As Passed by the Senate

127th General Assembly Regular Session 2007-2008

Sub. H. B. No. 493

Representative Daniels 

Cosponsors: Representatives Ujvagi, Flowers, Goodwin, Collier, Zehringer, Strahorn, Otterman, J., Hagan, R., Budish, Chandler, Combs, Domenick, Evans, Gerberry, Harwood, Letson, Szollosi 

Senators Wagoner, Seitz, Harris, Schuler, Niehaus 

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A BILL

To amend sections 3923.05 and 3923.80 and to enact

1

sections 3701.86, 3701.861, 3923.82, and 4731.72

2

of the Revised Code and to amend Section 5 of

3

Sub. H.B. 125 of the 127th General Assembly

4

regarding billing for anatomic pathology

5

services, health benefits for routine patient care

6

during cancer clinical trials, health benefits for

7

injuries resulting from use of alcohol or drugs,

8

and most favored nation clauses in health care

9

contracts.

10

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

Section 1. That sections 3923.05 and 3923.80 be amended and	11
sections 3701.86, 3701.861, 3923.82, and 4731.72 of the Revised	12
Code be enacted to read as follows:	13

Sec. 3701.86.  As used in this section and in section	14
3701.861 of the Revised Code:	15

(A) "Anatomic pathology services" means all of the following:

16

(1) Histopathology or surgical pathology;

17

(2) Cytopathology;

18

(3) Hematology;

19

(4) Subcellular or molecular pathology;

20

(5) Blood banking services performed by pathologists.

21

(B) "Assignment of benefits" means the transfer of health	22
care coverage reimbursement benefits or other rights under an	23
insurance policy, subscription contract, or health care plan by an	24
insured, subscriber, or plan enrollee to a health care provider,	25
hospital, or other health care facility.	26

(C) "Clinical laboratory" means a facility for the	27
biological, microbiological, serological, chemical,	28
immunohematological, hematological, biophysical, cytological,	29
pathological, or other examination of substances derived from the	30
human body for the purpose of providing information for the	31
diagnosis, prevention, or treatment of any disease, or in the	32
assessment or impairment of the health of human beings.	33

(D) "Cytopathology" means the microscopic examination of	34
cells from fluids, aspirates, washings, brushings, or smears,	35
including a Papanicolaou smear (PAP smear or test).	36

(E) "Hematology" means the microscopic evaluation of bone	37
marrow aspirates and biopsies performed by a physician or under	38
the supervision of a physician and peripheral blood smears when	39
the attending or treating physician or technologist requests that	40
a blood smear be reviewed by a pathologist.	41

(F) "Histologic processing" means fixation, processing,	42
embedding, microtomy, and other special staining, including	43
histochemical or immunohistochemical staining and in situ	44
hybridization of clinical human tissues or cells, for pathological	45
examination.	46

(G) "Histopathology" or "surgical pathology" means the gross	47
and microscopic examination and histologic processing of organ	48
tissue performed by a physician or under the supervision of a	49
physician.	50

(H) "Insurer" means a person authorized under Title XXXIX of	51
the Revised Code to engage in the business of insurance in this	52
state, a health insuring corporation, or an entity that is	53
self-insured and provides benefits to its employees or members.	54

(I) "Physician" means an individual authorized by Chapter	55
4731. of the Revised Code to practice medicine and surgery,	56
osteopathic medicine and surgery, or podiatric medicine and	57
surgery.	58

(J) "Referring clinical laboratory" means a clinical	59
laboratory that refers a patient specimen to another clinical	60
laboratory for an anatomic pathology service, but excludes a	61
laboratory in the office of one or more physicians that refers a	62
specimen and does not perform the professional component of the	63
anatomic pathology service, as that component is defined in	64
section 4731.72 of the Revised Code.	65

(K) "Subcellular or molecular pathology" means the assessment	66
of a patient specimen for the detection, localization,	67
measurement, or analysis of one or more protein or nucleic acid	68
targets performed or interpreted by or under supervision of a	69
pathologist.	70

Sec. 3701.861. (A) No clinical laboratory shall present or	71
cause to be presented a claim, bill, or demand for payment for	72
anatomic pathology services to any person or entity other than	73
the following:	74

(1) The patient who receives the services or another	75
individual, such as a parent, spouse, or guardian, who is	76
responsible for the patient's bills;	77

(2) A responsible insurer or other third-party payor of a	78
patient who receives the services;	79

