REPRESENTATIVES Schmidt, Schneider, White, Collier, Peterson, Hollister, Kearns, Wagner, Faber, Gibbs, DeWine, Flowers, Taylor, Setzer, Raga, Reidelbach, Wolpert, Webster, Aslanides, Raussen, Daniels, Carmichael, Blasdel

To amend sections 3929.482, 3929.85, 3931.01,

1

3955.05, 3960.06, and 4731.143, to enact sections

2

2323.45, 2323.451, 2323.452, 2323,453, 2323.454,

3

2323.455, 2323.456, 2323.457, 2323.458, 2323.459,

4

2323.4510, 2323.4511, 2323.4512, 2323.4513,

5

2323.4514, 2323.4515, 2323.4516, 2323.4517,

6

2323.4518, 2323.4519, and 2323.4520, and to repeal

7

sections 3929.71, 3929.72, 3929.721, 3929.73,

8

3929.75, 3929.76, 3929.77, 3929.78, 3929.79,

9

3929.80, 3929.81, 3929.82, 3929.83, and 3929.84 of

10

the Revised Code to require medical claims against

11

healthcare providers to be reviewed by a medical

12

review panel prior to the claim proceeding in

13

court.

14

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

Section 1. That sections 3929.482, 3929.85, 3931.01, 3955.05,	15
3960.06, and 4731.143 be amended, and sections 2323.45, 2323.451,	16
2323.452, 2323,453, 2323.454, 2323.455, 2323.456, 2323.457,	17
2323.458, 2323.459, 2323.4510, 2323.4511, 2323.4512, 2323.4513,	18
2323.4514, 2323.4515, 2323.4516, 2323.4517, 2323.4518, 2323.4519,	19
and 2323.4520 of the Revised Code be enacted to read as follows:	20

Sec. 2323.45.  (A) As used in sections 2323.45 and 2323.451	21
to 2323.4520 of the Revised Code:	22

(1) "Medical claim" means any claim that is asserted in any	23
civil actions against a physician, podiatrist, hospital, home, or	24
residential facility, against any employee or agent of a	25
physician, podiatrist, hospital, home, or residential facility, or	26
against a licensed practical nurse, registered nurse, advanced	27
practice nurse, physical therapist, physician assistant, emergency	28
medical technician-basic, emergency medical	29
technician-intermediate, or emergency medical	30
technician-paramedic, and that arises out of the medical	31
diagnosis, care, or treatment of any person. "Medical claim"	32
includes the following:	33

(a) A derivative claim for relief that arises out of the	34
medical diagnosis, care, or treatment of an individual;	35

(b) A claim that arises out of the medical diagnosis, care,	36
or treatment of an individual, resulting from acts or omissions in	37
providing medical care or the hiring, training, supervision,	38
retention, or termination of caregivers providing medical	39
diagnosis, care, or treatment.	40

(2) "Provider" means a physician, podiatrist, hospital, home,	41
or residential facility, an employee or agent of a physician,	42
podiatrist, hospital, home, or residential facility, a licensed	43
practical nurse, registered nurse, advanced practice nurse,	44
physical therapist, physician assistant, emergency medical	45
technician-basic, emergency medical technician-intermediate, or	46
emergency medical technician-paramedic.	47

(B) Sections 2323.45 and 2323.451 to 2323.4520 of the Revised	48
Code apply when a medical claim is asserted against a provider,	49
unless the plaintiff and provider have entered into a valid and	50
enforceable contract under section 2711.22 of the Revised Code	51
requiring binding arbitration of medical claims or have agreed to	52
submit to nonbinding arbitration under section 2711.21 of the	53
Revised Code.	54

(C) A medical review panel shall review medical claims	55
against providers pursuant to sections 2323.45 and 2323.451 to	56
2323.4520 of the Revised Code. A provider shall notify the	57
superintendent of insurance when a civil action asserting a	58
medical claim against the provider is commenced. The medical	59
review panel shall review the claim and render its expert opinion	60
prior to the civil action proceeding on the claim.	61

(D) Section 2305.113 of the Revised Code governs the time	62
limits for commencing the medical claim with the common pleas	63
court.	64

