H. B. No. 34 As Introduced

As Introduced

130th General Assembly

Regular Session

2013-2014

H. B. No. 34

Representative Hackett

A BILL

To amend sections 4121.129, 4121.44, 4121.441,

4123.29, 4123.291, 4123.353, 4123.37, 4123.411,

4123.47, 4123.511, 4123.512, 4123.66, 4123.82,

4123.93, and 4729.80 of the Revised Code to allow

the Administrator of Workers' Compensation to pay

for specified medical benefits during an earlier

time frame, to make changes to the Health

Partnership Program, to eliminate the $15,000

Medical-Only Program, to make other changes to the

Workers' Compensation Law, and to make

appropriations for the Bureau of Workers'

Compensation for the biennium beginning July 1,

2013, and ending June 30, 2015; and to provide

authorization and conditions for the operation of

the Bureau's programs.

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

Section 1. That sections 4121.129, 4121.44, 4121.441,	16
4123.29, 4123.291, 4123.353, 4123.37, 4123.411, 4123.47, 4123.511,	17
4123.512, 4123.66, 4123.82, 4123.93, and 4729.80 of the Revised	18
Code be amended to read as follows:	19

Sec. 4121.129. (A) There is hereby created the workers'	20
compensation audit committee consisting of at least three members.	21
One member shall be the member of the bureau of workers'	22
compensation board of directors who is a certified public	23
accountant. The board, by majority vote, shall appoint two	24
additional members of the board to serve on the audit committee	25
and may appoint additional members who are not board members, as	26
the board determines necessary. Members of the audit committee	27
serve at the pleasure of the board, and the board, by majority	28
vote, may remove any member except the member of the committee who	29
is the certified public accountant member of the board. The board,	30
by majority vote, shall determine how often the audit committee	31
shall meet and report to the board. If the audit committee meets	32
on the same day as the board holds a meeting, no member shall be	33
compensated for more than one meeting held on that day. The audit	34
committee shall do all of the following:	35

(1) Recommend to the board an accounting firm to perform the	36
annual ~~audits~~analysis required under section 4123.47 of the	37
Revised Code;	38

(2) Recommend an auditing firm for the board to use when	39
conducting audits under section 4121.125 of the Revised Code;	40

(3) Review the results of each annual audit and management	41
review and, if any problems exist, assess the appropriate course	42
of action to correct those problems and develop an action plan to	43
correct those problems;	44

(4) Monitor the implementation of any action plans created	45
pursuant to division (A)(3) of this section;	46

(5) Review all internal audit reports on a regular basis.

(B) There is hereby created the workers' compensation	48
actuarial committee consisting of at least three members. One	49
member shall be the member of the board who is an actuary. The	50
board, by majority vote, shall appoint two additional members of	51
the board to serve on the actuarial committee and may appoint	52
additional members who are not board members, as the board	53
determines necessary. Members of the actuarial committee serve at	54
the pleasure of the board and the board, by majority vote, may	55
remove any member except the member of the committee who is the	56
actuary member of the board. The board, by majority vote, shall	57
determine how often the actuarial committee shall meet and report	58
to the board. If the actuarial committee meets on the same day as	59
the board holds a meeting, no member shall be compensated for more	60
than one meeting held on that day. The actuarial committee shall	61
do both of the following:	62

(1) Recommend actuarial consultants for the board to use for	63
the funds specified in this chapter and Chapters 4123., 4127., and	64
4131. of the Revised Code;	65

(2) Review calculations on rate schedules and performance	66
prepared by the actuarial consultants with whom the board enters	67
into a contract.	68

(C)(1) There is hereby created the workers' compensation	69
investment committee consisting of at least four members. Two of	70
the members shall be the members of the board who serve as the	71
investment and securities experts on the board. The board, by	72
majority vote, shall appoint two additional members of the board	73
to serve on the investment committee and may appoint additional	74
members who are not board members. Each additional member the	75
board appoints shall have at least one of the following	76
qualifications:	77

(a) Experience managing another state's pension funds or	78
workers' compensation funds;	79

(b) Expertise that the board determines is needed to make	80
investment decisions.	81

Members of the investment committee serve at the pleasure of	82
the board and the board, by majority vote, may remove any member	83
except the members of the committee who are the investment and	84
securities expert members of the board. The board, by majority	85
vote, shall determine how often the investment committee shall	86
meet and report to the board. If the investment committee meets on	87
the same day as the board holds a meeting, no member shall be	88
compensated for more than one meeting held on that day.	89

(2) The investment committee shall do all of the following:

