As Passed by the Senate

125th General Assembly Regular Session 2003-2004

Sub. H. B. No. 331

Representatives Schmidt, Schneider, Hughes, Clancy, Raga, Schlichter, Webster, T. Patton, Grendell, Flowers, Barrett, J. Stewart, Miller, Allen, DeBose, McGregor, Latta, S. Patton, Key, Kearns, Brown, Jerse, Beatty, Harwood, Kilbane, Walcher, Price, G. Smith, S. Smith, Cirelli, Hollister, Reidelbach, Aslanides, Boccieri, Book, Buehrer, Callender, Carano, Carmichael, Cates, Chandler, Collier, Daniels, DeGeeter, Distel, Domenick, C. Evans, D. Evans, Faber, Gilb, Hagan, Hartnett, Hoops, Koziura, Martin, Mason, Oelslager, Olman, Otterman, Schaffer, Seaver, Setzer, Sferra, Skindell, Slaby, D. Stewart, Strahorn, Sykes, Taylor, Ujvagi, Widener, Widowfield, Willamowski, Wilson, Woodard, Yates 

Senators Hagan, Amstutz, Austria, Blessing, Brady, Carey, Coughlin, Dann, Fedor, Fingerhut, Goodman, Harris, Hottinger, Jacobson, Jordan, Mallory, Miller, Mumper, Nein, Padgett, Prentiss, Randy Gardner, Robert Gardner, Roberts, Schuring, Spada, Wachtmann, White, Zurz 

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A BILL

To amend sections 1751.62, 3701.74, 3701.741,

1

3701.742, 3923.52, 3923.53, and 3923.54 of the

2

Revised Code to cap the benefits health care plans

3

provide for the expense of screening

4

mammographies, an examination that the plans are

5

required to cover, at 130% of the Medicare

6

reimbursement rate, to continue and adjust fee

7

schedules for copies of medical records, and to

8

declare an emergency.

9

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

Section 1. That sections 1751.62, 3701.74, 3701.741,	10
3701.742, 3923.52, 3923.53, and 3923.54 of the Revised Code be	11
amended to read as follows:	12

Sec. 1751.62.  (A) As used in this section, "screening:

13

(1) "Screening mammography" means a radiologic examination	14
utilized to detect unsuspected breast cancer at an early stage in	15
an asymptomatic woman and includes the x-ray examination of the	16
breast using equipment that is dedicated specifically for	17
mammography, including, but not limited to, the x-ray tube,	18
filter, compression device, screens, film, and cassettes, and that	19
has an average radiation exposure delivery of less than one rad	20
mid-breast. "Screening mammography" includes two views for each	21
breast. The term also includes the professional interpretation of	22
the film.	23

"Screening mammography" does not include diagnostic	24
mammography.	25

(2) "Medicare reimbursement rate" means the reimbursement	26
rate paid in Ohio under the medicare program for screening	27
mammography that does not include digitization or computer-aided	28
detection, regardless of whether the actual benefit includes	29
digitization or computer-aided detection.	30

(B) Every individual or group health insuring corporation	31
policy, contract, or agreement providing basic health care	32
services that is delivered, issued for delivery, or renewed in	33
this state shall provide benefits for the expenses of both of the	34
following:	35

(1) Screening mammography to detect the presence of breast	36
cancer in adult women;	37

(2) Cytologic screening for the presence of cervical cancer.

38

(C) The benefits provided under division (B)(1) of this	39
section shall cover expenses in accordance with all of the	40
following:	41

(1) If a woman is at least thirty-five years of age but under	42
forty years of age, one screening mammography;	43

(2) If a woman is at least forty years of age but under fifty	44
years of age, either of the following:	45

(a) One screening mammography every two years;

46

(b) If a licensed physician has determined that the woman has	47
risk factors to breast cancer, one screening mammography every	48
year.	49

(3) If a woman is at least fifty years of age but under	50
sixty-five years of age, one screening mammography every year.	51

(D)(1) The benefitsSubject to divisions (D)(2) and (3) of	52
this section, if a provider, hospital, or other health care	53
facility provides a service that is a component of the screening	54
mammography benefit in division (B)(1) of this section and submits	55
a separate claim for that component, a separate payment shall be	56
made to the provider, hospital, or other health care facility in	57
an amount that corresponds to the ratio paid by medicare in this	58
state for that component.	59