Sec. 2323.451.  Not earlier than twenty days after a provider	66
notifies the department of insurance of the commencement of a	67
medical claim against the provider either party to the claim may	68
request the formation of a medical review panel by serving notice	69
by certified mail upon all parties and the superintendent of	70
insurance.	71

Sec. 2323.452.  (A) A medical review panel shall consist of	72
one attorney and three providers.	73

(B) The attorney member of the medical review panel shall act	74
as chairperson of the panel and in an advisory capacity, but shall	75
not vote.	76

(C) The chairperson of a medical review panel shall expedite	77
the selection of the other panel members, convene the panel, and	78
expedite the panel's review of the medical claim. The chairperson	79
shall establish a reasonable schedule for submission of evidence	80
to the medical review panel, allowing sufficient time for the	81
parties to make full and adequate presentation of facts and	82
authorities related to the claim.	83

Sec. 2323.453.  A medical review panel shall be selected in	84
the following manner:	85

(A) Within fifteen days after the filing of a request for the	86
formation of a medical review panel under section 2323.45 of the	87
Revised Code, the parties shall select a chairperson by agreement.	88

(B)(1) If an agreement on a chairperson cannot be reached,	89
either party may request the clerk of the Ohio supreme court to	90
draw at random a list of the names of five attorneys who are	91
qualified to practice in Ohio and who maintain offices in the	92
county of venue designated in the medical claim or in a contiguous	93
county.	94

(2) The clerk may charge a reasonable fee for drawing the	95
list of qualified attorneys.	96

(3) The clerk shall notify the parties when a list of	97
attorneys' names has been drawn, and the parties shall then strike	98
names alternately, with the plaintiff striking first. The clerk	99
shall notify a party after the opposing party has stricken a name.	100
The remaining attorney shall be the chairperson of the medical	101
review panel. The clerk shall notify the attorney and all other	102
parties of the identity of the chairperson within five days after	103
the selection.	104

(4) If a party does not strike a name within five days after	105
receiving notice from the clerk, the opposing party shall, in	106
writing, direct the clerk to strike an attorney's name. The	107
remaining attorney shall be the chairperson of the medical review	108
panel. The clerk shall notify the attorney and all other parties	109
of the identity of the chairperson within five days after the	110
selection.	111

(C) Within fifteen days after receiving notice of being	112
selected as chairperson, the chairperson either shall:	113

(1) Send a written acknowledgment of appointment to the	114
clerk;	115

(2) Show good cause for relief from the appointment under	116
section 2323.458 of the Revised Code.	117

Sec. 2323.454.  (A) Within fifteen days after being notified	118
of the selection of a chairperson, each party before a medical	119
review panel shall select a provider to serve as a member of the	120
panel. Except for individuals who are serving as an administrator	121
of a hospital, home, or residential facility, all individual	122
providers shall be available for selection as a member of a	123
medical review panel. Each party shall identify the provider	124
selected, in writing, to the other party and the chairperson,	125
within this fifteen-day period. If a party fails to make a	126
selection and provide notice within the time provided, the	127
chairperson shall make the selection and identify the provider	128
selected, in writing, to all parties.	129

(B) Within fifteen days after being selected, the two	130
providers selected under division (A) of this section shall select	131
a third provider and notify the chairperson and all parties in	132
writing. If the providers fail to make a selection, the	133
chairperson shall select the third provider and notify all	134
parties.	135

Sec. 2323.455.  (A) If there are multiple plaintiffs or	136
defendants before a medical review panel, only one provider shall	137
be selected per side to serve as a member of the panel. The	138
plaintiff, whether single or multiple, has the right to select one	139
provider and the defendant, whether single or multiple, has the	140
right to select one provider.	141

(B) If there is only one defendant, and that defendant is an	142
individual, two of the panel members selected shall be providers	143
in the same health care profession as the defendant. If the	144
defendant specializes in a limited field, two of the panel members	145
selected shall be providers who specialize in the same field as	146
the defendant.	147

Sec. 2323.456.  (A) Within ten days after a party is notified	148
of the opposing party's selection of a provider to serve as a	149
member of the medical review panel, the opposing party may	150
challenge the selection without cause and submit the challenge to	151
the chairperson in writing. Upon a challenge, the party whose	152
selection is challenged shall select another provider.	153