(3) A hospital, public health clinic, or not-for-profit	80
health clinic ordering the services;	81

(4) A referring clinical laboratory;

82

(5) A governmental agency or any person acting on behalf of a	83
governmental agency;	84

(6) A physician who is permitted to bill for the services	85
under division (D) of section 4731.72 of the Revised Code.	86

(B) Nothing in this section shall be construed to do either	87
of the following:	88

(1) Mandate the assignment of benefits for anatomic pathology	89
services;	90

(2) Prohibit a clinical laboratory that provides anatomic	91
pathology services from billing a referring clinical laboratory	92
for anatomic pathology services in instances in which the	93
referring clinical laboratory sends one or more samples to the	94
clinical laboratory for purposes of having a specialist perform	95
analysis, consultation, or histologic processing.	96

Sec. 3923.05.  Except as provided in section 3923.07 of the	97
Revised Code, no policy of sickness and accident insurance	98
delivered, issued for delivery, or used in this state shall	99
contain provisions respecting the matters set forth in this	100
section unless such provisions are in the words in which the same	101
appear in this section. Any such provisions in any such policy	102
shall be preceded by the appropriate caption appearing in this	103
section or, at the option of the insurer, by such appropriate	104
individual or group captions or subcaptions as the superintendent	105
of insurance may approve.	106

(A) A provision as follows: Change of occupation. If the	107
insured be injured or contract sickness after having changed his	108
the insured's occupation to one classified by the insurer as more	109
hazardous than that stated in this policy or while doing for	110
compensation anything pertaining to an occupation so classified,	111
the insurer will pay only such portion of the indemnities provided	112
in this policy as the premium paid would have purchased at the	113
rates and within the limits fixed by the insurer for such more	114
hazardous occupation. If the insured changes histhe insured's	115
occupation to one classified by the insurer as less hazardous than	116
that stated in this policy, the insurer, upon receipt of proof of	117
such change of occupation, will reduce the premium rate	118
accordingly, and will return the excess pro rata unearned premium	119
from the date of change of occupation or from the policy	120
anniversary date immediately preceding receipt of such proof,	121
whichever is the more recent. In applying this provision, the	122
classification for occupational risk and the premium rates shall	123
be such as have been last filed by the insurer prior to the	124
occurrence of the loss for which the insurer is liable or prior to	125
the date of proof of change in occupation with the state official	126
having supervision of insurance in the state where the insured	127
resided at the time this policy was issued; but if such filing was	128
not required, then the classification of occupational risk and the	129
premium rates shall be those last made effective by the insurer in	130
such state prior to the occurrence of the loss or prior to the	131
date of proof of change in occupation.	132

(B) A provision as follows: Misstatement of age. If the age	133
of the insured has been misstated, all amounts payable under this	134
policy shall be such as the premium paid would have purchased at	135
the correct age.	136

(C) A provision as follows:

137

(1) Other insurance in this insurer. If an accident or	138
sickness or accident and sickness policy or policies previously	139
issued by the insurer to the insured be in force concurrently	140
herewith, making the aggregate indemnity for ............... in	141
excess of ......... dollars, the excess insurance shall be void	142
and all premiums paid for such excess shall be returned to the	143
insured or to histhe insured's estate.	144

The insurer shall insert the type of coverage or coverages in	145
the first blank space in the provision in division (C)(1) of this	146
section and the maximum limit of indemnity or indemnities in the	147
second blank space in the provision in division (C)(1) of this	148
section.	149

(2) In lieu of the foregoing provision in division (C)(1) of	150
this section, a provision as follows: Other insurance in this	151
insurer. Insurance effective at any time on the insured under a	152
like policy or policies in this insurer is limited to the one such	153
policy elected by the insured, histhe insured's beneficiary or	154
histhe insured's estate, as the case may be, and the insurer will	155
return all premiums paid for all other such policies.	156

(D) A provision as follows: Insurance with other insurers. If	157
there be other valid coverage, not with this insurer, providing	158
benefits for the same loss on a provision of service basis or on	159
an expense incurred basis and of which this insurer has not been	160
given written notice prior to the occurrence or commencement of	161
loss, the only liability under any expense incurred coverage of	162
this policy shall be for such proportion of the loss as the amount	163
which would otherwise have been payable hereunder plus the total	164
of the like amounts under all such other valid coverages for the	165
same loss of which this insurer had notice bears to the total like	166
amounts under all valid coverages for such loss, and for the	167
return of such portion of the premiums paid as shall exceed the	168
pro-rata portion for the amount so determined. For the purpose of	169
applying this provision when other coverage is on a provision of	170
service basis, the "like amount" of such other coverage shall be	171
taken as the amount which the services rendered would have cost in	172
the absence of such coverage.	173