(a) Develop the investment policy for the administration of	91
the investment program for the funds specified in this chapter and	92
Chapters 4123., 4127., and 4131. of the Revised Code in accordance	93
with the requirements specified in section 4123.442 of the Revised	94
Code;	95

(b) Submit the investment policy developed pursuant to	96
division (C)(2)(a) of this section to the board for approval;	97

(c) Monitor implementation by the administrator of workers'	98
compensation and the bureau of workers' compensation chief	99
investment officer of the investment policy approved by the board;	100

(d) Recommend outside investment counsel with whom the board	101
may contract to assist the investment committee in fulfilling its	102
duties;	103

(e) Review the performance of the bureau of workers'	104
compensation chief investment officer and any investment	105
consultants retained by the administrator to assure that the	106
investments of the assets of the funds specified in this chapter	107
and Chapters 4123., 4127., and 4131. of the Revised Code are made	108
in accordance with the investment policy approved by the board and	109
~~that the best possible return on~~to assure compliance with the	110
investment ~~is achieved~~policy and effective management of the	111
funds.	112

Sec. 4121.44. (A) The administrator of workers' compensation	113
shall oversee the implementation of the Ohio workers' compensation	114
qualified health plan system as established under section 4121.442	115
of the Revised Code.	116

(B) The administrator shall direct the implementation of the	117
health partnership program administered by the bureau as set forth	118
in section 4121.441 of the Revised Code. To implement the health	119
partnership program, the bureau:	120

(1) Shall certify one or more external vendors, which shall	121
be known as "managed care organizations," to provide medical	122
management and cost containment services in the health partnership	123
program for a period of two years beginning on the date of	124
certification, consistent with the standards established under	125
this section;	126

(2) May recertify external vendors for additional periods of	127
two years; and	128

(3) May integrate the certified vendors with bureau staff and	129
existing bureau services for purposes of operation and training to	130
allow the bureau to assume operation of the health partnership	131
program at the conclusion of the certification periods set forth	132
in division (B)(1) or (2) of this section.	133

The bureau may enter into a contract with any vendor that is	134
certified by the bureau to provide medical management and cost	135
containment services in the health partnership program pursuant to	136
division (B)(1) or (2) of this section. The contract may include	137
incentives and penalties that may be imposed within the discretion	138
of the administrator based upon the vendor's compliance and	139
performance.	140

(C) Any vendor selected shall demonstrate all of the	141
following:	142

(1) Arrangements and reimbursement agreements with a provider	143
panel including a substantial number of ~~the~~ medical, professional,	144
and pharmacy providers ~~currently being utilized by claimants~~	145
participating in the health partnership program, selected on the	146
basis of access, quality, and cost.	147

(2) Ability to accept a common format of medical bill data in	148
an electronic fashion from any provider who wishes to submit	149
medical bill data in that form.	150

(3) A computer system able to handle the volume of medical	151
bills and willingness to customize that system to the bureau's	152
needs and to be operated by the vendor's staff, bureau staff, or	153
some combination of both staffs.	154

(4) A prescription drug system where pharmacies on a	155
statewide basis have access to the eligibility and pricing, at a	156
discounted rate, of all prescription drugs.	157

(5) A tracking system to record all telephone calls from	158
claimants and providers regarding the status of submitted medical	159
bills so as to be able to track each inquiry.	160

(6) Data processing capacity to absorb all of the bureau's	161
medical bill processing or at least that part of the processing	162
which the bureau arranges to delegate.	163

(7) Capacity to store, retrieve, array, simulate, and model	164
in a relational mode all of the detailed medical bill data so that	165
analysis can be performed in a variety of ways and so that the	166
bureau and its governing authority can make informed decisions.	167

(8) Wide variety of software programs which translate medical	168
terminology into standard codes, and which reveal if a provider is	169
manipulating the procedures codes, commonly called "unbundling."	170

(9) Necessary professional staff to conduct, at a minimum,	171
authorizations for treatment, medical necessity, utilization	172
review, concurrent review, post-utilization review, and have the	173
attendant computer system which supports such activity and	174
measures the outcomes and the savings.	175

(10) Management experience and flexibility to be able to	176
react quickly to the needs of the bureau in the case of required	177
change in federal or state requirements.	178

(D) For purposes of division (C)(1) of this section, any	179
provider panel used by a vendor shall provide reasonable access to	180
providers, deliver cost-effective treatment, and achieve quality	181
benchmarks as established by the administrator.	182