(B) If either party challenges the selection made by the two	154
providers chosen by the parties, the providers shall make a new	155
selection. If two challenges without cause are submitted to the	156
chairperson, the chairperson shall nominate three qualified	157
providers within ten days after receiving the second challenge	158
without cause. Each party shall eliminate one of the nominated	159
providers within ten days, and the remaining provider shall serve	160
as the third member of the panel.	161

Sec. 2323.457.  Within five days after all members of a	162
medical review panel are selected, the chairperson shall send a	163
notice by certified mail to the superintendent of insurance and	164
all parties before the panel, notifying them of the following:	165

(A) The names and addresses of the panel members;

166

(B) The date on which the last panel member was selected.

167

Sec. 2323.458.  (A) An individual selected to serve as a	168
member of a medical review panel under section 2323.453, 2323.454,	169
or 2323.456 of the Revised Code shall serve unless:	170

(1) The parties excuse the individual by mutual agreement;

171

(2) The individual is excused for good cause shown under	172
division (B) or (C) of this section.	173

(B) To show good cause for relief from serving on a medical	174
review panel, the attorney selected as chairperson of a medical	175
review panel shall serve an affidavit upon the clerk of the Ohio	176
supreme court, setting out facts showing that service would	177
constitute an unreasonable burden or undue hardship. The clerk may	178
excuse the attorney from serving on the panel and shall notify all	179
parties. The parties shall select a new chairperson pursuant to	180
section 2323.453 of the Revised Code.	181

(C) To show good cause for relief from serving on a medical	182
review panel, a provider shall serve an affidavit upon the panel	183
chairperson. The affidavit shall set out facts showing that	184
service would constitute an unreasonable burden or undue hardship.	185
The chairperson may excuse the provider from serving on the panel,	186
and shall notify all parties. The remaining members of the panel	187
shall select a new provider within fifteen days.	188

Sec. 2323.459.  (A) A medical review panel shall give its	189
expert opinion within one hundred eighty days after the selection	190
of the last member of the panel. However, if more than ninety days	191
after the last member of the panel is selected the panel's	192
chairperson is removed under division (C) of this section, the	193
chairperson removes a panel member under division (D) of this	194
section, or any member of the panel is removed by a court order,	195
the panel has ninety days after the selection of a new panel	196
member to give its expert opinion.	197

(B) If the medical review panel does not give an opinion	198
within the time allowed under division (A) of this section, the	199
panel shall submit a report to the superintendent of insurance	200
stating the reason for the delay.	201

(C) The superintendent of insurance may remove the	202
chairperson of a medical review panel if the superintendent	203
determines that the chairperson is not fulfilling the duties	204
imposed upon the chairperson by sections 2323.45 and 2323.451 to	205
2323.4520 of the Revised Code. If the chairperson is removed under	206
this division, the parties shall select a new chairperson pursuant	207
to section 2323.453 of the Revised Code.	208

(D) The chairperson may remove a member of the medical review	209
panel if the chairperson determines that the member is not	210
fulfilling the duties imposed upon panel members by sections	211
2323.45 and 2323.451 to 2323.4520 of the Revised Code. If a member	212
is removed under this division, the remaining members of the panel	213
shall select a new member within fifteen days.	214

Sec. 2323.4510.  (A) Parties wanting written evidence to be	215
considered by the medical review panel shall submit the evidence	216
promptly. The evidence may consist of medical charts, x-rays, lab	217
tests, excerpts of treatises, depositions of witnesses including	218
parties, and any other form of evidence allowable by the medical	219
review panel.	220

(B) Parties and witnesses may be deposed before the convening	221
of the medical review panel.	222

(C) The chairperson shall ensure that before the medical	223
review panel gives its expert opinion under section 2323.4515 of	224
the Revised Code, each panel member has the opportunity to review	225
every item of evidence submitted by the parties.	226

(D) Before considering any evidence or deliberating with	227
other panel members, each member of the medical review panel shall	228
take an oath in writing on a form provided by the panel	229
chairperson, which shall read as follows:	230