If the provision in division (D) of this section is included	174
in a policy of sickness and accident insurance which also contains	175
the provision in division (E) of this section, the insurer shall	176
add to the caption of the provision in division (D) of this	177
section the following: Expense incurred benefits.	178

The insurer may at its option include in the provision in	179
division (D) of this section a definition of "other valid	180
coverage" approved as to form by the superintendent. Such	181
definition shall be limited in subject matter to coverage provided	182
by organizations subject to regulation by insurance law or by	183
insurance authorities of this or any other state of the United	184
States or any province of the Dominion of Canada, and by hospital	185
or medical service organizations, and to any other coverage the	186
inclusion of which may be approved by the superintendent. In the	187
absence of such definition in the provision in division (D) of	188
this section, "other valid coverage" as used in such provision	189
shall not include group insurance, automobile medical payments	190
insurance, or coverage provided by hospital or medical service	191
organizations or by union welfare plans or employer or employee	192
benefit organizations.	193

For the purpose of applying the provision in division (D) of	194
this section with respect to any insured, any amount of benefit	195
provided for such insured pursuant to any compulsory benefit	196
statute, including any workers' compensation or employer's	197
liability statute, whether provided by governmental agency or	198
otherwise, shall in all cases be deemed to be "other valid	199
coverage" of which the insurer has had notice.	200

In applying the provision in division (D) of this section no	201
third party liability coverage shall be included as "other valid	202
coverage."	203

(E) A provision as follows: Insurance with other insurers. If	204
there be other valid coverage, not with this insurer, providing	205
benefits for the same loss on other than an expense incurred basis	206
and of which the insurer has not been given written notice prior	207
to the occurrence or commencement of loss, the only liability for	208
such benefits under this policy shall be for such proportion of	209
the indemnities otherwise provided hereunder for such loss as the	210
like indemnities of which the insurer had notice (including the	211
indemnities under this policy) bear to the total amount of all	212
like indemnities for such loss, and for the return of such portion	213
of the premium paid as shall exceed the pro-rata portion for the	214
indemnities thus determined.	215

If the provision in division (E) of this section is included	216
in a policy of sickness and accident insurance which also contains	217
the provision in division (D) of this section, the insurer shall	218
add to the caption of the provision in division (E) of this	219
section the following: Other benefits.	220

The insurer may at its option include in the provision in	221
division (E) of this section a definition of "other valid	222
coverage" approved as to form by the superintendent. Such	223
definition shall be limited in subject matter to coverage provided	224
by organizations subject to regulation by insurance law or by	225
insurance authorities of this or any other state of the United	226
States or any province of the Dominion of Canada, and to any other	227
coverage the inclusion of which may be approved by the	228
superintendent. In the absence of such definition in the provision	229
in division (E) of this section, "other valid coverage" as used in	230
such provision shall not include group insurance, or benefits	231
provided by union welfare plans or by employer or employee benefit	232
organizations.	233

For the purpose of applying the provision in division (E) of	234
this section with respect to any insured, any amount of benefit	235
provided for such insured pursuant to any compulsory benefit	236
statute, including any workers' compensation or employer's	237
liability statute, whether provided by a governmental agency or	238
otherwise, shall in all cases be deemed to be "other valid	239
coverage" of which the insurer has had notice.	240

In applying the provision in division (E) of this section no	241
third party liability coverage shall be included as "other valid	242
coverage."	243

(F) A provision as follows: Relation of earnings to	244
insurance. If the total monthly amount of loss of time benefits	245
promised for the same loss under all valid loss of time coverage	246
upon the insured, whether payable on a weekly or monthly basis,	247
shall exceed the monthly earnings of the insured at the time	248
disability commenced or histhe insured's average monthly earnings	249
for the period of two years immediately preceding a disability for	250
which claim is made, whichever is the greater, the insurer will be	251
liable only for such proportionate amount of such benefits under	252
this policy as the amount of such monthly earnings or such average	253
monthly earnings of the insured bears to the total amount of	254
monthly benefits for the same loss under all such coverage upon	255
the insured at the time such disability commences and for the	256
return of such part of the premiums paid during such two years as	257
shall excedexceed the pro-rata amount of the premiums for the	258
benefits actually paid hereunder; this shall not operate to reduce	259
the total monthly amount of benefits payable under all such	260
coverage upon the insured below the sum of two hundred dollars or	261
the sum of the monthly benefits specified in such coverages,	262
whichever is the lesser, nor shall this operate to reduce benefits	263
other than those payable for loss of time.	264