(E)(1) Information contained in a vendor's application for	183
certification in the health partnership program, and other	184
information furnished to the bureau by a vendor for purposes of	185
obtaining certification or to comply with performance and	186
financial auditing requirements established by the administrator,	187
is for the exclusive use and information of the bureau in the	188
discharge of its official duties, and shall not be open to the	189
public or be used in any court in any proceeding pending therein,	190
unless the bureau is a party to the action or proceeding, but the	191
information may be tabulated and published by the bureau in	192
statistical form for the use and information of other state	193
departments and the public. No employee of the bureau, except as	194
otherwise authorized by the administrator, shall divulge any	195
information secured by the employee while in the employ of the	196
bureau in respect to a vendor's application for certification or	197
in respect to the business or other trade processes of any vendor	198
to any person other than the administrator or to the employee's	199
superior.	200

(2) Notwithstanding the restrictions imposed by division	201
~~(D)~~(E)(1) of this section, the governor, members of select or	202
standing committees of the senate or house of representatives, the	203
auditor of state, the attorney general, or their designees,	204
pursuant to the authority granted in this chapter and Chapter	205
4123. of the Revised Code, may examine any vendor application or	206
other information furnished to the bureau by the vendor. None of	207
those individuals shall divulge any information secured in the	208
exercise of that authority in respect to a vendor's application	209
for certification or in respect to the business or other trade	210
processes of any vendor to any person.	211

~~(E)~~(F) On and after January 1, 2001, a vendor shall not be	212
any insurance company holding a certificate of authority issued	213
pursuant to Title XXXIX of the Revised Code or any health insuring	214
corporation holding a certificate of authority under Chapter 1751.	215
of the Revised Code.	216

~~(F)~~(G)(1) The administrator may limit freedom of choice of	217
health care provider or supplier by requiring, beginning ~~with the~~	218
~~period set forth in division (B)(1) or (2) of this section~~the	219
forty-sixth day after the date of the injury or the forty-sixth	220
day after the beginning date for treatment for the occupational	221
disease, that claimants ~~shall~~ pay an appropriate out-of-plan	222
copayment for selecting a medical provider not within the provider	223
panel of a health partnership program vendor as provided for in	224
this section.	225

(2) The administrator shall adopt rules, with the advice and	226
consent of the bureau of workers' compensation board of directors,	227
to allow an employee to continue to receive treatment from a	228
medical provider who is not within the provider panel of a health	229
partnership program vendor if the employee is receiving	230
appropriate and quality care from that medical provider. The rules	231
shall include criteria that the employee shall satisfy to be	232
permitted to continue to receive treatment from that medical	233
provider.	234

(3) Notwithstanding division (G)(1) of this section, an	235
employee who satisfies the criteria specified in the rules adopted	236
by the administrator pursuant to division (G)(2) of this section	237
may continue treatment with a medical provider not within the	238
provider panel of a health partnership program vendor, if the	239
employee is receiving appropriate and quality care from the	240
medical provider.	241

~~(G)~~(H) The administrator, six months prior to the expiration	242
of the bureau's certification or recertification of the vendor or	243
vendors as set forth in division (B)(1) or (2) of this section,	244
may certify and provide evidence to the governor, the speaker of	245
the house of representatives, and the president of the senate that	246
the existing bureau staff is able to match or exceed the	247
performance and outcomes of the external vendor or vendors and	248
that the bureau should be permitted to internally administer the	249
health partnership program upon the expiration of the	250
certification or recertification as set forth in division (B)(1)	251
or (2) of this section.	252

~~(H)~~(I) The administrator shall establish and operate a bureau	253
of workers' compensation health care data program. The	254
administrator shall develop reporting requirements from all	255
employees, employers and medical providers, medical vendors, and	256
plans that participate in the workers' compensation system. The	257
administrator shall do all of the following:	258

(1) Utilize the collected data to measure and perform	259
comparison analyses of costs, quality, appropriateness of medical	260
care, and effectiveness of medical care delivered by all	261
components of the workers' compensation system.	262

(2) Compile data to support activities of the selected vendor	263
or vendors and to measure the outcomes and savings of the health	264
partnership program.	265

(3) Publish and report compiled data on the measures of	266
outcomes and savings of the health partnership program and submit	267
the report to the president of the senate, the speaker of the	268
house of representatives, and the governor with the annual report	269
prepared under division (F)(3) of section 4121.12 of the Revised	270
Code. The administrator shall protect the confidentiality of all	271
proprietary pricing data.	272

~~(I)~~(J) Any rehabilitation facility the bureau operates is	273
eligible for inclusion in the Ohio workers' compensation qualified	274
health plan system or the health partnership program under the	275
same terms as other providers within health care plans or the	276
program.	277

