loss as described in division (A)(1)(a) of1437
this section;1438

       (iv) Economic loss as described in division (A)(1)(b) of1439
this section;1440

       (v) Economic loss as described in division (A)(1)(c) of this1441
section.1442

       (2) In any tort action that is tried to a court and in which1443
a plaintiff makes a good faith claim against the defendant in1444
question for future damages that exceed two hundred thousand1445
dollars, upon motion of that plaintiff or the defendant in1446
question, the court shall make its determination in the action1447
and, if that determination is in favor of that plaintiff, make1448
findings of fact that shall specify damages as provided in1449
division (B)(1) of this section.1450

       (C) If answers to interrogatories are returned or findings1451
of fact are made pursuant to division (B) of this section and if1452
the total of the portions of the future damages described in1453
divisions (B)(1)(b)(i), (iv), and (v) of this section exceeds both1454
two hundred thousand dollars and twenty-five per cent of the total1455
of the damages described in divisions (B)(1)(a) and (b) of this1456
section, the plaintiff or defendant in question may file a motion1457
with the court that seeks a determination under division (D) of1458
this section. Such a motion shall be filed at any time after the1459
verdict or determination in favor of the plaintiff in question is1460
rendered by the trier of fact but prior to the entry of judgment1461
in accordance with Civil Rule 58.1462

       (D)(1) Upon the filing of a motion pursuant to division (C)1463
of this section and prior to the entry of judgment in accordance1464
with Civil Rule 58, the court shall do all of the following:1465

       (a) Set a date for a hearing to address whether all or any1466
part of the total of the portions of the future damages described1467
in divisions (B)(1)(b)(i), (iv), and (v) of this section shall be1468
received by the plaintiff in question in a series of periodic1469
payments rather than in a lump sum;1470

       (b) Give notice of the date of the hearing described in1471
division (D)(1)(a) of this section to the parties involved and1472
their counsel of record;1473

       (c) Conduct the hearing described in division (D)(1)(a) of1474
this section, allow the parties involved to present any relevant1475
evidence at the hearing, consider the factors described in1476
division (D)(2) of this section in making its determination, and1477
make its determination in accordance with division (D)(3) of this1478
section.1479

       (2) In determining whether all or any part of the total of1480
the portions of the future damages described in divisions1481
(B)(1)(b)(i), (iv), and (v) of this section shall be received by1482
the plaintiff in question in a series of periodic payments rather1483
than in a lump sum, the court shall consider all of the following1484
factors:1485

       (a) The purposes for which those portions of the future1486
damages were awarded to that plaintiff;1487

       (b) The business or occupational experience of that1488
plaintiff;1489

       (c) The age of that plaintiff;1490

       (d) The physical and mental condition of that plaintiff;1491

       (e) Whether that plaintiff or the parent, guardian, or1492
custodian of that plaintiff is able to competently manage those1493
portions of the future damages;1494

       (f) Any other circumstance that relates to whether the1495
injury sustained by that plaintiff would be better compensated by1496
the payment of those portions of the future damages in a lump sum1497
or by their receipt in a series of periodic payments.1498

       (3) After the hearing described in division (D)(1) of this1499
section and prior to the entry of judgment in accordance with1500
Civil Rule 58, the court shall determine, in its discretion,1501
whether all or any part of the total of the portions of the future1502
damages described in divisions (B)(1)(b)(i), (iv), and (v) of this1503
section shall be received by the plaintiff in question in a series1504
of periodic payments rather than in a lump sum. If the court1505
determines that a series of periodic payments shall be received by1506
that plaintiff, it may order such payments only as to the amount1507
of that total that exceeds both two hundred thousand dollars and1508
twenty-five per cent of the total of the damages described in1509
divisions (B)(1)(a) and (b) of this section.1510

       (E)(1)(a) If the court determines pursuant to division (D)1511
of this section that a series of periodic payments shall be1512
received by the plaintiff in question, then, within twenty days1513
after the court so determines, that plaintiff shall submit a1514
periodic payments plan to the court. Such a plan may include, but1515
is not limited to, a provision for a trust or an annuity, and may1516
be submitted by that plaintiff alone or by that plaintiff and the1517
defendant in question.1518

       (b) If that defendant and that plaintiff do not jointly1519
submit a periodic payments plan, then, within twenty days after1520
the court makes its determination pursuant to division (D) of this1521
section that a series of periodic payments shall be received by1522
that plaintiff, that defendant may submit to the court a periodic1523
payments plan. If hethat defendant does so, it may include, but1524
is not limited to, a provision for a trust or an annuity.1525

       (c) If that defendant and that plaintiff do not jointly1526
submit a periodic payments plan and if that defendant does not1527
separately submit such a plan pursuant to division (E)(1)(b) of1528
this section, then, within ten days after that plaintiff submits1529
such a plan, that defendant may submit to the court written1530
comments relative to the periodic payments plan of that plaintiff.1531
If that defendant and that plaintiff do not jointly submit a1532
periodic payments plan and if that defendant separately submits1533
such a plan pursuant to division (E)(1)(b) of this section, then,1534
within ten days after that defendant submits such a plan, that1535
plaintiff may submit to the court written comments relative to the1536
periodic payments plan of that defendant.1537

       (d) The court, in its discretion, may modify, approve, or1538
reject any submitted periodic payments plan. In approving any1539
periodic payments plan, the court shall take into consideration1540
interest on the judgment in question, in accordance with section1541
1343.03 of the Revised Code. Additionally, in approving any1542
periodic payments plan, the court is not required to ensure that1543
payments under the periodic payments plan are equal in amount or1544
that the total amount paid each year under the periodic payments1545
plan is equal in amount to the total amount paid in other years1546
under the plan; rather, a periodic payments plan may provide for1547
payments to be made in irregular or varied amounts, or to be1548
graduated upward or downward in amount over the duration of the1549
periodic payments plan.1550

       (e) The court shall include in any approved periodic1551
payments plan adequate security to insure that the plaintiff in1552
question will receive all of the periodic payments under that1553
plan. If the approved periodic payments plan includes a provision1554
for an annuity as the adequate security or otherwise, the1555
defendant in question shall purchase the annuity from either of1556
the following types of insurance companies:1557

       (i) An insurance company that the A.M. Best Company, in its1558
most recently published rating guide of life insurance companies,1559
has rated A or better and has rated XII or higher as to financial1560
size or strength;1561

       (ii) An insurance company that the superintendent of1562
insurance, under rules adopted pursuant to Chapter 119. of the1563
Revised Code for purposes of implementing this division,1564
determines is licensed to do business in this state and,1565
considering the factors described in this division, is a stable1566
insurance company that issues annuities that are safe and1567
desirable.1568