(2) Regardless of whether separate payments are made for the	60
benefit provided under division (B)(1) of this section, the total	61
benefit for a screening mammography shall not exceed eighty-five	62
dollars per year unless a lower amount is established pursuant to	63
a provider contractone hundred thirty per cent of the medicare	64
reimbursement rate in this state for screening mammography. If	65
there is more than one medicare reimbursement rate in this state	66
for screening mammography or a component of a screening	67
mammography, the reimbursement limit shall be one hundred thirty	68
per cent of the lowest medicare reimbursement rate in this state.	69

(2)(3) The benefit paid in accordance with division (D)(1) of	70
this section shall constitute full payment. No institutional or	71
professionalprovider, hospital, or other health care provider	72
facility shall seek or receive remuneration in excess of the	73
payment made in accordance with division (D)(1) of this section,	74
except for approved deductibles and copayments.	75

(E) The benefits provided under division (B)(1) of this	76
section shall be provided only for screening mammographies that	77
are performed in a health care facility or mobile mammography	78
screening unit that is accredited under the American college of	79
radiology mammography accreditation program or in a hospital as	80
defined in section 3727.01 of the Revised Code.	81

(F) The benefits provided under divisions (B)(1) and (2) of	82
this section shall be provided according to the terms of the	83
subscriber contract.	84

(G) The benefits provided under division (B)(2) of this	85
section shall be provided only for cytologic screenings that are	86
processed and interpreted in a laboratory certified by the college	87
of American pathologists or in a hospital as defined in section	88
3727.01 of the Revised Code.	89

Sec. 3701.74.  (A) As used in this section and section	90
3701.741 of the Revised Code:	91

(1) "Ambulatory care facility" means a facility that provides	92
medical, diagnostic, or surgical treatment to patients who do not	93
require hospitalization, including a dialysis center, ambulatory	94
surgical facility, cardiac catheterization facility, diagnostic	95
imaging center, extracorporeal shock wave lithotripsy center, home	96
health agency, inpatient hospice, birthing center, radiation	97
therapy center, emergency facility, and an urgent care center.	98
"Ambulatory care facility" does not include the private office of	99
a physician or dentist, whether the office is for an individual or	100
group practice.	101

(2) "Chiropractor" means an individual licensed under Chapter	102
4734. of the Revised Code to practice chiropractic.	103

(3) "Emergency facility" means a hospital emergency	104
department or any other facility that provides emergency medical	105
services.	106

(4) "Health care practitioner" means all of the following:

107

(a) A dentist or dental hygienist licensed under Chapter	108
4715. of the Revised Code;	109

(b) A registered or licensed practical nurse licensed under	110
Chapter 4723. of the Revised Code;	111

(c) An optometrist licensed under Chapter 4725. of the	112
Revised Code;	113

(d) A dispensing optician, spectacle dispensing optician,	114
contact lens dispensing optician, or spectacle-contact lens	115
dispensing optician licensed under Chapter 4725. of the Revised	116
Code;	117

(e) A pharmacist licensed under Chapter 4729. of the Revised	118
Code;	119

(f) A physician;

120

(g) A physician assistant authorized under Chapter 4730. of	121
the Revised Code to practice as a physician assistant;	122

(h) A practitioner of a limited branch of medicine issued a	123
certificate under Chapter 4731. of the Revised Code;	124

(i) A psychologist licensed under Chapter 4732. of the	125
Revised Code;	126

(j) A chiropractor;

127

(k) A hearing aid dealer or fitter licensed under Chapter	128
4747. of the Revised Code;	129

(l) A speech-language pathologist or audiologist licensed	130
under Chapter 4753. of the Revised Code;	131

(m) An occupational therapist or occupational therapy	132
assistant licensed under Chapter 4755. of the Revised Code;	133

(n) A physical therapist or physical therapy assistant	134
licensed under Chapter 4755. of the Revised Code;	135

(o) A professional clinical counselor, professional	136
counselor, social worker, or independent social worker licensed,	137
or a social work assistant registered, under Chapter 4757. of the	138
Revised Code;	139

(p) A dietitian licensed under Chapter 4759. of the Revised	140
Code;	141

(q) A respiratory care professional licensed under Chapter	142
4761. of the Revised Code;	143

(r) An emergency medical technician-basic, emergency medical	144
technician-intermediate, or emergency medical technician-paramedic	145
certified under Chapter 4765. of the Revised Code.	146