The provision in division (F) of this section may be placed	265
only in a policy of sickness and accident insurance which the	266
insured has a right to continue in force subject to its terms by	267
the timely payment of premiums until at least age fifty or in a	268
policy of sickness and accident insurance issued after the insured	269
has attained age forty-four and which the insured has the right to	270
continue in force subject to its terms by the timely payment of	271
premiums for at least five years from its date of issue.	272

The insurer may at its option include in the provision in	273
division (F) of this section a definition of "valid loss of time	274
coverage" approved as to form by the superintendent. Such	275
definition shall be limited in subject matter to coverage provided	276
by governmental agencies or by organizations subject to regulation	277
by insurance law or by insurance authorities of this or any other	278
state of the United States or any province of the Dominion of	279
Canada or to any other coverage the inclusion of which may be	280
approved by the superintendent or any combination of such	281
coverages. In the absence of such definition in the provision in	282
division (F) of this section "valid loss of time coverage" as used	283
in such provision shall not include any coverage provided for such	284
insured pursuant to any compulsory benefit statute, including any	285
workers' compensation or employer's liability statute, whether	286
provided by a governmental agency or otherwise, or benefits	287
provided by union welfare plans or by employer or employee benefit	288
organizations.	289

(G) A provision as follows: Unpaid premium. Upon the payment	290
of a claim under this policy, any premium then due and unpaid or	291
covered by any note or written order may be deducted therefrom.	292

(H) A provision as follows: Conformity with state statutes.	293
Any provision of this policy which, on its effective date, is in	294
conflict with the statutes of the state in which the insured	295
resides on such date is hereby amended to conform to the minimum	296
requirements of such statutes.	297

(I) A provision as follows: Illegal occupation. The insurer	298
shall not be liable for any loss to which a contributing cause was	299
the insured's commission of or attempt to commit a felony or to	300
which a contributing cause was the insured's being engaged in an	301
illegal occupation.	302

(J) A provision as follows: Intoxicants and narcotics. The	303
insurer shall not be liable for any loss sustained or contracted	304
in consequence of the insured's being intoxicated or under the	305
influence of any narcotic unless administered on the advice of a	306
physician.	307

Sec. 3923.80. (A) NoNotwithstanding section 3901.71 of the	308
Revised Code, no health benefit plan or public employee benefit	309
plan shall deny coverage for the costs of any routine patient	310
care administered to an insured participating in any stage of an	311
eligible cancer clinical trial, if that care would be covered	312
under the plan if the insured was not participating in a clinical	313
trial.	314

(B) The coverage that may not be excluded under division (A)	315
of this section is subject to all terms, conditions, restrictions,	316
exclusions, and limitations that apply to any other coverage under	317
the plan, policy, or arrangement for services performed by	318
participating and nonparticipating providers. Nothing in this	319
section shall be construed as requiring reimbursement to a	320
provider or facility providing the routine care that does not have	321
a health care contract with the entity issuing the health benefit	322
plan or public employee benefit plan, or as prohibiting the entity	323
issuing a health benefit plan or public employee benefit plan that	324
does not have a health care contract with the provider or	325
facility providing the routine care from negotiating a single case	326
or other agreement for coverage.	327

(C) As used in this section:

328

(1) "Eligible cancer clinical trial" means a cancer clinical	329
trial that meets all of the following criteria:	330

(a) A purpose of the trial is to test whether the	331
intervention potentially improves the trial participant's health	332
outcomes.	333

(b) The treatment provided as part of the trial is given with	334
the intention of improving the trial participant's health	335
outcomes.	336

(c) The trial has a therapeutic intent and is not designed	337
exclusively to test toxicity or disease pathophysiology.	338

(d) The trial does one of the following:

339

(i) Tests how to administer a health care service, item, or	340
drug for the treatment of cancer;	341

(ii) Tests responses to a health care service, item, or drug	342
for the treatment of cancer;	343

(iii) Compares the effectiveness of a health care service,	344
item, or drug for the treatment of cancer with that of other	345
health care services, items, or drugs for the treatment of cancer;	346

(iv) Studies new uses of a health care service, item, or drug	347
for the treatment of cancer.	348

(e) The trial is approved by one of the following entities:

349

(i) The national institutes of health or one of its	350
cooperative groups or centers under the United States department	351
of health and human services;	352

(ii) The United States food and drug administration;

353

(iii) The United States department of defense;

354

(iv) The United States department of veterans' affairs.