       In making determinations as described in this division, the1569
superintendent shall be guided by the principle that annuities1570
should be safe and desirable for plaintiffs who are awarded1571
damages. In making such determinations, the superintendent shall1572
consider the financial condition, general standing, operating1573
results, profitability, leverage, liquidity, amount and soundness1574
of reinsurance, adequacy of reserves, and the management of any1575
insurance company in question and also may consider ratings,1576
grades, and classifications of any nationally recognized rating1577
services of insurance companies and any other factors relevant to1578
the making of such determinations.1579

       (f) If a periodic payments plan provides for periodic1580
payments over a period of five years or more to the plaintiff in1581
question, the court, in its discretion, may include in the1582
approved periodic payments plan a provision in which it reserves1583
to itself continuing jurisdiction over that plan, including1584
jurisdiction to review and modify that plan.1585

       (g) After a periodic payments plan is approved, the future1586
damages that are to be received in periodic payments shall be paid1587
in accordance with the plan, including, if applicable, payment1588
over to a trust or annuity provided for in the plan.1589

       (2) If the court determines pursuant to division (D) of this1590
section that a series of periodic payments shall not be received1591
by the plaintiff in question, the future damages described in1592
divisions (B)(1)(b)(i), (iv), and (v) of this section shall be1593
paid in a lump sum.1594

       (3) The court shall specify in the entry of judgment in the1595
tort action the determination made pursuant to division (D) of1596
this section and, if applicable, the terms of any approved1597
periodic payments plan.1598

       (F) If a court orders a series of periodic payments of1599
future damages in accordance with this section, the following1600
rules shall govern those payments if the plaintiff in question1601
dies prior to the receipt of all of them:1602

       (1) The liability for the portion of those payments that1603
represents future economic loss as described in division1604
(B)(1)(b)(iv) of this section and that is not due at the time of1605
the death of that plaintiff shall cease at that time;1606

       (2) The liability for the portion of those payments that1607
represents future noneconomic loss of that plaintiff as described1608
in division (B)(1)(b)(i) of this section and that is not due at1609
the time of the death of that plaintiff shall continue, but the1610
payments shall be paid to the heirs of that plaintiff as scheduled1611
in and otherwise in accordance with the approved periodic payments1612
plan or, if the plan does not contain a relevant provision, as the1613
court shall order;1614

       (3) The liability for the portion of those payments not1615
described in division (F)(1) or (2) of this section shall1616
continue, but the payments shall be paid as described in division1617
(F)(2) of this section.1618

       (G)(1) Nothing in this section precludes a plaintiff in1619
question and a defendant in question from mutually agreeing to a1620
settlement of the action.1621

       (2) Except to the extent provided in divisions (A) to (F) of1622
this section, nothing in those divisions increases the time for1623
filing any motion or notice of appeal or taking any other action1624
relative to a tort action, alters the amount of any verdict or1625
determination of damages by the trier of fact in a tort action, or1626
alters the liability of any party to pay or satisfy any such1627
verdict or determination.1628

       (H) This section does not apply to tort actions against1629
political subdivisions of this state that are commenced under or1630
are subject to Chapter 2744. of the Revised Code or to tort1631
actions against the state in the court of claims. This section1632
also does not apply to a tort or other civil action upon a medical1633
claim, dental claim, optometric claim, or chiropractic claim, and1634
instead such an action shall be subject to section 2323.572323.551635
of the Revised Code.1636

       Sec. 2711.21.  (A) Upon the filing of any medical, dental,1637
optometric, or chiropractic claim as defined in division (D) of1638
section 2305.112305.113 of the Revised Code, if all of the1639
parties to the medical, dental, optometric, or chiropractic claim1640
agree to submit it to nonbinding arbitration, the controversy1641
shall be submitted to an arbitration board consisting of three1642
arbitrators to be named by the court. The arbitration board shall1643
consist of one person designated by the plaintiff or plaintiffs,1644
one person designated by the defendant or defendants, and a person1645
designated by the court. The person designated by the court shall1646
serve as the chairmanchairperson of the board. Each member of1647
the board shall receive a reasonable compensation based on the1648
extent and duration of actual service rendered, and shall be paid1649
in equal proportions by the parties in interest. In a claim1650
accompanied by a poverty affidavit, the cost of the arbitration1651
shall be borne by the court.1652

       (B) The arbitration proceedings shall be conducted in1653
accordance with sections 2711.06 to 2711.16 of the Revised Code1654
insofar as they are applicable. Such proceedings shall be1655
conducted in the county in which the trial is to be held.1656

       (C) If the decision of the arbitration board is not accepted1657
by all parties to the medical, dental, optometric, or chiropractic1658
claim, the claim shall proceed as if it had not been submitted to1659
nonbinding arbitration pursuant to this section. The decision of1660
the arbitration board and any dissenting opinion written by any1661
board member are not admissible into evidence at the trial.1662

       (D) Nothing in this section shall be construed to limit the1663
right of any person to enter into an agreement to submit a1664
controversy underlying a medical, dental, optometric, or1665
chiropractic claim to binding arbitration.1666

       Sec. 2711.22. A(A) Except as otherwise provided in this1667
section, a written contract between a patient and a hospital or1668
physicianhealthcare provider to settle by binding arbitration any1669
dispute or controversy arising out of the diagnosis, treatment, or1670
care of the patient rendered by a physician or hospital or1671
healthcare provider, that is entered into prior to or subsequent1672
to the rendering of such diagnosis, treatment, or care of the1673
patient is valid, irrevocable, and enforceable, save upon such1674
grounds as exist at law or in equity for the revocation of any1675
contractonce the contract is signed by all parties. The contract1676
remains valid, irrevocable, and enforceable until or unless the1677
patient or the patient's legal representative rescinds the1678
contract by written notice within thirty days of the signing of1679
the contract. A guardian or other legal representative of the1680
patient may give written notice of the rescission of the contract1681
if the patient is incapacitated or a minor.1682

       (B) As used in this section the terms "hospital" and1683
"physician" shall have the meaning set forth in division (D) of1684
section 2305.11 of the Revised Code. The provisions of this1685
division apply to hospitals, doctors of medicine, doctors of1686
osteopathic medicine, and doctors of podiatric medicine.and in1687
sections 2711.23 and 2711.24 of the Revised Code:1688

       (1) "Healthcare provider" means a physician, podiatrist,1689
dentist, licensed practical nurse, registered nurse, advanced1690
practice nurse, chiropractor, optometrist, physician's assistant,1691
emergency medical technician, or physical therapist.1692

       (2) "Hospital," "physician," "podiatrist," "dentist,"1693
"registered nurse," "advanced practice nurse," "chiropractor,"1694
"optometrist," "physical therapist," "medical claim," "dental1695
claim," "optometric claim," and "chiropractic claim" have the same1696
meanings as in section 2305.113 of the Revised Code.1697