(5) "Health care provider" means a hospital, ambulatory care	147
facility, long-term care facility, pharmacy, emergency facility,	148
or health care practitioner.	149

(6) "Hospital" has the same meaning as in section 3727.01 of	150
the Revised Code.	151

(7) "Long-term care facility" means a nursing home,	152
residential care facility, or home for the aging, as those terms	153
are defined in section 3721.01 of the Revised Code; an adult care	154
facility, as defined in section 3722.01 of the Revised Code; a	155
nursing facility or intermediate care facility for the mentally	156
retarded, as those terms are defined in section 5111.20 of the	157
Revised Code; a facility or portion of a facility certified as a	158
skilled nursing facility under Title XVIII of the "Social Security	159
Act," 49 Stat. 286 (1965), 42 U.S.C.A. 1395, as amended.	160

(8) "Medical record" means data in any form that pertains to	161
a patient's medical history, diagnosis, prognosis, or medical	162
condition and that is generated and maintained by a health care	163
provider in the process of the patient's health care treatment.	164

(9) "Medical records company" means a person who stores,	165
locates, or copies medical records for a health care provider, or	166
is compensated for doing so by a health care provider, and charges	167
a fee for providing medical records to a patient or patient's	168
representative.	169

(10) "Patient" means either of the following:

170

(a) An individual who received health care treatment from a	171
health care provider;	172

(b) A guardian, as defined in section 1337.11 of the Revised	173
Code, of an individual described in division (A)(10)(a) of this	174
section.	175

(11) "Patient's personal representative" means a person to	176
whom a patient has given written authorization to act on the	177
patient's behalf regarding the patient's medical records, except	178
that if the patient is deceased, "patient's representative" means	179
theminor patient's parent or other person acting in loco	180
parentis, a court-appointed guardian, or a person with durable	181
power of attorney for health care for a patient, the executor or	182
administrator of the patient's estate, or the person responsible	183
for the patient's estate if it is not to be probated. "Patient's	184
personal representative" does not include an insurer authorized	185
under Title XXXIX of the Revised Code to do the business of	186
sickness and accident insurance in this state or, a health	187
insuring corporation holding a certificate of authority under	188
Chapter 1751. of the Revised Code, or any other person not named	189
in this division.	190

(12) "Pharmacy" has the same meaning as in section 4729.01 of	191
the Revised Code.	192

(13) "Physician" means a person authorized under Chapter	193
4731. of the Revised Code to practice medicine and surgery,	194
osteopathic medicine and surgery, or podiatric medicine and	195
surgery.	196

(14) "Authorized person" means a person to whom a patient has	197
given written authorization to act on the patient's behalf	198
regarding the patient's medical record.	199

(B) A patient or, a patient's personal representative or an	200
authorized person who wishes to examine or obtain a copy of part	201
or all of a medical record shall submit to the health care	202
provider a written request signed by the patient, personal	203
representative, or authorized person dated not more than sixty	204
days before the date on which it is submitted. The patient or	205
patient's representative who wishes to obtain a copy of the record	206
shall indicate in the request shall indicate whether the copy is	207
to be sent to the patient's residencerequestor, physician or	208
chiropractor, or representative, or held for the patientrequestor	209
at the office of the health care provider. Within a reasonable	210
time after receiving a request that meets the requirements of this	211
division and includes sufficient information to identify the	212
record requested, a health care provider that has the patient's	213
medical records shall permit the patient to examine the record	214
during regular business hours without charge or, on request, shall	215
provide a copy of the record in accordance with section 3701.741	216
of the Revised Code, except that if a physician or chiropractor	217
who has treated the patient determines for clearly stated	218
treatment reasons that disclosure of the requested record is	219
likely to have an adverse effect on the patient, the health care	220
provider shall provide the record to a physician or chiropractor	221
designated by the patient. The health care provider shall take	222
reasonable steps to establish the identity of the person making	223
the request to examine or obtain a copy of the patient's record.	224

(C) If a health care provider fails to furnish a medical	225
record as required by division (B) of this section, the patient or	226
patient's, personal representative, or authorized person who	227
requested the record may bring a civil action to enforce the	228
patient's right of access to the record.	229