"I (swear) (affirm) under penalties of perjury that I will	231
well and truly consider the evidence submitted by the parties;	232
that I will render my opinion without bias, based upon the	233
evidence submitted by the parties, and that I have not and will	234
not communicate with any party or representative of a party before	235
rendering my opinion, except as authorized by law."	236

Sec. 2323.4511.  The parties before a medical review panel,	237
agents and attorneys of the parties, and the defendant's medical	238
malpractice insurer, shall not communicate with any member of the	239
panel before the panel gives its expert opinion under section	240
2323.4515 of the Revised Code.	241

Sec. 2323.4512.  The chairperson of the medical review panel	242
shall advise the panel relative to any legal question involved in	243
the review proceeding and shall prepare the opinion of the panel	244
given under section 2323.4515 of the Revised Code.	245

Sec. 2323.4513.  (A) A medical review panel may request all	246
information necessary to reach its expert opinion and may consult	247
with medical authorities. The panel may examine relevant provider	248
medical reports.	249

(B) All parties shall have full access to any material	250
received by the medical review panel.	251

Sec. 2323.4514.  (A) After all evidence is submitted to the	252
medical review panel, either party may convene the panel at a time	253
and place agreeable to the members of the panel. After an	254
agreement is reached on the time and place, the chairperson of the	255
panel shall give ten days notice to the other party. Either party	256
may question the panel concerning any matter pertaining to the	257
panel's review.	258

(B) The chairperson of the medical review panel shall preside	259
at all meetings. Meetings shall be informal.	260

Sec. 2323.4515.  (A) The sole duty of the medical review	261
panel is to express the panel's expert opinion as to whether or	262
not the evidence supports a conclusion that the defendant or	263
defendants failed to act within the appropriate standards of	264
medical care as claimed by the plaintiff. The opinion is not a	265
ruling of law. The opinion may be a consideration to parties	266
negotiating a settlement.	267

(B) Within thirty days after all evidence is submitted by the	268
parties, the panel shall review the evidence and give one or more	269
of the following expert opinions, in writing and signed by the	270
panel members:	271

(1) The evidence supports the conclusion that the defendant	272
or defendants failed to comply with the appropriate standard of	273
care as claimed by the plaintiff.	274

(2) The evidence does not support the conclusion that the	275
defendant or defendants failed to meet the applicable standard of	276
care as claimed by the plaintiff.	277

(3) There is a material question of fact bearing on the	278
defendant's or defendants' liability.	279

(4) The conduct complained of was or was not a factor in the	280
resultant damages. If the panel concludes the conduct was a	281
factor, the panel shall state whether the plaintiff suffered any	282
disability and the extent and duration of the disability, or	283
suffered any permanent impairment and the percentage of the	284
impairment.	285

(C) Upon issuing its opinion, the panel shall cease to exist.

286

Sec. 2323.4516.  The expert opinion reached by the medical	287
review panel is admissible as evidence in any civil action brought	288
by the plaintiff. The expert opinion is not conclusive. Either	289
party to the civil action, at the party's cost, may call any	290
member of the medical review panel as a witness. If called, the	291
member shall appear and testify.	292

Sec. 2323.4517.  The chairperson of a medical review panel	293
shall send a copy of the panel's report, by certified mail, to the	294
superintendent of insurance and all parties within five days after	295
the panel gives its expert opinion.	296

Sec. 2323.4518.  Members of a medical review panel have	297
absolute immunity from civil liability for all communications,	298
findings, opinions, and conclusions made in the course and scope	299
of the duties assigned to them under sections 2323.45 and 2323.451	300
to 2323.4520 of the Revised Code.	301

Sec. 2323.4519. (A) Each provider member of a medical review	302
panel shall receive both of the following:	303

(1) Three hundred fifty dollars for all work performed as a	304
member of the panel. If the member is called to testify as a	305
witness in court, the member's time in court is not work as a	306
member of the panel.	307

(2) Reasonable travel expenses.

308

(B) The chairperson of a medical review panel shall receive	309
both of the following:	310

(1) Pay of two hundred fifty dollars per day, not to exceed	311
two thousand dollars;	312

(2) Reasonable travel expenses.