       Sec. 2711.23.  To be valid and enforceable any arbitration1698
agreements pursuant to sections 2711.01 and 2711.22 of the Revised1699
Code for controversies involving hospital ora medical care,1700
diagnosis, or treatment which are, dental, chiropractic, or1701
optometric claim that is entered into prior to rendering sucha1702
patient receiving any care, diagnosis, or treatment shall include1703
or be subject to the following conditions:1704

       (A) The agreement shall provide that medical or hospitalthe1705
care, diagnosis, or treatment will be provided whether or not the1706
patient signs the agreement to arbitrate;1707

       (B) The agreement shall provide that the patient, or the1708
patient's spouse, or the personal representative of histhe1709
patient's estate in the event of the patient's death or1710
incapacity, shall have a right to withdraw the patient's consent1711
to arbitrate histhe patient's claim by notifying the physician1712
healthcare provider or hospital in writing within sixtythirty1713
days after the patient's discharge from the hospital for any claim1714
arising out of hospitalization, or within sixty days after the1715
termination of the physician-patient relationship for the physical1716
condition involved for any claim against a physiciansigning of1717
the agreement. Nothing in this division shall be construed to mean1718
that the spouse of a competent patient can withdraw over the1719
objection of the patient the consent of the patient to arbitrate;1720

       (C) The agreement shall provide that the decision whether or1721
not to sign the agreement is solely a matter for the patient's1722
determination without any influence by the physician or hospital;1723

       (D) The agreement shall, if appropriate, provide that its1724
terms constitute a waiver of any right to a trial in court, or a1725
waiver of any right to a trial by jury;1726

       (E) The agreement shall provide that the arbitration1727
expenses shall be divided equally between the parties to the1728
agreement;1729

       (F) Any arbitration panel shall consist of three persons, no1730
more than one of whom shall be a physician or the representative1731
of a hospital;1732

       (G) The arbitration agreement shall be separate from any1733
other agreement, consent, or document;1734

       (H) The agreement shall not be submitted to a patient for1735
approval when the patient's condition prevents the patient from1736
making a rational decision whether or not to agree;1737

       (I) Filing of a medical, dental, chiropractic, or optometric1738
claim, as defined in division (D) of section 2305.11 of the1739
Revised Code, within the sixtythirty days provided for withdrawal1740
of a patient from the arbitration agreement shall be deemed a1741
withdrawal from suchthe agreement;1742

       (J) The agreement shall contain a separately stated notice1743
that clearly informs the patient of histhe patient's rights under1744
division (B) of this section.1745

       As used in this section, the terms "hospital" and "physician"1746
shall have the meanings set forth in division (D) of section1747
2305.11 of the Revised Code.1748

       The provisions of this division apply to hospitals, doctors1749
of medicine, doctors of osteopathic medicine, and doctors of1750
podiatric medicine.1751

       Sec. 2711.24.  To the extent it is in ten-point type and is1752
executed in the following form, an arbitration agreement of the1753
type stated in section 2711.23 of the Revised Code shall be1754
presumed valid and enforceable in the absence of proof by a1755
preponderance of the evidence that the execution of the agreement1756
was induced by fraud, that the patient executed the agreement as a1757
direct result of the willful or negligent disregard by the1758
physician or hospitalhealthcare provider of the patient's right1759
not to so execute, or that the patient executing the agreement was1760
not able to communicate effectively in spoken and written English1761
or any other language in which the agreement is written:1762

"AGREEMENT TO RESOLVE FUTURE MALPRACTICE
1763

CLAIM BY BINDING ARBITRATION
1764

       In the event of any dispute or controversy arising out of the1765
diagnosis, treatment, or care of the patient by the healthcare1766
provider of medical services, the dispute or controversy shall be1767
submitted to binding arbitration.1768

       Within fifteen days after a party to this agreement has given1769
written notice to the other of demand for arbitration of said1770
dispute or controversy, the parties to the dispute or controversy1771
shall each appoint an arbitrator and give notice of such1772
appointment to the other. Within a reasonable time after such1773
notices have been given the two arbitrators so selected shall1774
select a neutral arbitrator and give notice of the selection1775
thereof to the parties. The arbitrators shall hold a hearing1776
within a reasonable time from the date of notice of selection of1777
the neutral arbitrator.1778

       Expenses of the arbitration shall be shared equally by the1779
parties to this agreement.1780

       The patient, by signing this agreement, also acknowledges1781
that hethe patient has been informed that:1782

       (1) Medical or hospital careCare, diagnosis, or treatment1783
will be provided whether or not the patient signs the agreement to1784
arbitrate;1785

       (2) The agreement may not even be submitted to a patient for1786
approval when the patient's condition prevents the patient from1787
making a rational decision whether or not to agree;1788

       (3) The decision whether or not to sign the agreement is1789
solely a matter for the patient's determination without any1790
influence by the physician or hospital;1791

       (4) The agreement waives the patient's right to a trial in1792
court for any future malpractice claim hethe patient may have1793
against the physician or hospitalhealthcare provider;1794

       (5) The patient must be furnished with two copies of this1795
agreement.1796

PATIENT'S RIGHT TO CANCEL
1797

HIS
AGREEMENT TO ARBITRATE
1798

       The patient, or the patient's spouse or the personal1799
representative of histhe patient's estate in the event of the1800
patient's death or incapacity, has the right to cancel this1801
agreement to arbitrate by notifying the physician or hospital1802
healthcare provider in writing within sixtythirty days after the1803
patient's discharge from the hospital for any claim against a1804
hospital, or within sixty days after the termination of the1805
physician-patient relationship for the physical condition involved1806
for claims against physicianssigning of the agreement. The1807
patient, or histhe patient's spouse or representative, as1808
appropriate, may cancel this agreement by merely writing1809
"cancelled" on the face of one of histhe patient's copies of the1810
agreement, signing histhe patient's name under such word, and1811
mailing, by certified mail, return receipt requested, suchthe1812
copy to the physician or hospitalhealthcare provider within such1813
sixty-daythe thirty-day period.1814

       Filing of a medical claim in a court within the sixtythirty1815
days provided for cancellation of the arbitration agreement by the1816
patient will cancel the agreement without any further action by1817
the patient.1818

Date:1819

................................................................1820

Signature of Provider of Medical Services
1821

................................................................1822

Signature of Patient"
1823

       (B) As used in this section the terms "hospital" and1824
"physician" have the meanings set forth in division (D) of section1825
2305.11 of the Revised Code. The provisions of this division1826
apply to hospitals, doctors of medicine, doctors of osteopathic1827
medicine, and doctors of podiatric medicine.1828