~~(J) In~~(K) Notwithstanding division (G) of this section, in	278
areas outside the state or within the state where no qualified	279
health plan or an inadequate number of providers within the health	280
partnership program exist, the administrator shall permit	281
employees to use a provider not within the provider panel of a	282
qualified health plan or health partnership program vendor,	283
including, if necessary, a nonplan or nonprogram health care	284
provider and shall pay the provider for the services or supplies	285
provided to or on behalf of an employee for an injury or	286
occupational disease that is compensable under this chapter or	287
Chapter 4123., 4127., or 4131. of the Revised Code on a fee	288
schedule the administrator adopts.	289

~~(K)~~(L) No health care provider, whether certified or not,	290
shall charge, assess, or otherwise attempt to collect from an	291
employee, employer, a managed care organization, or the bureau any	292
amount for covered services or supplies that is in excess of the	293
allowed amount paid by a managed care organization, the bureau, or	294
a qualified health plan.	295

~~(L)~~(M) The administrator shall permit any employer or group	296
of employers who agree to abide by the rules adopted under this	297
section and sections 4121.441 and 4121.442 of the Revised Code to	298
provide services or supplies to or on behalf of an employee for an	299
injury or occupational disease that is compensable under this	300
chapter or Chapter 4123., 4127., or 4131. of the Revised Code	301
through qualified health plans of the Ohio workers' compensation	302
qualified health plan system pursuant to section 4121.442 of the	303
Revised Code or through the health partnership program pursuant to	304
section 4121.441 of the Revised Code. No amount paid under the	305
qualified health plan system pursuant to section 4121.442 of the	306
Revised Code by an employer who is a state fund employer shall be	307
charged to the employer's experience or otherwise be used in	308
merit-rating or determining the risk of that employer for the	309
purpose of the payment of premiums under this chapter, and if the	310
employer is a self-insuring employer, the employer shall not	311
include that amount in the paid compensation the employer reports	312
under section 4123.35 of the Revised Code.	313

Sec. 4121.441. (A) The administrator of workers'	314
compensation, with the advice and consent of the bureau of	315
workers' compensation board of directors, shall adopt rules under	316
Chapter 119. of the Revised Code for the health care partnership	317
program administered by the bureau of workers' compensation to	318
provide medical, surgical, nursing, drug, hospital, and	319
rehabilitation services and supplies to an employee for an injury	320
or occupational disease that is compensable under this chapter or	321
Chapter 4123., 4127., or 4131. of the Revised Code.	322

The rules shall include, but are not limited to, the	323
following:	324

(1) Procedures for the resolution of medical disputes between	325
an employer and an employee, an employee and a provider, or an	326
employer and a provider, prior to an appeal under section 4123.511	327
of the Revised Code. Rules the administrator adopts pursuant to	328
division (A)(1) of this section may specify that the resolution	329
procedures shall not be used to resolve disputes concerning	330
medical services rendered that have been approved through standard	331
treatment guidelines, pathways, or presumptive authorization	332
guidelines.	333

(2) Prohibitions against discrimination against any category	334
of health care providers;	335

(3) Procedures for reporting injuries to employers and the	336
bureau by providers;	337

(4) Appropriate financial incentives to reduce service cost	338
and insure proper system utilization without sacrificing the	339
quality of service;	340

(5) Adequate methods of peer review, utilization review,	341
quality assurance, and dispute resolution to prevent, and provide	342
sanctions for, inappropriate, excessive or not medically necessary	343
treatment;	344

(6) A timely and accurate method of collection of necessary	345
information regarding medical and health care service and supply	346
costs, quality, and utilization to enable the administrator to	347
determine the effectiveness of the program;	348

(7) Provisions for necessary emergency medical treatment for	349
an injury or occupational disease provided by a health care	350
provider who is not part of the program;	351

(8) Discounted pricing for all in-patient and out-patient	352
medical services, all professional services, and all	353
pharmaceutical services;	354

(9) Provisions for provider referrals, pre-admission and	355
post-admission approvals, second surgical opinions, and other cost	356
management techniques;	357

(10) Antifraud mechanisms;

358

(11) Standards and criteria for the bureau to utilize in	359
certifying or recertifying a health care provider or a vendor for	360
participation in the health partnership program;	361

(12) Standards and criteria for the bureau to utilize in	362
~~penalizing or~~ decertifying a health care provider or a vendor from	363
participation in the health partnership program.	364

(B) The bureau may enter into a contract with any health care	365
provider or supplier certified by the bureau to participate in the	366
health partnership program pursuant to the rules adopted under	367
this section. The contract may include incentives and penalties	368
that may be imposed within the discretion of the administrator	369
based upon the health care provider's or supplier's compliance and	370
performance.	371