313

(C) The chairperson shall keep an accurate record of the time	314
and expenses of each member of the panel. The record shall be	315
submitted to the parties for payment with the panel's report.	316

(D) The prevailing party shall pay the panel's expenses,	317
including travel expenses and other expenses of the review. If	318
there is no majority opinion, each side shall pay fifty per cent	319
of the panel's expenses.	320

Sec. 2323.4520.  If all parties to a medical claim agree to	321
submit the claim to nonbinding arbitration, the medical review	322
panel shall end its review of the medical claim and the claim	323
shall proceed to nonbinding arbitration under section 2711.21 of	324
the Revised Code. Sections 2323.45 and 2323.451 to 2323.4517 of	325
the Revised Code shall not apply to a medical claim after the	326
parties have agreed to submit the claim to nonbinding arbitration.	327

Sec. 3929.482.  (A) The Ohio fair plan underwriting	328
association by action of its board of governors, with the approval	329
of the superintendent of insurance, is authorized to enter into a	330
contract with any association formed under a medical professional	331
liability insurance plan created by authority of section 3929.72	332
of the Revised Code, whereby Ohio fair plan underwriting	333
association will perform administrative services necessary or	334
incidental to the operation of the medical professional liability	335
insurance plan. Such contract shall provide that the Ohio fair	336
plan underwriting association will be reimbursed for its actual	337
expenses incurred in performing such services. Common expenses	338
applicable both to the Ohio fair plan and to the medical	339
professional liability insurance plan shall be allocated between	340
them on an equitable basis approved by the superintendent of	341
insurance.	342

(B) The Ohio fair plan underwriting association by action of	343
its board of governors, with the approval of the superintendent of	344
insurance, is authorized to enter into a contract with the Ohio	345
mine subsidence insurance underwriting association to provide	346
administrative and claims adjusting services required by it. Such	347
contract shall provide indemnification by the Ohio mine subsidence	348
insurance underwriting association to the Ohio fair plan	349
underwriting association, its members, members of its board of	350
governors, officers, employees, and agents against all liability,	351
loss, and expense resulting from acts done or omitted in good	352
faith in performing such contract. Such contract shall also	353
provide that the Ohio fair plan underwriting association will be	354
reimbursed for its actual expenses incurred in performing such	355
services. Common expenses applicable both to the Ohio fair plan	356
and to the mine subsidence insurance underwriting association	357
shall be allocated between them on an equitable basis approved by	358
the superintendent of insurance.	359

(C)(B) The Ohio fair plan underwriting association by action	360
of its board of governors, with the approval of the superintendent	361
of insurance, is authorized to enter into a contract with the Ohio	362
commercial joint underwriting association to provide	363
administrative and claims adjusting services required by it. Such	364
contract shall provide indemnification by the Ohio commercial	365
joint underwriting association to the Ohio fair plan underwriting	366
association, its members, members of its board of governors,	367
officers, employees, and agents against all liability, loss, and	368
expenses resulting from acts done or omitted in good faith in	369
performing such contract. Such contract shall also provide that	370
the Ohio fair plan underwriting association will be reimbursed for	371
its actual expenses incurred in performing such services. Common	372
expenses applicable both to the Ohio fair plan and to the Ohio	373
commercial joint underwriting association shall be allocated	374
between them on an equitable basis approved by the superintendent	375
of insurance.	376

Sec. 3929.85.  No insurer licensed to carry on the business	377
of insurance in this state that is required by law to contribute	378
to, participate in, or which can be assessed by the Ohio insurance	379
guaranty association pursuant to sections 3955.01 to 3955.19 of	380
the Revised Code, or by the plan for apportionment of applicants	381
for motor vehicle insurance pursuant to section 4509.70 of the	382
Revised Code, or by the Ohio fair plan underwriting association	383
pursuant to sections 3929.43 to 3929.61 of the Revised Code, or by	384
the joint underwriting association pursuant to sections 3929.71 to	385
3929.85 of the Revised Code, or by the Ohio commercial insurance	386
joint underwriting association pursuant to sections 3930.03 to	387
3930.18 of the Revised Code shall in any calendar year be required	388
to contribute to, participate in, or be assessed by any one or	389
more of the aforementioned plans or associations in an amount or	390
amounts totaling in excess of two and one-half per cent of its net	391
direct Ohio premium volume for the year next preceding the year in	392
which the assessment or assessments are made or the contributions	393
or participations are required.	394