(D)(1) This section does not apply to medical records whose	230
release is covered by section 173.20 or 3721.13 of the Revised	231
Code, by Chapter 1347. or 5122. of the Revised Code, by 42 C.F.R.	232
part 2, "Confidentiality of Alcohol and Drug Abuse Patient	233
Records," or by 42 C.F.R. 483.10.	234

(2) Nothing in this section is intended to supersede the	235
confidentiality provisions of sections 2305.24, 2305.25, 2305.251,	236
and 2305.252 of the Revised Code.	237

Sec. 3701.741.  (A) Through December 31, 20042008, each	238
health care provider and medical records company shall provide	239
copies of medical records in accordance with this section.	240

(B) Except as provided in divisions (C) and (E) of this	241
section, a health care provider or medical records company that	242
receives a request for a copy of a patient's medical record may	243
shall charge not more than the amounts set forth in this section.	244
Total	245

(1) If the request is made by the patient or the patient's	246
personal representative, total costs for copies and all services	247
related to those copies shall not exceed the sum of the following:	248

(1)(a) With respect to data recorded on paper, the following	249
amounts:	250

(i) Two dollars and fifty cents per page for the first ten	251
pages;	252

(ii) Fifty-one cents per page for pages eleven through fifty;

253

(iii) Twenty cents per page for pages fifty-one and higher;

254

(b) With respect to data recorded other than on paper, one	255
dollar and seventy cents per page;	256

(c) The actual cost of any related postage incurred by the	257
health care provider or medical records company.	258

(2) If the request is made other than by the patient or the	259
patient's personal representative, total costs for copies and all	260
services related to those copies shall not exceed the sum of the	261
following:	262

(a) An initial fee of fifteen dollars and thirty-five cents,	263
which shall compensate for the records search;	264

(2)(b) With respect to data recorded on paper, the following	265
amounts:	266

(a)(i) One dollar and two cents per page for the first ten	267
pages;	268

(b)(ii) Fifty-one cents per page for pages eleven through	269
fifty;	270

(c)(iii) Twenty cents per page for pages fifty-one and	271
higher.	272

(3)(c) With respect to data recorded other than on paper, the	273
actual cost of making the copyone dollar and seventy cents per	274
page;	275

(4)(d) The actual cost of any related postage incurred by the	276
health care provider or medical records company.	277

(C)(1) A health care provider or medical records company	278
shall provide one copy without charge to the following:	279

(1)(a) The bureau of workers' compensation, in accordance	280
with Chapters 4121. and 4123. of the Revised Code and the rules	281
adopted under those chapters;	282

(2)(b) The industrial commission, in accordance with Chapters	283
4121. and 4123. of the Revised Code and the rules adopted under	284
those chapters;	285

(3)(c) The department of job and family services, in	286
accordance with Chapter 5101. of the Revised Code and the rules	287
adopted under those chapters;	288

(4)(d) The attorney general, in accordance with sections	289
2743.51 to 2743.72 of the Revised Code and any rules that may be	290
adopted under those sections;	291

(5)(e) A patient or patient's personal representative if the	292
medical record is necessary to support a claim under Title II or	293
Title XVI of the "Social Security Act," 49 Stat. 620 (1935), 42	294
U.S.C.A. 401 and 1381, as amended, and the request is accompanied	295
by documentation that a claim has been filed.	296

(2) Nothing in division (C)(1) of this section requires a	297
health care provider or medical records company to provide a copy	298
without charge to any person or entity not listed in division	299
(C)(1) of this section.	300

(D) Division (C) of this section shall not be construed to	301
supersede any rule of the bureau of workers' compensation, the	302
industrial commission, or the department of job and family	303
services.	304

(E) A health care provider or medical records company may	305
enter into a contract with a patient, a patient's representative,	306
or an insurereither of the following for the copying of medical	307
records at a fee other than as provided in division (B) of this	308
section:	309

(1) A patient, a patient's personal representative, or an	310
authorized person;	311

(2) An insurer authorized under Title XXXIX of the Revised	312
Code to do the business of sickness and accident insurance in this	313
state or health insuring corporations holding a certificate of	314
authority under Chapter 1751. of the Revised Code.	315

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

316

(1) Copies of medical records provided to insurers authorized	317
under Title XXXIX of the Revised Code to do the business of	318
sickness and accident insurance in this state or health insuring	319
corporations holding a certificate of authority under Chapter	320
1751. of the Revised Code;	321