(C) The administrator shall implement the health partnership	372
program according to the rules the administrator adopts under this	373
section for the provision and payment of medical, surgical,	374
nursing, drug, hospital, and rehabilitation services and supplies	375
to an employee for an injury or occupational disease that is	376
compensable under this chapter or Chapter 4123., 4127., or 4131.	377
of the Revised Code.	378

Sec. 4123.29. (A) The administrator of workers'	379
compensation, subject to the approval of the bureau of workers'	380
compensation board of directors, shall do all of the following:	381

(1) Classify occupations or industries with respect to their	382
degree of hazard and determine the risks of the different classes	383
according to the categories the national council on compensation	384
insurance establishes that are applicable to employers in this	385
state;	386

(2)(a) Fix the rates of premium of the risks of the classes	387
based upon the total payroll in each of the classes of occupation	388
or industry sufficiently large to provide a fund for the	389
compensation provided for in this chapter and to maintain a state	390
insurance fund from year to year. The administrator shall set the	391
rates at a level that assures the solvency of the fund. Where the	392
payroll cannot be obtained or, in the opinion of the	393
administrator, is not an adequate measure for determining the	394
premium to be paid for the degree of hazard, the administrator may	395
determine the rates of premium upon such other basis, consistent	396
with insurance principles, as is equitable in view of the degree	397
of hazard, and whenever in this chapter reference is made to	398
payroll or expenditure of wages with reference to fixing premiums,	399
the reference shall be construed to have been made also to such	400
other basis for fixing the rates of premium as the administrator	401
may determine under this section.	402

(b) If an employer elects to obtain other-states' coverage	403
pursuant to section 4123.292 of the Revised Code through either	404
the administrator, if the administrator elects to offer such	405
coverage, or an other-states' insurer, calculate the employer's	406
premium for the state insurance fund in the same manner as	407
otherwise required under division (A) of this section and section	408
4123.34 of the Revised Code, except that when the administrator	409
determines the expenditure of wages, payroll, or both upon which	410
to base the employer's premium, the administrator shall use only	411
the expenditure of wages, payroll, or both attributable to the	412
labor performed and services provided by that employer's employees	413
when those employees performed labor and provided services in this	414
state only and to which the other-states' coverage does not apply.	415

(c) The administrator in setting or revising rates shall	416
furnish to employers an adequate explanation of the basis for the	417
rates set.	418

(3) Develop and make available to employers who are paying	419
premiums to the state insurance fund alternative premium plans.	420
Alternative premium plans shall include retrospective rating	421
plans. The administrator may make available plans under which an	422
advanced deposit may be applied against a specified deductible	423
amount per claim.	424

(4)(a) Offer to insure the obligations of employers under	425
this chapter under a plan that groups, for rating purposes,	426
employers, and pools the risk of the employers within the group	427
provided that the employers meet all of the following conditions:	428

(i) All of the employers within the group are members of an	429
organization that has been in existence for at least two years	430
prior to the date of application for group coverage;	431

(ii) The organization was formed for purposes other than that	432
of obtaining group workers' compensation under this division;	433

(iii) The employers' business in the organization is	434
substantially similar such that the risks which are grouped are	435
substantially homogeneous;	436

(iv) The group of employers consists of at least one hundred	437
members or the aggregate workers' compensation premiums of the	438
members, as determined by the administrator, are expected to	439
exceed one hundred fifty thousand dollars during the coverage	440
period;	441

(v) The formation and operation of the group program in the	442
organization will substantially improve accident prevention and	443
claims handling for the employers in the group;	444

(vi) Each employer seeking to enroll in a group for workers'	445
compensation coverage has an industrial insurance account in good	446
standing with the bureau of workers' compensation such that at the	447
time the agreement is processed no outstanding premiums,	448
penalties, or assessments are due from any of the employers.	449

(b) If an organization sponsors more than one employer group	450
to participate in group plans established under this section, that	451
organization may submit a single application that supplies all of	452
the information necessary for each group of employers that the	453
organization wishes to sponsor.	454

(c) In providing employer group plans under division (A)(4)	455
of this section, the administrator shall consider an employer	456
group as a single employing entity for purposes of group rating.	457
No employer may be a member of more than one group for the purpose	458
of obtaining workers' compensation coverage under this division.	459

(d) At the time the administrator revises premium rates	460
pursuant to this section and section 4123.34 of the Revised Code,	461
if the premium rate of an employer who participates in a group	462
plan established under this section changes from the rate	463
established for the previous year, the administrator, in addition	464
to sending the invoice with the rate revision to that employer,	465
shall send a copy of that invoice to the third-party administrator	466
that administers the group plan for that employer's group.	467