Sec. 3931.01.  Individuals, partnerships, and corporations of	395
this state, designated in sections 3931.01 to 3931.12 of the	396
Revised Code, as "subscribers," may exchange reciprocal or	397
interinsurance contracts with each other, and with individuals,	398
partnerships, and corporations of other states, districts,	399
provinces, and countries, providing indemnity among themselves	400
from any loss which may be legally insured against by any fire or	401
casualty insurance company or association provided that contracts	402
of indemnity against property damage and bodily injury arising out	403
of the ownership, maintenance or use of a singly owned private	404
passenger automobile principally used for nonbusiness purposes may	405
not be exchanged through a reciprocal insurer which maintains a	406
surplus over all liabilities of less than two and one-half million	407
dollars and provided that this exception shall not prohibit the	408
exchanging of contracts of indemnity against any form of liability	409
otherwise authorized and arising out of any business or commercial	410
enterprise. Such contracts and the exchange thereof and such	411
subscribers, their attorneys, and representatives shall be	412
regulated by such sections, and no law enacted after July 4, 1917,	413
shall apply to them, unless they are expressly designated therein.	414

Such a contract may be executed by an attorney or other	415
representative designated "attorney," in sections 3931.01 to	416
3931.12 of the Revised Code, authorized by and acting for such	417
subscribers under powers of attorney. Such attorney may be a	418
corporation. The principal office of such attorney shall be	419
maintained at the place designated by the subscribers in the	420
powers of attorney.	421

Except for such limitations on assessability as are approved	422
by the superintendent of insurance, every reciprocal or	423
interinsurance contract written pursuant to this chapter for	424
medical malpractice insurance as defined in division (A) of	425
section 3929.71 of the Revised Code shall be fully assessable and	426
shall contain a statement, in boldface capital letters and in type	427
more prominent than that of the balance of the contract, setting	428
forth such terms of accessabilityassessability.	429

Sec. 3955.05.  Sections 3955.01 to 3955.19 of the Revised	430
Code apply to all kinds of direct insurance, except:	431

(A) Title insurance;

432

(B) Fidelity or surety bonds, or any other bonding	433
obligations;	434

(C) Credit insurance, vendors' single interest insurance,	435
collateral protection insurance, or any similar insurance	436
protecting the interests of a creditor arising out of a	437
creditor-debtor transaction;	438

(D) Mortgage guaranty, financial guaranty, residual value, or	439
other forms of insurance offering protection against investment	440
risks;	441

(E) Ocean marine insurance;

442

(F) Any insurance provided by or guaranteed by government	443
including, but not limited to, any department, board, office,	444
commission, agency, institution, or other instrumentality or	445
entity of any branch of state government, any political	446
subdivision of this state, the United States or any agency of the	447
United States, or any separate or joint governmental	448
self-insurance or risk-pooling program, plan, or pool;	449

(G) Contracts of any corporation by which health services are	450
to be provided to its subscribers;	451

(H) Life, annuity, health, or disability insurance, including	452
sickness and accident insurance written pursuant to Chapter 3923.	453
of the Revised Code;	454

(I) Fraternal benefit insurance;

455

(J) Mutual protective insurance of persons or property;

456

(K) Reciprocal or interinsurance contracts written pursuant	457
to Chapter 3931. of the Revised Code for medical malpractice	458
insurance as defined in division (A) of section 3929.71 of the	459
Revised Code;	460

(L) Any political subdivision self-insurance program or joint	461
political subdivision self-insurance pool established under	462
Chapter 2744. of the Revised Code;	463

(M) Warranty or service contracts, or the insurance of such	464
contracts;	465

(N) Any state university or college self-insurance program	466
established under section 3345.202 of the Revised Code;	467

(O) Any transaction, or combination of transactions, between	468
a person, including affiliates of such person, and an insurer,	469
including affiliates of such insurer, that involves the transfer	470
of investment or credit risk unaccompanied by a transfer of	471
insurance risk;	472

(P) Credit union share guaranty insurance issued pursuant to	473
Chapter 1761. of the Revised Code;	474