       Sec. 2743.02.  (A)(1) The state hereby waives its immunity1829
from liability and consents to be sued, and have its liability1830
determined, in the court of claims created in this chapter in1831
accordance with the same rules of law applicable to suits between1832
private parties, except that the determination of liability is1833
subject to the limitations set forth in this chapter and, in the1834
case of state universities or colleges, in section 3345.40 of the1835
Revised Code, and except as provided in division (A)(2) of this1836
section. To the extent that the state has previously consented to1837
be sued, this chapter has no applicability.1838

       Except in the case of a civil action filed by the state,1839
filing a civil action in the court of claims results in a complete1840
waiver of any cause of action, based on the same act or omission,1841
which the filing party has against any officer or employee, as1842
defined in section 109.36 of the Revised Code. The waiver shall1843
be void if the court determines that the act or omission was1844
manifestly outside the scope of the officer's or employee's office1845
or employment or that the officer or employee acted with malicious1846
purpose, in bad faith, or in a wanton or reckless manner.1847

       (2) If a claimant proves in the court of claims that an1848
officer or employee, as defined in section 109.36 of the Revised1849
Code, would have personal liability for histhe officer's or1850
employee's acts or omissions but for the fact that the officer or1851
employee has personal immunity under section 9.86 of the Revised1852
Code, the state shall be held liable in the court of claims in any1853
action that is timely filed pursuant to section 2743.16 of the1854
Revised Code and that is based upon the acts or omissions.1855

       (B) The state hereby waives the immunity from liability of1856
all hospitals owned or operated by one or more political1857
subdivisions and consents for them to be sued, and to have their1858
liability determined, in the court of common pleas, in accordance1859
with the same rules of law applicable to suits between private1860
parties, subject to the limitations set forth in this chapter.1861
This division is also applicable to hospitals owned or operated by1862
political subdivisions which have been determined by the supreme1863
court to be subject to suit prior to July 28, 1975.1864

       (C) Any hospital, as defined underin section 2305.111865
2305.113 of the Revised Code, may purchase liability insurance1866
covering its operations and activities and its agents, employees,1867
nurses, interns, residents, staff, and members of the governing1868
board and committees, and, whether or not such insurance is1869
purchased, may, to such extent as its governing board considers1870
appropriate, indemnify or agree to indemnify and hold harmless any1871
such person against expense, including attorney's fees, damage,1872
loss, or other liability arising out of, or claimed to have arisen1873
out of, the death, disease, or injury of any person as a result of1874
the negligence, malpractice, or other action or inaction of the1875
indemnified person while acting within the scope of histhe1876
indemnified person's duties or engaged in activities at the1877
request or direction, or for the benefit, of the hospital. Any1878
hospital electing to indemnify such persons, or to agree to so1879
indemnify, shall reserve such funds as are necessary, in the1880
exercise of sound and prudent actuarial judgment, to cover the1881
potential expense, fees, damage, loss, or other liability. The1882
superintendent of insurance may recommend, or, if such hospital1883
requests himthe superintendent to do so, the superintendent shall1884
recommend, a specific amount for any period that, in histhe1885
superintendent's opinion, represents such a judgment. This1886
authority is in addition to any authorization otherwise provided1887
or permitted by law.1888

       (D) Recoveries against the state shall be reduced by the1889
aggregate of insurance proceeds, disability award, or other1890
collateral recovery received by the claimant. This division does1891
not apply to civil actions in the court of claims against a state1892
university or college under the circumstances described in section1893
3345.40 of the Revised Code. The collateral benefits provisions1894
of division (B)(2) of that section apply under those1895
circumstances.1896

       (E) The only defendant in original actions in the court of1897
claims is the state. The state may file a third-party complaint1898
or counterclaim in any civil action, except a civil action for two1899
thousand five hundred dollars or less, that is filed in the court1900
of claims.1901

       (F) A civil action against an officer or employee, as1902
defined in section 109.36 of the Revised Code, that alleges that1903
the officer's or employee's conduct was manifestly outside the1904
scope of histhe officer's or employee's employment or official1905
responsibilities, or that the officer or employee acted with1906
malicious purpose, in bad faith, or in a wanton or reckless manner1907
shall first be filed against the state in the court of claims,1908
which has exclusive, original jurisdiction to determine,1909
initially, whether the officer or employee is entitled to personal1910
immunity under section 9.86 of the Revised Code and whether the1911
courts of common pleas have jurisdiction over the civil action.1912

       The filing of a claim against an officer or employee under1913
this division tolls the running of the applicable statute of1914
limitations until the court of claims determines whether the1915
officer or employee is entitled to personal immunity under section1916
9.86 of the Revised Code.1917

       (G) Whenever a claim lies against an officer or employee who1918
is a member of the Ohio national guard, and the officer or1919
employee was, at the time of the act or omission complained of,1920
subject to the "Federal Tort Claims Act," 60 Stat. 842 (1946), 281921
U.S.C. 2671, et seq., then the Federal Tort Claims Act is the1922
exclusive remedy of the claimant and the state has no liability1923
under this section.1924

       Sec. 2743.43.  (A) No person shall be deemed competent to1925
give expert testimony on the liability issues in a medical claim,1926
as defined in division (D)(3) of section 2305.112305.113 of the1927
Revised Code, unless:1928

       (1) Such person is licensed to practice medicine and1929
surgery, osteopathic medicine and surgery, or podiatric medicine1930
and surgery by the state medical board or by the licensing1931
authority of any state;1932

       (2) Such person devotes three-fourths of histhe person's1933
professional time to the active clinical practice of medicine or1934
surgery, osteopathic medicine and surgery, or podiatric medicine1935
and surgery, or to its instruction in an accredited university.1936

       (B) Nothing in division (A) of this section shall be1937
construed to limit the power of the trial court to adjudge the1938
testimony of any expert witness incompetent on any other ground.1939

       Sec. 2919.16.  As used in sections 2919.16 to 2919.18 of the1940
Revised Code:1941

       (A) "Fertilization" means the fusion of a human spermatozoon1942
with a human ovum.1943

       (B) "Gestational age" means the age of an unborn human as1944
calculated from the first day of the last menstrual period of a1945
pregnant woman.1946

       (C) "Health care facility" means a hospital, clinic,1947
ambulatory surgical treatment center, other center, medical1948
school, office of a physician, infirmary, dispensary, medical1949
training institution, or other institution or location in or at1950
which medical care, treatment, or diagnosis is provided to a1951
person.1952

       (D) "Hospital" has the same meanings as in sections 2108.01,1953
3701.01, and 5122.01 of the Revised Code.1954

       (E) "Live birth" has the same meaning as in division (A) of1955
section 3705.01 of the Revised Code.1956