(e) In providing employer group plans under division (A)(4)	468
of this section, the administrator shall establish a program	469
designed to mitigate the impact of a significant claim that would	470
come into the experience of a private, state fund group-rated	471
employer or a taxing district employer for the first time and be a	472
contributing factor in that employer being excluded from a	473
group-rated plan. The administrator shall establish eligibility	474
criteria and requirements that such employers must satisfy in	475
order to participate in this program. For purposes of this	476
program, the administrator shall establish a discount on premium	477
rates applicable to employers who qualify for the program.	478

(f) In no event shall division (A)(4) of this section be	479
construed as granting to an employer status as a self-insuring	480
employer.	481

(g) The administrator shall develop classifications of	482
occupations or industries that are sufficiently distinct so as not	483
to group employers in classifications that unfairly represent the	484
risks of employment with the employer.	485

(5) Generally promote employer participation in the state	486
insurance fund through the regular dissemination of information to	487
all classes of employers describing the advantages and benefits of	488
opting to make premium payments to the fund. To that end, the	489
administrator shall regularly make employers aware of the various	490
workers' compensation premium packages developed and offered	491
pursuant to this section.	492

~~(6) Make available to every employer who is paying premiums~~	493
~~to the state insurance fund a program whereby the employer or the~~	494
~~employer's agent pays to the claimant or on behalf of the claimant~~	495
~~the first fifteen thousand dollars of a compensable workers'~~	496
~~compensation medical-only claim filed by that claimant that is~~	497
~~related to the same injury or occupational disease. No formal~~	498
~~application is required; however, an employer must elect to~~	499
~~participate by telephoning the bureau after July 1, 1995. Once an~~	500
~~employer has elected to participate in the program, the employer~~	501
~~will be responsible for all bills in all medical-only claims with~~	502
~~a date of injury the same or later than the election date, unless~~	503
~~the employer notifies the bureau within fourteen days of receipt~~	504
~~of the notification of a claim being filed that it does not wish~~	505
~~to pay the bills in that claim, or the employer notifies the~~	506
~~bureau that the fifteen thousand dollar maximum has been paid, or~~	507
~~the employer notifies the bureau of the last day of service on~~	508
~~which it will be responsible for the bills in a particular~~	509
~~medical-only claim. If an employer elects to enter the program,~~	510
~~the administrator shall not reimburse the employer for such~~	511
~~amounts paid and shall not charge the first fifteen thousand~~	512
~~dollars of any medical-only claim paid by an employer to the~~	513
~~employer's experience or otherwise use it in merit rating or~~	514
~~determining the risks of any employer for the purpose of payment~~	515
~~of premiums under this chapter. A certified health care provider~~	516
~~shall extend to an employer who participates in this program the~~	517
~~same rates for services rendered to an employee of that employer~~	518
~~as the provider bills the administrator for the same type of~~	519
~~medical claim processed by the bureau and shall not charge,~~	520
~~assess, or otherwise attempt to collect from an employee any~~	521
~~amount for covered services or supplies that is in excess of that~~	522
~~rate. If an employer elects to enter the program and the employer~~	523
~~fails to pay a bill for a medical-only claim included in the~~	524
~~program, the employer shall be liable for that bill and the~~	525
~~employee for whom the employer failed to pay the bill shall not be~~	526
~~liable for that bill. The administrator shall adopt rules to~~	527
~~implement and administer division (A)(6) of this section. Upon~~	528
~~written request from the bureau, the employer shall provide~~	529
~~documentation to the bureau of all medical-only bills that they~~	530
~~are paying directly. Such requests from the bureau may not be made~~	531
~~more frequently than on a semiannual basis. Failure to provide~~	532
~~such documentation to the bureau within thirty days of receipt of~~	533
~~the request may result in the employer's forfeiture of~~	534
~~participation in the program for such injury. The provisions of~~	535
~~this section shall not apply to claims in which an employer with~~	536
~~knowledge of a claimed compensable injury or occupational disease,~~	537
~~has paid wages in lieu of compensation or total disability.~~	538

(B) The administrator, with the advice and consent of the	539
board, by rule, may do both of the following:	540

(1) Grant an employer who makes the employer's semiannual	541
premium payment at least one month prior to the last day on which	542
the payment may be made without penalty, a discount as the	543
administrator fixes from time to time;	544

(2) Levy a minimum annual administrative charge upon risks	545
where semiannual premium reports develop a charge less than the	546
administrator considers adequate to offset administrative costs of	547
processing.	548