(Q) Insurance issued by risk retention groups as defined in	475
Chapter 3960. of the Revised Code;	476

(R) Workers' compensation insurance, including any contract	477
indemnifying an employer who pays compensation directly to	478
employees.	479

Sec. 3960.06.  (A) A purchasing group and its insurer or	480
insurers are subject to all applicable laws of this state, except	481
that a purchasing group and its insurer or insurers, in regard to	482
liability insurance for the purchasing group, are exempt from any	483
law that does any of the following:	484

(1) Prohibits the establishment of a purchasing group;

485

(2) Makes it unlawful for an insurer to provide or offer to	486
provide insurance on a basis providing, to a purchasing group or	487
its members, advantages based on their loss and expense experience	488
not afforded to other persons with respect to rates, policy forms,	489
coverages, or other matters;	490

(3) Prohibits a purchasing group or its members from	491
purchasing insurance on a group basis described in division (A)(2)	492
of this section;	493

(4) Prohibits a purchasing group from obtaining insurance on	494
a group basis because the group has not been in existence for a	495
minimum period of time or because any member has not belonged to	496
the group for a minimum period of time;	497

(5) Requires that a purchasing group have a minimum number of	498
members, common ownership or affiliation, or a certain legal form;	499

(6) Requires that a certain percentage of a purchasing group	500
obtain insurance on a group basis;	501

(7) Otherwise discriminates against a purchasing group or any	502
of its members;	503

(8) Requires that any insurance policy issued to a purchasing	504
group or any of its members be countersigned by an insurance agent	505
or broker residing in this state.	506

(B) The superintendent of insurance may require or exempt a	507
risk retention group from participation in any joint underwriting	508
association established under section 3929.72 or 3930.03 or in the	509
plan established under section 4509.70 of the Revised Code. Any	510
risk retention group that is required to participate under this	511
division shall submit sufficient information to the superintendent	512
to enable himthe superintendent to apportion on a	513
nondiscriminatory basis the risk retention group's proportionate	514
share of losses and expenses.	515

Sec. 4731.143.  (A) Each person holding a valid certificate	516
under this chapter authorizing the certificate holder to practice	517
medicine and surgery, osteopathic medicine and surgery, or	518
podiatric medicine and surgery, who is not covered by medical	519
malpractice insurance as defined in section 3929.71 of the Revised	520
Code, shall provide a patient with written notice of the	521
certificate holder's lack of such insurance coverage prior to	522
providing nonemergency professional services to the patient. The	523
notice shall be provided alone on its own page. The notice shall	524
provide space for the patient to acknowledge receipt of the	525
notice, and shall be in the following form:	526

"N O T I C E:

527

Dr. ............... (here state the full name of the	528
certificate holder) is not covered by medical malpractice	529
insurance.	530

The undersigned acknowledges the receipt of this notice.

531

The certificate holder shall obtain the patient's signature,	536
acknowledging the patient's receipt of the notice, prior to	537
providing nonemergency professional services to the patient. The	538
certificate holder shall maintain the signed notice in the	539
patient's file.	540

(B) This section does not apply to any officer or employee of	541
the state, as those terms are defined in section 9.85 of the	542
Revised Code, who is immune from civil liability under section	543
9.86 of the Revised Code or is entitled to indemnification	544
pursuant to section 9.87 of the Revised Code, to the extent that	545
the person is acting within the scope of the person's employment	546
or official responsibilities.	547

This section does not apply to a person who complies with	548
division (B)(2) of section 2305.234 of the Revised Code.	549

Section 2. That existing sections 3929.482, 3929.85, 3931.01,	550
3955.05, 3960.06, and 4731.143 and sections        Sec. 3929.71. ,        Sec. 3929.72. ,	551
Sec. 3929.721. ,        Sec. 3929.73. ,        Sec. 3929.75. ,        Sec. 3929.76. ,        Sec. 3929.77. ,        Sec. 3929.78. ,        Sec. 3929.79. ,	552
Sec. 3929.80. ,        Sec. 3929.81. ,        Sec. 3929.82. ,        Sec. 3929.83. , and        Sec. 3929.84.  of the Revised	553
Code are hereby repealed.	554