       (F) "Medical emergency" means a condition that a pregnant1957
woman's physician determines, in good faith and in the exercise of1958
reasonable medical judgment, so complicates the woman's pregnancy1959
as to necessitate the immediate performance or inducement of an1960
abortion in order to prevent the death of the pregnant woman or to1961
avoid a serious risk of the substantial and irreversible1962
impairment of a major bodily function of the pregnant woman that1963
delay in the performance or inducement of the abortion would1964
create.1965

       (G) "Physician" has the same meaning as in section 2305.111966
2305.113 of the Revised Code.1967

       (H) "Pregnant" means the human female reproductive1968
condition, that commences with fertilization, of having a1969
developing fetus.1970

       (I) "Premature infant" means a human whose live birth occurs1971
prior to thirty-eight weeks of gestational age.1972

       (J) "Serious risk of the substantial and irreversible1973
impairment of a major bodily function" means any medically1974
diagnosed condition that so complicates the pregnancy of the woman1975
as to directly or indirectly cause the substantial and1976
irreversible impairment of a major bodily function, including, but1977
not limited to, the following conditions:1978

       (1) Pre-eclampsia;1979

       (2) Inevitable abortion;1980

       (3) Prematurely ruptured membrane;1981

       (4) Diabetes;1982

       (5) Multiple sclerosis.1983

       (K) "Unborn human" means an individual organism of the1984
species homo sapiens from fertilization until live birth.1985

       (L) "Viable" means the stage of development of a human fetus1986
at which in the determination of a physician, based on the1987
particular facts of a woman's pregnancy that are known to the1988
physician and in light of medical technology and information1989
reasonably available to the physician, there is a realistic1990
possibility of the maintaining and nourishing of a life outside of1991
the womb with or without temporary artificial life-sustaining1992
support.1993

       Sec. 3923.63.  (A) Notwithstanding section 3901.71 of the1994
Revised Code, each individual or group policy of sickness and1995
accident insurance delivered, issued for delivery, or renewed in1996
this state that provides maternity benefits shall provide coverage1997
of inpatient care and follow-up care for a mother and her newborn1998
as follows:1999

       (1) The policy shall cover a minimum of forty-eight hours of2000
inpatient care following a normal vaginal delivery and a minimum2001
of ninety-six hours of inpatient care following a cesarean2002
delivery. Services covered as inpatient care shall include2003
medical, educational, and any other services that are consistent2004
with the inpatient care recommended in the protocols and2005
guidelines developed by national organizations that represent2006
pediatric, obstetric, and nursing professionals.2007

       (2) The policy shall cover a physician-directed source of2008
follow-up care. Services covered as follow-up care shall include2009
physical assessment of the mother and newborn, parent education,2010
assistance and training in breast or bottle feeding, assessment of2011
the home support system, performance of any medically necessary2012
and appropriate clinical tests, and any other services that are2013
consistent with the follow-up care recommended in the protocols2014
and guidelines developed by national organizations that represent2015
pediatric, obstetric, and nursing professionals. The coverage2016
shall apply to services provided in a medical setting or through2017
home health care visits. The coverage shall apply to a home2018
health care visit only if the health care professional who2019
conducts the visit is knowledgeable and experienced in maternity2020
and newborn care.2021

       When a decision is made in accordance with division (B) of2022
this section to discharge a mother or newborn prior to the2023
expiration of the applicable number of hours of inpatient care2024
required to be covered, the coverage of follow-up care shall apply2025
to all follow-up care that is provided within seventy-two hours2026
after discharge. When a mother or newborn receives at least the2027
number of hours of inpatient care required to be covered, the2028
coverage of follow-up care shall apply to follow-up care that is2029
determined to be medically necessary by the health care2030
professionals responsible for discharging the mother or newborn.2031

       (B) Any decision to shorten the length of inpatient stay to2032
less than that specified under division (A)(1) of this section2033
shall be made by the physician attending the mother or newborn,2034
except that if a nurse-midwife is attending the mother in2035
collaboration with a physician, the decision may be made by the2036
nurse-midwife. Decisions regarding early discharge shall be made2037
only after conferring with the mother or a person responsible for2038
the mother or newborn. For purposes of this division, a person2039
responsible for the mother or newborn may include a parent,2040
guardian, or any other person with authority to make medical2041
decisions for the mother or newborn.2042

       (C)(1) No sickness and accident insurer may do either of the2043
following:2044

       (a) Terminate the participation of a health care2045
professional or health care facility as a provider under a2046
sickness and accident insurance policy solely for making2047
recommendations for inpatient or follow-up care for a particular2048
mother or newborn that are consistent with the care required to be2049
covered by this section;2050

       (b) Establish or offer monetary or other financial2051
incentives for the purpose of encouraging a person to decline the2052
inpatient or follow-up care required to be covered by this2053
section.2054

       (2) Whoever violates division (C)(1)(a) or (b) of this2055
section has engaged in an unfair and deceptive act or practice in2056
the business of insurance under sections 3901.19 to 3901.26 of the2057
Revised Code.2058

       (D) This section does not do any of the following:2059

       (1) Require a policy to cover inpatient or follow-up care2060
that is not received in accordance with the policy's terms2061
pertaining to the health care professionals and facilities from2062
which an individual is authorized to receive health care services;2063

       (2) Require a mother or newborn to stay in a hospital or2064
other inpatient setting for a fixed period of time following2065
delivery;2066

       (3) Require a child to be delivered in a hospital or other2067
inpatient setting;2068

       (4) Authorize a nurse-midwife to practice beyond the2069
authority to practice nurse-midwifery in accordance with Chapter2070
4723. of the Revised Code;2071

       (5) Establish minimum standards of medical diagnosis, care2072
or treatment for inpatient or follow-up care for a mother or2073
newborn. A deviation from the care required to be covered under2074
this section shall not, solely on the basis of this section, give2075
rise to a medical claim or derivative medical claim, as those2076
terms are defined in section 2305.112305.113 of the Revised Code.2077

       Sec. 3923.64.  (A) Notwithstanding section 3901.71 of the2078
Revised Code, each public employee benefit plan established or2079
modified in this state that provides maternity benefits shall2080
provide coverage of inpatient care and follow-up care for a mother2081
and her newborn as follows:2082

       (1) The plan shall cover a minimum of forty-eight hours of2083
inpatient care following a normal vaginal delivery and a minimum2084
of ninety-six hours of inpatient care following a cesarean2085
delivery. Services covered as inpatient care shall include2086
medical, educational, and any other services that are consistent2087
with the inpatient care recommended in the protocols and2088
guidelines developed by national organizations that represent2089
pediatric, obstetric, and nursing professionals.2090