(2) Medicalmedical records the copying of which is covered	322
by section 173.20 of the Revised Code or by 42 C.F.R. 483.10.	323

(G) Nothing in this section requires or precludes the	324
distribution of medical records at any particular cost or fee to	325
insurers authorized under Title XXXIX of the Revised Code to do	326
the business of sickness and accident insurance in this state or	327
health insuring corporations holding a certificate of authority	328
under Chapter 1751. of the Revised Code.	329

Sec. 3701.742. If the date specified in section 3701.741 of	330
the Revised Code is amended to reflect a date that occurs after	331
December 31, 2004, then notNot later than January 31, 20052006,	332
the amounts specified in division (B) of section 3701.741 of the	333
Revised Code and, not later than the first day of January of each	334
year thereafter, any amounts computed by adjustments made under	335
this section, shall be increased or decreased by the average	336
percentage of increase or decrease in the consumer price index for	337
all urban consumers (United States city average, all items),	338
prepared by the United States department of labor, bureau of labor	339
statistics, for the twelve-calendar-month period prior to the	340
immediately preceding first day of January over the immediately	341
preceding twelve-calendar-month period, as reported by the bureau.	342
The director of health shall make this determination and adjust	343
the amounts accordingly. The director shall provide a list of the	344
adjusted amounts to any party upon request and the department of	345
health shall make the list available to the public on its internet	346
web site.	347

Sec. 3923.52.  (A) As used in this section and section	348
3923.53 of the Revised Code, "screening mammography" means a	349
radiologic examination utilized to detect unsuspected breast	350
cancer at an early stage in asymptomatic women and includes the	351
x-ray examination of the breast using equipment that is dedicated	352
specifically for mammography, including, but not limited to, the	353
x-ray tube, filter, compression device, screens, film, and	354
cassettes, and that has an average radiation exposure delivery of	355
less than one rad mid-breast. "Screening mammography" includes two	356
views for each breast. The term also includes the professional	357
interpretation of the film.	358

"Screening mammography" does not include diagnostic	359
mammography.	360

(B) Every policy of individual or group sickness and accident	361
insurance that is delivered, issued for delivery, or renewed in	362
this state shall offer to provide benefits for the expenses of	363
both of the following:	364

(1) Screening mammography to detect the presence of breast	365
cancer in adult women;	366

(2) Cytologic screening for the presence of cervical cancer.

367

(C) The benefits provided under division (B)(1) of this	368
section shall cover expenses in accordance with all of the	369
following:	370

(1) If a woman is at least thirty-five years of age but under	371
forty years of age, one screening mammography;	372

(2) If a woman is at least forty years of age but under fifty	373
years of age, either of the following:	374

(a) One screening mammography every two years;

375

(b) If a licensed physician has determined that the woman has	376
risk factors to breast cancer, one screening mammography every	377
year.	378

(3) If a woman is at least fifty years of age but under	379
sixty-five years of age, one screening mammography every year.	380

(D)(1) The benefitsAs used in this division, "medicare	381
reimbursement rate" means the reimbursement rate paid in this	382
state under the medicare program for screening mammography that	383
does not include digitization or computer-aided detection,	384
regardless of whether the actual benefit includes digitization or	385
computer-aided detection.	386

(1) Subject to divisions (D)(2) and (3) of this section, if a	387
provider, hospital, or other health care facility provides a	388
service that is a component of the screening mammography benefit	389
in division (B)(1) of this section and submits a separate claim	390
for that component, a separate payment shall be made to the	391
provider, hospital, or other health care facility in an amount	392
that corresponds to the ratio paid by medicare in this state for	393
that component.	394

(2) Regardless of whether separate payments are made for the	395
benefit provided under division (B)(1) of this section, the total	396
benefit for a screening mammography shall not exceed eighty-five	397
dollars per year unless a lower amount is established pursuant to	398
a provider contractone hundred thirty per cent of the medicare	399
reimbursement rate in this state for screening mammography. If	400
there is more than one medicare reimbursement rate in this state	401
for screening mammography or a component of a screening	402
mammography, the reimbursement limit shall be one hundred thirty	403
per cent of the lowest medicare reimbursement rate in this state.	404

(2)(3) The benefit paid in accordance with division (D)(1) of	405
this section shall constitute full payment. No institutional or	406
professionalprovider, hospital, or other health care provider	407
facility shall seek or receive compensation in excess of the	408
payment made in accordance with division (D)(1) of this section,	409
except for approved deductibles and copayments.	410