Sec. 4123.291. (A) An adjudicating committee appointed by	549
the administrator of workers' compensation to hear any matter	550
specified in divisions (B)(1) to (7) of this section shall hear	551
the matter within sixty days of the date on which an employer	552
files the request, protest, or petition. An employer desiring to	553
file a request, protest, or petition regarding any matter	554
specified in divisions (B)(1) to (7) of this section shall file	555
the request, protest, or petition to the adjudicating committee on	556
or before twenty-four months after the administrator sends notice	557
of the determination about which the employer is filing the	558
request, protest, or petition.	559

(B) An employer who is adversely affected by a decision of an	560
adjudicating committee appointed by the administrator may appeal	561
the decision of the committee to the administrator or the	562
administrator's designee. The employer shall file the appeal in	563
writing within thirty days after the employer receives the	564
decision of the adjudicating committee. The administrator or the	565
designee shall hear the appeal and hold a hearing, provided that	566
the decision of the adjudicating committee relates to one of the	567
following:	568

(1) An employer request for a waiver of a default in the	569
payment of premiums pursuant to section 4123.37 of the Revised	570
Code;	571

(2) An employer request for the settlement of liability as a	572
noncomplying employer under section 4123.75 of the Revised Code;	573

(3) An employer petition objecting to ~~the~~an assessment ~~of a~~	574
~~premium~~ pursuant to section 4123.37 of the Revised Code and the	575
rules adopted pursuant to that section;	576

(4) An employer request for the abatement of penalties	577
assessed pursuant to section 4123.32 of the Revised Code and the	578
rules adopted pursuant to that section;	579

(5) An employer protest relating to an audit finding or a	580
determination of a manual classification, experience rating, or	581
transfer or combination of risk experience;	582

(6) Any decision relating to any other risk premium matter	583
under Chapters 4121., 4123., and 4131. of the Revised Code;	584

(7) An employer petition objecting to the amount of security	585
required under division (C) of section 4125.05 of the Revised Code	586
and the rules adopted pursuant to that section.	587

(C) The bureau of workers' compensation board of directors,	588
based upon recommendations of the workers' compensation actuarial	589
committee, shall establish the policy for all adjudicating	590
committee procedures, including, but not limited to, specific	591
criteria for manual premium rate adjustment.	592

Sec. 4123.353. (A) A public employer, except for a board of	593
county commissioners described in division (G) of section 4123.01	594
of the Revised Code, a board of a county hospital, or a publicly	595
owned utility, who is granted the status of self-insuring employer	596
pursuant to section 4123.35 of the Revised Code shall do all of	597
the following:	598

(1) Reserve funds as necessary, in accordance with sound and	599
prudent actuarial judgment, to cover the costs the public employer	600
may potentially incur to remain in compliance with this chapter	601
and Chapter 4121. of the Revised Code;	602

(2) Include all activity under this chapter and Chapter 4121.	603
of the Revised Code in a single fund on the public employer's	604
accounting records;	605

(3) Within ninety days after the last day of each fiscal	606
year, prepare and maintain a report of the reserved funds	607
described in division (A)(1) of this section and disbursements	608
made from those reserved funds;	609

~~(4) Within ninety days after the last day of each fiscal~~	610
~~year, obtain a written report prepared by a member of the American~~	611
~~academy of actuaries, certifying whether the reserved funds~~	612
~~described in division (A)(1) of this section are sufficient to~~	613
~~cover the costs the public employer may potentially incur to~~	614
~~remain in compliance with this chapter and Chapter 4121. of the~~	615
~~Revised Code, are computed in accordance with accepted loss~~	616
~~reserving standards, and are fairly stated in accordance with~~	617
~~sound loss reserving principles~~.	618

(B) A public employer who is subject to division (A) of this	619
section shall make the reports required by that division available	620
for inspection by the administrator of workers' compensation and	621
any other person at all reasonable times during regular business	622
hours.	623

Sec. 4123.37. In(A) As used in this section ~~"amenable~~:

624

(1) "Amenable employer" has the same meaning as "employer" as	625
defined in division (J) of section 4123.32 of the Revised Code.	626

(2) "Assessment" means any determination by the administrator	627
of workers' compensation that a specific sum of money is owed by	628
an employer under this chapter or Chapter 4121., 4127., or 4131.	629
of the Revised Code, except for amounts owed by an employer	630
pursuant to section 4123.75 of the Revised Code.	631

(B) If the administrator ~~of workers' compensation~~ finds that	632
any person, firm, or private corporation, including any public	633
service corporation, is, or has been at any time after January 1,	634
1923, an amenable employer and has not complied with section	635
4123.35 of the Revised Code the administrator shall determine the	636
period during which the person, firm, or corporation was an	637
amenable employer and shall forthwith give notice of the	638
determination to the employer. Within twenty days thereafter the	639
employer shall furnish the bureau of workers' compensation with	640
the payroll covering the period included in the determination and,	641
if the employer is an amenable employer at the time of the	642
determination, shall pay a premium security deposit for the eight	643
months next succeeding the date of the determination and shall pay	644
into the state insurance fund the amount of premium applicable to	645
such payroll.	646