355

(2) "Subject of a cancer clinical trial" means the health	356
care service, item, or drug that is being evaluated in the	357
clinical trial and that is not routine patient care.	358

(3) "Health benefit plan" has the same meaning as in section	359
3924.01 of the Revised Code.	360

(4) "Routine patient care" means all health care services	361
consistent with the coverage provided in the health benefit plan	362
or public employee benefit plan for the treatment of cancer,	363
including the type and frequency of any diagnostic modality,	364
that is typically covered for a cancer patient who is not	365
enrolled in a cancer clinical trial, and that was not	366
necessitated solely because of the trial.	367

(5) For purposes of this section, a health benefit plan or	368
public employee benefit plan may exclude coverage for any of the	369
following:	370

(a) A health care service, item, or drug that is the subject	371
of the cancer clinical trial;	372

(b) A health care service, item, or drug provided solely to	373
satisfy data collection and analysis needs for the cancer clinical	374
trial that is not used in the direct clinical management of the	375
patient;	376

(c) An investigational or experimental drug or device that	377
has not been approved for market by the United States food and	378
drug administration;	379

(d) Transportation, lodging, food, or other expenses for the	380
patient, or a family member or companion of the patient, that are	381
associated with the travel to or from a facility providing the	382
cancer clinical trial;	383

(e) An item or drug provided by the cancer clinical trial	384
sponsors free of charge for any patient;	385

(f) A service, item, or drug that is eligible for	386
reimbursement by a person other than the insurer, including the	387
sponsor of the cancer clinical trial.	388

Sec. 3923.82.  (A) As used in this section, "health benefit	389
plan" has the same meaning as in section 3924.01 of the Revised	390
Code.	391

(B) Notwithstanding section 3901.71 of the Revised Code, no	392
health benefit plan or public employee benefit plan shall contain	393
a provision that limits or excludes an insured's coverage under	394
the plan for a loss or expense the insured sustains that is the	395
result of the insured's use of alcohol or other drugs or both and	396
the loss or expense is otherwise covered under the plan.	397

(C) Nothing in this section shall be construed as doing	398
either of the following:	399

(1) Requiring coverage for the treatment of alcohol or	400
substance abuse except as otherwise required by law;	401

(2) Prohibiting the enforcement of an exclusion based on	402
injuries sustained by an insured during the commission of an	403
offense by the insured in which the insured is convicted of or	404
pleads guilty or no contest to a felony.	405

(D) Not later than four years after the effective date of	406
this section, the department of insurance shall conduct an	407
analysis of the impact of the requirements of this section on the	408
cost of and coverage provided by health benefit plans in this	409
state and prepare a written report of its findings from the	410
analysis. The department shall submit the report to the governor	411
and, in accordance with section 101.68 of the Revised Code, to	412
the general assembly.	413

Sec. 4731.72. (A) As used in this section:

414

(1) "Anatomic pathology services," "assignment of benefits,"	415
"histologic processing," "insurer," "physician," and "referring	416
clinical laboratory" have the same meanings as in section	417
3701.86 of the Revised Code.	418

(2) "Professional component of an anatomic pathology service"	419
means the entire anatomic pathology service other than histologic	420
processing.	421

(3) "Technical component of an anatomic pathology service"	422
means only histologic processing.	423

(B) No physician shall present or cause to be presented a	424
claim, bill, or demand for payment for anatomic pathology	425
services to any person or entity other than the following:	426

(1) The patient who receives the services or another	427
individual, such as a parent, spouse, or guardian, who is	428
responsible for the patient's bills;	429

(2) A responsible insurer or other third-party payor of a	430
patient who receives the services;	431

(3) A hospital, public health clinic, or not-for-profit	432
health clinic ordering the services;	433

(4) A referring clinical laboratory;

434

(5) A governmental agency or any person acting on behalf of a	435
governmental agency;	436

(6) A physician who is permitted to bill for the services	437
under division (D) of this section.	438