(E) The benefits provided under division (B)(1) of this	411
section shall be provided only for screening mammographies that	412
are performed in a facility or mobile mammography screening unit	413
that is accredited under the American college of radiology	414
mammography accreditation program or in a hospital as defined in	415
section 3727.01 of the Revised Code.	416

(F) The benefits provided under division (B)(2) of this	417
section shall be provided only for cytologic screenings that are	418
processed and interpreted in a laboratory certified by the college	419
of American pathologists or in a hospital as defined in section	420
3727.01 of the Revised Code.	421

(G) This section does not apply to any policy that provides	422
coverage for specific diseases or accidents only, or to any	423
hospital indemnity, medicare supplement, or other policy that	424
offers only supplemental benefits.	425

Sec. 3923.53.  (A) Every public employee benefit plan that is	426
established or modified in this state shall provide benefits for	427
the expenses of both of the following:	428

(1) Screening mammography to detect the presence of breast	429
cancer in adult women;	430

(2) Cytologic screening for the presence of cervical cancer.

431

(B) The benefits provided under division (A)(1) of this	432
section shall cover expenses in accordance with all of the	433
following:	434

(1) If a woman is at least thirty-five years of age but under	435
forty years of age, one screening mammography;	436

(2) If a woman is at least forty years of age but under fifty	437
years of age, either of the following:	438

(a) One screening mammography every two years;

439

(b) If a licensed physician has determined that the woman has	440
risk factors to breast cancer, one screening mammography every	441
year.	442

(3) If a woman is at least fifty years of age but under	443
sixty-five years of age, one screening mammography every year.	444

(C)(1) The benefitsAs used in this division, "medicare	445
reimbursement rate" means the reimbursement rate paid in this	446
state under the medicare program for screening mammography that	447
does not include digitization or computer-aided detection,	448
regardless of whether the actual benefit includes digitization or	449
computer-aided detection.	450

(1) Subject to divisions (C)(2) and (3) of this section, if a	451
provider, hospital, or other health care facility provides a	452
service that is a component of the screening mammography benefit	453
in division (B)(1) of this section and submits a separate claim	454
for that component, a separate payment shall be made to the	455
provider, hospital, or other health care facility in an amount	456
that corresponds to the ratio paid by medicare in this state for	457
that component.	458

(2) Regardless of whether separate payments are made for the	459
benefit provided under division (A)(1) of this section, the total	460
benefit for a screening mammography shall not exceed eighty-five	461
dollars per year unless a lower amount is established pursuant to	462
a provider contractone hundred thirty per cent of the medicare	463
reimbursement rate in this state for screening mammography. If	464
there is more than one medicare reimbursement rate in this state	465
for screening mammography or a component of a screening	466
mammography, the reimbursement limit shall be one hundred thirty	467
per cent of the lowest medicare reimbursement rate in this state.	468

(2)(3) The benefit paid in accordance with division (C)(1) of	469
this section shall constitute full payment. No institutional or	470
professionalprovider, hospital, or other health care provider	471
facility shall seek or receive compensation in excess of the	472
payment made in accordance with division (C)(1) of this section,	473
except for approved deductibles and copayments.	474

(D) The benefits provided under division (A)(1) of this	475
section shall be provided only for screening mammographies that	476
are performed in a facility or mobile mammography screening unit	477
that is accredited under the American college of radiology	478
mammography accreditation program or in a hospital as defined in	479
section 3727.01 of the Revised Code.	480

(E) The benefits provided under division (A)(2) of this	481
section shall be provided only for cytologic screenings that are	482
processed and interpreted in a laboratory certified by the college	483
of American pathologists or in a hospital as defined in section	484
3727.01 of the Revised Code.	485

Sec. 3923.54.  (A) As used in this section, "screening	486
mammography" means a radiologic examination utilized to detect	487
unsuspected breast cancer at an early stage in asymptomatic women	488
and includes the x-ray examination of the breast using equipment	489
that is dedicated specifically for mammography including, but not	490
limited to, the x-ray tube, filter, compression device, screens,	491
film, and cassettes, and that has an average radiation exposure	492
delivery of less than one rad mid-breast. "Screening mammography"	493
includes two views for each breast. The term also includes the	494
professional interpretation of the film.	495

"Screening mammography" does not include diagnostic	496
mammography.	497

(B) Each employer in this state that provides, in whole or in	498
part, health care benefits for its employees under a policy of	499
sickness and accident insurance issued in accordance with Chapter	500
3923. of the Revised Code shall also provide to its employees	501
benefits for the expenses of both of the following:	502

(1) Screening mammography to detect the presence of breast	503
cancer in adult women;	504

(2) Cytologic screening for the presence of cervical cancer.