       (2) The plan shall cover a physician-directed source of2091
follow-up care. Services covered as follow-up care shall include2092
physical assessment of the mother and newborn, parent education,2093
assistance and training in breast or bottle feeding, assessment of2094
the home support system, performance of any medically necessary2095
and appropriate clinical tests, and any other services that are2096
consistent with the follow-up care recommended in the protocols2097
and guidelines developed by national organizations that represent2098
pediatric, obstetric, and nursing professionals. The coverage2099
shall apply to services provided in a medical setting or through2100
home health care visits. The coverage shall apply to a home2101
health care visit only if the health care professional who2102
conducts the visit is knowledgeable and experienced in maternity2103
and newborn care.2104

       When a decision is made in accordance with division (B) of2105
this section to discharge a mother or newborn prior to the2106
expiration of the applicable number of hours of inpatient care2107
required to be covered, the coverage of follow-up care shall apply2108
to all follow-up care that is provided within seventy-two hours2109
after discharge. When a mother or newborn receives at least the2110
number of hours of inpatient care required to be covered, the2111
coverage of follow-up care shall apply to follow-up care that is2112
determined to be medically necessary by the health care2113
professionals responsible for discharging the mother or newborn.2114

       (B) Any decision to shorten the length of inpatient stay to2115
less than that specified under division (A)(1) of this section2116
shall be made by the physician attending the mother or newborn,2117
except that if a nurse-midwife is attending the mother in2118
collaboration with a physician, the decision may be made by the2119
nurse-midwife. Decisions regarding early discharge shall be made2120
only after conferring with the mother or a person responsible for2121
the mother or newborn. For purposes of this division, a person2122
responsible for the mother or newborn may include a parent,2123
guardian, or any other person with authority to make medical2124
decisions for the mother or newborn.2125

       (C)(1) No public employer who offers an employee benefit2126
plan may do either of the following:2127

       (a) Terminate the participation of a health care2128
professional or health care facility as a provider under the plan2129
solely for making recommendations for inpatient or follow-up care2130
for a particular mother or newborn that are consistent with the2131
care required to be covered by this section;2132

       (b) Establish or offer monetary or other financial2133
incentives for the purpose of encouraging a person to decline the2134
inpatient or follow-up care required to be covered by this2135
section.2136

       (2) Whoever violates division (C)(1)(a) or (b) of this2137
section has engaged in an unfair and deceptive act or practice in2138
the business of insurance under sections 3901.19 to 3901.26 of the2139
Revised Code.2140

       (D) This section does not do any of the following:2141

       (1) Require a plan to cover inpatient or follow-up care that2142
is not received in accordance with the plan's terms pertaining to2143
the health care professionals and facilities from which an2144
individual is authorized to receive health care services;2145

       (2) Require a mother or newborn to stay in a hospital or2146
other inpatient setting for a fixed period of time following2147
delivery;2148

       (3) Require a child to be delivered in a hospital or other2149
inpatient setting;2150

       (4) Authorize a nurse-midwife to practice beyond the2151
authority to practice nurse-midwifery in accordance with Chapter2152
4723. of the Revised Code;2153

       (5) Establish minimum standards of medical diagnosis, care,2154
or treatment for inpatient or follow-up care for a mother or2155
newborn. A deviation from the care required to be covered under2156
this section shall not, solely on the basis of this section, give2157
rise to a medical claim or derivative medical claim, as those2158
terms are defined in section 2305.112305.113 of the Revised Code.2159

       Sec. 3929.71.  As used in sections 3929.71 to 3929.85 of the2160
Revised Code, or any rules adopted pursuant thereto:2161

       (A) "Medical malpractice insurance" means insurance coverage2162
against the legal liability of the insured and against loss,2163
damage, or expense incident to a claim arising out of the death,2164
disease, or injury of any person as the result of negligence or2165
malpractice in rendering professional service by any licensed2166
physician, podiatrist, or hospital, as those terms are defined in2167
section 2305.112305.113 of the Revised Code.2168

       (B) "Association" means the nonprofit unincorporated joint2169
underwriting association established pursuant to section 3929.722170
of the Revised Code.2171

       (C) "Net direct premiums" means gross direct premiums2172
written on liability insurance including the liability component2173
of multiple peril package policies as computed by the2174
superintendent of insurance less return premiums or the unused or2175
unabsorbed portions of premium deposits.2176

       Sec. 4705.15.  (A) As used in this section:2177

       (1) "Contingent fee agreement" means an agreement for the2178
provision of legal services by an attorney under which the2179
compensation of the attorney is contingent, in whole or in part,2180
upon a judgment being rendered in favor of or a settlement being2181
obtained for the client and is either a fixed amount or an amount2182
to be determined by a specified formula, including, but not2183
limited to, a percentage of any judgment rendered in favor of or2184
settlement obtained for the client.2185

       (2) "Tort action" means a civil action for damages for2186
injury, death, or loss to person or property. "Tort action"2187
includes a product liability claim that is subject to sections2188
2307.71 to 2307.80 of the Revised Code, but does not include a2189
civil action for damages for a breach of contract or another2190
agreement between persons.2191

       (3) "Medical claim," "dental claim," "optometric claim," and2192
"chiropractic claim" have the same meanings as in section 2305.1132193
of the Revised Code.2194

        (4) "Recovered" means the net sum recovered on a claim after2195
deducting any disbursements, costs, and expenses incurred in2196
connection with the prosecution or settlement of the claim. Costs2197
of medical care incurred by the plaintiff and the attorney's2198
office overhead costs or charges are not deductible disbursements2199
or costs for the purposes of this division. 2200

       (B) If an attorney and a client contract for the provision2201
of legal services in connection with a claim that is or may become2202
the basis of a tort action and if the contract includes a2203
contingent fee agreement, that agreement shall be reduced to2204
writing and signed by the attorney and the client. The attorney2205
shall provide a copy of the signed writing to the client.2206

       (C)(1) If an attorney and a client contract for the2207
provision of legal services in connection with a medical claim,2208
dental claim, optometric claim, or chiropractic claim that may2209
become the basis of a tort action and if the contract includes a2210
contingent fee agreement, that agreement shall not provide for the2211
payment of a fee that exceeds, and the attorney shall not collect2212
a contingency fee for representing the client in excess of, the2213
following limits:2214

        (a) Thirty-five per cent of the first one hundred thousand2215
dollars recovered on the claim;2216

        (b) Twenty-five per cent of the next five hundred thousand2217
dollars recovered on the claim;2218

        (c) Fifteen per cent of any amount on which the recovery on2219
the claim exceeds six hundred thousand dollars.2220

        (2) The limits in division (C)(1) of this section shall2221
apply regardless of whether the recovery is by settlement,2222
arbitration, or judgment or whether the person for whom the2223
recovery is made is a responsible adult, an infant, or a person of2224
unsound mind.2225