(C) Except as provided in division (D) of this section, no	439
physician shall charge, bill, or otherwise solicit payment,	440
directly or indirectly, for anatomic pathology services unless	441
the services are personally rendered by the physician or	442
rendered under the on-site supervision of the physician.	443

(D)(1) A physician who performs the professional component of	444
an anatomic pathology service on a patient specimen may bill for	445
the amount incurred in doing either of the following:	446

(a) Having a clinical laboratory or another physician perform	447
the technical component of the anatomic pathology service;	448

(b) Obtaining another physician's consultation regarding the	449
patient specimen.	450

(2) A physician may bill for having a clinical laboratory or	451
another physician perform an anatomic pathology service on a	452
dermatology specimen, but only if the billing physician discloses	453
to the person or entity being billed both of the following:	454

(a) The name and address of the clinical laboratory or	455
physician who performed the service;	456

(b) The amount the billing physician was charged by or paid	457
to the clinical laboratory or physician who performed the service.	458

(E) A violation of division (B) or (C) of this section	459
constitutes a reason for taking action under division (B)(20) of	460
section 4731.22 of the Revised Code.	461

(F) Nothing in this section shall be construed to mandate the	462
assignment of benefits for anatomic pathology services.	463

Section 2. That existing sections 3923.05 and 3923.80 of the	464
Revised Code are hereby repealed.	465

Section 3. That existing Section 5 of Sub. H.B. 125 of the	466
127th General Assembly be amended to read as follows:	467

Sec. 5. (A) As used in this section and Section 6 of this	468
actSub. H.B. 125 of the 127th General Assembly:	469

(1) "Most favored nation clause" means a provision in a	470
health care contract that does any of the following:	471

(a) Prohibits, or grants a contracting entity an option to	472
prohibit, the participating provider from contracting with another	473
contracting entity to provide health care services at a lower	474
price than the payment specified in the contract;	475

(b) Requires, or grants a contracting entity an option to	476
require, the participating provider to accept a lower payment in	477
the event the participating provider agrees to provide health care	478
services to any other contracting entity at a lower price;	479

(c) Requires, or grants a contracting entity an option to	480
require, termination or renegotiation of the existing health care	481
contract in the event the participating provider agrees to provide	482
health care services to any other contracting entity at a lower	483
price;	484

(d) Requires the participating provider to disclose the	485
participating provider's contractual reimbursement rates with	486
other contracting entities.	487

(2) "Contracting entity," "health care contract," "health	488
care services," "participating provider," and "provider" have the	489
same meanings as in section 3963.01 of the Revised Code, as	490
enacted by this actSub. H.B. 125 of the 127th General Assembly.	491

(B) NoWith respect to a contracting entity and a provider	492
other than a hospital, no health care contract that includes a	493
most favored nation clause shall be entered into, and no health	494
care contract at the instance of a contracting entity shall be	495
amended or renewed to include a most favored nation clause, for	496
a period of twothree years after the effective date of this	497
act, subject to extension as provided in Section 6 of this act	498
Sub. H.B. 125 of the 127th General Assembly. This	499

(C) With respect to a contracting entity and a hospital, no	500
health care contract that includes a most favored nation clause	501
shall be entered into, and no health care contract at the instance	502
of a contracting entity shall be amended or renewed to include a	503
most favored nation clause, for a period of two years after the	504
effective date of Sub. H.B. 125 of the 127th General Assembly,	505
subject to extension as provided in Section 6 of Sub. H.B. 125 of	506
the 127th General Assembly.	507

(D) This section does not apply to and does not prohibit	508
the continued use of a most favored nation clause in a health	509
care contract that is between a contracting entity and a	510
hospital and that is in existence on the effective date of this	511
actSub. H.B. 125 of the 127th General Assembly even if the health	512
care contract is materially amended with respect to any	513
provision of the health care contract other than the most	514
favored nation clause during the two-year period specified in	515
this section or during any extended period of time as provided	516
in Section 6 of this actSub. H.B. 125 of the 127th General	517
Assembly.	518

Section 4. That existing Section 5 of Sub. H.B. 125 of the	519
127th General Assembly is hereby repealed.	520

Section 5.  Sections 3923.05 and 3923.82 of the Revised	521
Code, as amended or enacted by this act, shall apply only to	522
health benefit plans that are delivered, issued for delivery, or	523
renewed in this state on or after one hundred eighty days after	524
the effective date of this act.	525