505

(C) An employer may comply with division (B) of this section	506
in any of the following ways:	507

(1) By providing the benefits under a health insuring	508
corporation contract issued in accordance with Chapter 1751. of	509
the Revised Code or a policy of sickness and accident insurance	510
issued in accordance with Chapter 3923. of the Revised Code;	511

(2) By reimbursing the employee for the direct health care	512
provider charges associated with receipt of the covered service;	513

(3) By making any other arrangement that provides the	514
benefits described in division (B) of this section.	515

(D) The benefits provided under division (B)(1) of this	516
section shall cover expenses in accordance with all of the	517
following:	518

(1) If a woman is at least thirty-five years of age but under	519
forty years of age, one screening mammography;	520

(2) If a woman is at least forty years of age but under fifty	521
years of age, either of the following:	522

(a) One screening mammography every two years;

523

(b) If a licensed physician has determined that the woman has	524
risk factors to breast cancer, one screening mammography every	525
year.	526

(3) If a woman is at least fifty years of age but under	527
sixty-five years of age, one screening mammography every year.	528

(E)(1) The benefitsAs used in this division, "medicare	529
reimbursement rate" means the reimbursement rate paid in this	530
state under the medicare program for screening mammography that	531
does not include digitization or computer-aided detection,	532
regardless of whether the actual benefit includes digitization or	533
computer-aided detection.	534

(1) Subject to divisions (E)(2) and (3) of this section, if a	535
provider, hospital, or other health care facility provides a	536
service that is a component of the screening mammography benefit	537
in division (B)(1) of this section and submits a separate claim	538
for that component, a separate payment shall be made to the	539
provider, hospital, or other health care facility in an amount	540
that corresponds to the ratio paid by medicare in this state for	541
that component.	542

(2) Regardless of whether separate payments are made for the	543
benefit provided under division (B)(1) of this section, the total	544
benefit for a screening mammography need not exceed eighty-five	545
dollars per yearone hundred thirty per cent of the medicare	546
reimbursement rate in this state for screening mammography. If	547
there is more than one medicare reimbursement rate in this state	548
for screening mammography or a component of a screening	549
mammography, the reimbursement limit shall be one hundred thirty	550
per cent of the lowest medicare reimbursement rate in this state.	551

(2)(3) The benefit paid in accordance with division (E)(1) of	552
this section shall constitute full payment. No institutional or	553
professionalprovider, hospital, or other health care provider	554
facility shall seek or receive compensation in excess of the	555
payment made in accordance with division (E)(1) of this section,	556
except for approved deductibles and copayments.	557

(F) The benefits provided under division (B)(1) of this	558
section shall be provided only for screening mammographies that	559
are performed in a facility or mobile mammography screening unit	560
that is accredited under the American college of radiology	561
mammography accreditation program or in a hospital as defined in	562
section 3727.01 of the Revised Code.	563

(G) The benefits provided under division (B)(2) of this	564
section shall be provided only for cytologic screenings that are	565
processed and interpreted in a laboratory certified by the college	566
of American pathologists or in a hospital as defined in section	567
3727.01 of the Revised Code.	568

Section 2. That existing sections 1751.62, 3701.74, 3701.741,	569
3701.742, 3923.52, 3923.53, and 3923.54 of the Revised Code are	570
hereby repealed.	571

Section 3. Sections 1751.62, 3923.52, 3923.53, and 3923.54 of	572
the Revised Code, as amended by this act, shall take effect on the	573
ninety-first day after the effective date of this act.	574

Section 4. This act is hereby declared to be an emergency	575
measure necessary for the immediate preservation of the public	576
peace, health, and safety. The reason for this necessity is that	577
the current fee schedule for copies of medical records ceases to	578
be effective on January 1, 2005, and a new fee schedule is needed	579
to ensure that Ohioans can obtain medical records efficiently.	580
Therefore, this act shall go into immediate effect.	581