        (D) If an attorney represents a client in connection with a2226
claim as described in division (B) or (C) of this section, if2227
their contract for the provision of legal services includes a2228
contingent fee agreement, and if the attorney becomes entitled to2229
compensation under that agreement, the attorney shall prepare a2230
signed closing statement and shall provide the client with that2231
statement at the time of or prior to the receipt of compensation2232
under that agreement. The closing statement shall specify the2233
manner in which the compensation of the attorney was determined2234
under that agreement, any costs and expenses deducted by the2235
attorney from the judgment or settlement involved, any proposed2236
division of the attorney's fees, costs, and expenses with2237
referring or associated counsel, and any other information that2238
the attorney considers appropriate.2239

       Sec. 5111.018.  (A) The provision of medical assistance2240
under this chapter shall include coverage of inpatient care and2241
follow-up care for a mother and her newborn as follows:2242

       (1) The medical assistance program shall cover a minimum of2243
forty-eight hours of inpatient care following a normal vaginal2244
delivery and a minimum of ninety-six hours of inpatient care2245
following a cesarean delivery. Services covered as inpatient care2246
shall include medical, educational, and any other services that2247
are consistent with the inpatient care recommended in the2248
protocols and guidelines developed by national organizations that2249
represent pediatric, obstetric, and nursing professionals.2250

       (2) The medical assistance program shall cover a2251
physician-directed source of follow-up care. Services covered as2252
follow-up care shall include physical assessment of the mother and2253
newborn, parent education, assistance and training in breast or2254
bottle feeding, assessment of the home support system, performance2255
of any medically necessary and appropriate clinical tests, and any2256
other services that are consistent with the follow-up care2257
recommended in the protocols and guidelines developed by national2258
organizations that represent pediatric, obstetric, and nursing2259
professionals. The coverage shall apply to services provided in a2260
medical setting or through home health care visits. The coverage2261
shall apply to a home health care visit only if the health care2262
professional who conducts the visit is knowledgeable and2263
experienced in maternity and newborn care.2264

       When a decision is made in accordance with division (B) of2265
this section to discharge a mother or newborn prior to the2266
expiration of the applicable number of hours of inpatient care2267
required to be covered, the coverage of follow-up care shall apply2268
to all follow-up care that is provided within forty-eight hours2269
after discharge. When a mother or newborn receives at least the2270
number of hours of inpatient care required to be covered, the2271
coverage of follow-up care shall apply to follow-up care that is2272
determined to be medically necessary by the health care2273
professionals responsible for discharging the mother or newborn.2274

       (B) Any decision to shorten the length of inpatient stay to2275
less than that specified under division (A)(1) of this section2276
shall be made by the physician attending the mother or newborn,2277
except that if a nurse-midwife is attending the mother in2278
collaboration with a physician, the decision may be made by the2279
nurse-midwife. Decisions regarding early discharge shall be made2280
only after conferring with the mother or a person responsible for2281
the mother or newborn. For purposes of this division, a person2282
responsible for the mother or newborn may include a parent,2283
guardian, or any other person with authority to make medical2284
decisions for the mother or newborn.2285

       (C) The department of job and family services, in2286
administering the medical assistance program, may not do either of2287
the following:2288

       (1) Terminate the participation of a health care2289
professional or health care facility as a provider under the2290
program solely for making recommendations for inpatient or2291
follow-up care for a particular mother or newborn that are2292
consistent with the care required to be covered by this section;2293

       (2) Establish or offer monetary or other financial2294
incentives for the purpose of encouraging a person to decline the2295
inpatient or follow-up care required to be covered by this2296
section.2297

       (D) This section does not do any of the following:2298

       (1) Require the medical assistance program to cover2299
inpatient or follow-up care that is not received in accordance2300
with the program's terms pertaining to the health care2301
professionals and facilities from which an individual is2302
authorized to receive health care services.2303

       (2) Require a mother or newborn to stay in a hospital or2304
other inpatient setting for a fixed period of time following2305
delivery;2306

       (3) Require a child to be delivered in a hospital or other2307
inpatient setting;2308

       (4) Authorize a nurse-midwife to practice beyond the2309
authority to practice nurse-midwifery in accordance with Chapter2310
4723. of the Revised Code;2311

       (5) Establish minimum standards of medical diagnosis, care,2312
or treatment for inpatient or follow-up care for a mother or2313
newborn. A deviation from the care required to be covered under2314
this section shall not, on the basis of this section, give rise to2315
a medical claim or derivative medical claim, as those terms are2316
defined in section 2305.112305.113 of the Revised Code.2317

       Section 2. That existing sections 1751.67, 2117.06, 2305.11,2318
2305.15, 2305.234, 2317.02, 2317.54, 2323.56, 2711.21, 2711.22,2319
2711.23, 2711.24, 2743.02, 2743.43, 2919.16, 3923.63, 3923.64,2320
3929.71, 4705.15, and 5111.018, and sections 2305.27 and 2323.572321
of the Revised Code are hereby repealed.2322

       Section 3. The General Assembly makes the following statement2323
of findings and intent:2324

       (A) The General Assembly finds:2325

       (1) Medical malpractice litigation represents an increasing2326
danger to the availability and quality of health care in Ohio.2327

       (2) The number of medical malpractice claims resulting in2328
payments to plaintiffs has remained relatively constant. However,2329
the average award to plaintiffs has risen dramatically. Payments2330
to plaintiffs at or exceeding one million dollars have doubled in2331
the past three years.2332

       (3) This state has a rational and legitimate state interest2333
in stabilizing the cost of health care delivery by limiting the2334
amount of compensatory damages representing noneconomic loss2335
awards in medical malpractice actions. The General Assembly bases2336
its finding on this state interest upon the following evidence:2337

       (a) The Superintendent of Insurance has stated that medical2338
malpractice insurers' investments are not to blame for the2339
increase in medical malpractice insurance premiums. The vast2340
majority of these insurers' assets are invested in bonds and other2341
fixed income investments, not in stocks. Investment income2342
declined by less than one per cent from 1996 to 2001.2343

       (b) Many medical malpractice insurers left the Ohio market as2344
they faced increasing losses, largely as a consequence of rapidly2345
rising compensatory damages and noneconomic loss awards in medical2346
malpractice actions. The Department of Insurance reports that2347
only six admitted carriers continue to actively write coverage in2348
Ohio at this time.2349

       (c) As insurers have left the market, physicians, hospitals,2350
and other health care practitioners have had an increasingly2351
difficult time finding affordable medical malpractice insurance.2352
Some health care practitioners, including a large number of2353
specialists, have been forced out of the practice of medicine2354
altogether as a consequence. The Ohio State Medical Association2355
reports fifteen per cent of Ohio's physicians are considering or2356
have already relocated their practices due to rising medical2357
malpractice insurance costs.2358

       (d) As stated in testimony provided by Lawrence E. Smarr,2359
President of the Physician Insurers Association of America,2360
medical malpractice costs have increased even while sixty-one per2361
cent of all claims filed against individual practitioners are2362
dropped or dismissed by the court and even while the defendants2363
win eighty per cent of all claims that are continued through trial2364
to verdict.2365

       (e) The U.S. Department of Health and Human Services2366
published a report in 2002 stating that health care practitioners2367
in states with effective caps on noneconomic damages are2368
experiencing premium increases in the twelve to fifteen per cent2369
range, as compared to an average forty-four per cent increase in2370
states that do not cap noneconomic damage awards.2371

       (4)(a) The distinction among claimants with a permanent2372
physical functional loss strikes a reasonable balance between2373
potential plaintiffs and defendants in consideration of the intent2374
of an award for noneconomic losses, while treating similar2375
plaintiffs equally, acknowledging that such distinctions do not2376
limit the award of actual economic damages.2377

       (b) The limit on compensatory damages representing2378
noneconomic loss to the greater of two hundred fifty thousand2379
dollars, or an amount equal to three times the plaintiff's2380
economic loss to a maximum of five hundred thousand dollars, and2381
the limit on the amount recoverable for noneconomic losses to the2382
greater of seven hundred fifty thousand dollars or thirty-five2383
thousand dollars times the number of years remaining in the2384
plaintiff's expected life for certain permanent and substantial2385
injuries and deformity, is based on testimony asking the members2386
of the General Assembly to recognize these distinctions and2387
stating that the cap amounts are similar to caps on awards adopted2388
by other states.2389

       (c) A report from the U.S. Department of Health and Human2390
Services, Update on the Medical Litigation Crisis: Not the Result2391
of the Insurance Cycle (Sept. 25, 2002), states that among states2392
that have adopted a two hundred fifty thousand dollar cap on2393
noneconomic damages are: Indiana, Colorado, California, Nebraska,2394
Utah, and Montana. These states, as well as others that have2395
imposed meaningful caps on noneconomic damages, report2396
significantly lower increases in average premium rates than those2397
states without caps.2398

       (5) This legislation does not affect the award of economic2399
damages, such as for lost wages and medical care.2400

       (6)(a) That a statute of repose on medical, dental,2401
optometric, and chiropractic claims strikes a rational balance2402
between the rights of prospective claimants and the rights of2403
hospitals and health care practitioners;2404

       (b) Over time, the availability of relevant evidence2405
pertaining to an incident and the availability of witnesses2406
knowledgeable with respect to the diagnosis, care, or treatment of2407
a prospective claimant becomes problematic.2408

       (c) The maintenance of records and other documentation2409
related to the delivery of medical services, for a period of time2410
in excess of the time period presented in the statute of repose,2411
presents an unacceptable burden to hospitals and health care2412
practitioners.2413

       (d) Over time, the standards of care pertaining to various2414
health care services may change dramatically due to advances being2415
made in health care, science, and technology, thereby making it2416
difficult for expert witnesses and triers of fact to discern the2417
standard of care relevant to the point in time when the relevant2418
health care services were delivered.2419

       (e) This legislation precludes unfair and unconstitutional2420
aspects of state litigation but does not affect timely medical2421
malpractice actions brought to redress legitimate grievances.2422

       (B) In consideration of these findings, the General Assembly2423
declares its intent to accomplish all of the following by the2424
enactment of this act:2425

       (1) To stem the exodus of medical malpractice insurers from2426
the Ohio market;2427

       (2) To increase the availability of medical malpractice2428
insurance to Ohio's hospitals, physicians, and other health care2429
practitioners, thus ensuring the availability of quality health2430
care for the citizens of this state;2431

       (3) To continue to hold negligent health care providers2432
accountable for their actions;2433

       (4) To preserve the right of patients to seek legal recourse2434
for medical malpractice.2435

       (5)(a) To abrogate the common law collateral source rules as2436
adopted by the Ohio Supreme Court in Pryor v. Webber (1970), 232437
Ohio St.2d 104, and reaffirmed in Sorrell v. Thevenir (1994), 692438
Ohio St.3d 415;2439

       (b) To address the aspects of former section 2317.45 of the2440
Revised Code that the Supreme Court found in Sorrell v. Thevenir2441
(1994), 69 Ohio St.3d 415, May v. Tandy Corp. (1994), 69 Ohio2442
St.3d 415, and DePew v. Ogella (1994), 69 Ohio St.3d 610, to be2443
unconstitutional as being violative of the equal protection2444
provision of Section 2, the right to a trial by jury provision of2445
Section 5, and the due course of law, right to a remedy, and open2446
court provision of Section 16 of Article I of the Ohio2447
Constitution.2448

       (C)(1) The Ohio General Assembly respectfully requests the2449
Ohio Supreme Court to uphold this intent in the courts of Ohio, to2450
reconsider its holding on damage caps in State v. Sheward (1999),2451
Ohio St.3d 451, to reconsider its holding on the deductibility of2452
collateral source benefits in Sorrel v. Thevenir (1994), 69 Ohio2453
St.3d 415, and to reconsider its holding on statutes of repose in2454
Sedar v. Knowlton Constr. Co. (1990), 49 Ohio St.3d 193, thereby2455
providing health care practitioners with access to affordable2456
medical malpractice insurance and maintaining the provision of2457
quality health care in Ohio.2458

       (2) The General Assembly acknowledges the Court's authority2459
in prescribing rules governing practice and procedure in the2460
courts of this state as provided by Section 5 of Article IV of the2461
Ohio Constitution.2462

       Section 4. If any item of law that constitutes the whole or2463
part of a section of law contained in this act, or if any2464
application of any item of law that constitutes the whole or part2465
of a section of law contained in this act, is held invalid, the2466
invalidity does not affect other items of law or applications of2467
items of law that can be given effect without the invalid item of2468
law or application. To this end, the items of law of which the2469
sections contained in this act are composed, and their2470
applications, are independent and severable.2471

       Section 5. If any item of law that constitutes the whole or2472
part of a section of law contained in this act, or if any2473
application of any item of law contained in this act, is held to2474
be preempted by federal law, the preemption of the item of law or2475
its application does not affect other items of law or applications2476
that can be given affect. The items of law of which the sections2477
of this act are composed, and their applications, are independent2478
and severable.2479

       Section 6.  Section 2117.06 of the Revised Code is presented2480
in this act as a composite of the section as amended by both Sub.2481
H.B. 85 and Sub. S.B. 108 of the 124th General Assembly. The2482
General Assembly, applying the principle stated in division (B) of2483
section 1.52 of the Revised Code that amendments are to be2484
harmonized if reasonably capable of simultaneous operation, finds2485
that the composite is the resulting version of the section in2486
effect prior to the effective date of the section as presented in2487
this act.2488