If the employer does not furnish the payroll and pay the	647
applicable premium and premium security deposit within the twenty	648
days, the administrator shall forthwith make an assessment of the	649
premium due from the employer for the period the administrator	650
determined the employer to be an amenable employer including the	651
premium security deposit according to section 4123.32 of the	652
Revised Code if the employer is an amenable employer at the time	653
of the determination, basing the ~~assessment~~amount due upon the	654
information in the possession of the administrator.	655

The administrator may issue an invoice or other similar	656
billing notice demanding payment of any assessment, and the	657
employer, upon receipt of the initial invoice or other similar	658
billing notice, may file with the bureau a petition in writing	659
verified under oath by the employer, or the employer's authorized	660
agent having knowledge of the facts, setting forth with	661
particularity the items of the assessment objected to, together	662
with the reason for the objections.	663

(C) The administrator shall give to the employer assessed	664
written notice of ~~the~~an assessment and include in that notice a	665
demand for payment in accordance with this division. The notice	666
shall be mailed to the employer at the employer's residence or	667
usual place of business by certified mail. Unless the employer to	668
whom the notice of assessment is directed files with the bureau	669
within twenty days after receipt thereof, a petition in writing,	670
verified under oath by the employer, or the employer's authorized	671
agent having knowledge of the facts, setting forth with	672
particularity the items of the assessment objected to, together	673
with the reason for the objections, the assessment shall become	674
conclusive and the amount thereof shall be due and payable from	675
the employer so assessed ~~to the state insurance fund~~. When a	676
petition objecting to an assessment is filed the bureau shall	677
assign a time and place for the hearing of the same and shall	678
notify the petitioner thereof ~~by certified mail~~. When an employer	679
files a petition the assessment made by the administrator shall	680
become due and payable ten days after the bureau sends notice of	681
the finding made at the hearing ~~has been sent by certified mail~~	682
to the party assessed. An employer may first appeal an adverse	683
decision to the administrator or the designee of the administrator	684
as provided in section 4123.291 of the Revised Code, and	685
subsequently an appeal may be taken from any finding to the court	686
of common pleas of Franklin county upon the execution by the party	687
assessed of a bond to the state in ~~double~~ the amount found due	688
and ordered paid by the bureau conditioned that the party will pay	689
any judgment and costs rendered against it for the ~~premium~~	690
assessment.	691

(D) When no petition objecting to an assessment is filed or	692
when a finding is made affirming or modifying an assessment after	693
hearing, a certified copy of the assessment as affirmed or	694
modified may be filed by the administrator in the office of the	695
clerk of the court of common pleas in any county in which the	696
employer has property or in which the employer has a place of	697
business. The clerk, immediately upon the filing of the	698
assessment, shall enter a judgment for the state against the	699
employer in the amount shown on the assessment. The judgment may	700
be filed by the clerk in a loose leaf book entitled "special	701
judgments for state insurance fund." The judgment shall bear the	702
same rate of interest, have the same effect as other judgments,	703
and be given the same preference allowed by law on other judgments	704
rendered for claims for taxes. An assessment or judgment under	705
this section shall not be a bar to the adjustment of the	706
employer's account upon the employer furnishing the employer's	707
payroll records to the bureau.	708

(E) The administrator, for good cause shown, may waive a	709
default in the payment of premium where the default is of less	710
than sixty days' duration, and upon payment by the employer of the	711
premium for the period, the employer and the employer's employees	712
are entitled to all of the benefits and immunities provided by	713
this chapter.	714

Sec. 4123.411. (A) For the purpose of carrying out sections	715
4123.412 to 4123.418 of the Revised Code, the administrator of	716
workers' compensation, with the advice and consent of the bureau	717
of workers' compensation board of directors, shall levy an	718
assessment against all employers at a rate~~, of at least five but~~	719
not to exceed ten cents per one hundred dollars of payroll, such	720
rate to be determined annually for each employer group listed in	721
divisions (A)(1) to (3) of this section, which will produce an	722
amount no greater than the amount the administrator estimates to	723
be necessary to carry out such sections for the period for which	724
the assessment is levied. In the event the amount produced by the	725
assessment is not sufficient to carry out such sections the	726
additional amount necessary shall be provided from the income	727
produced as a result of investments made pursuant to section	728
4123.44 of the Revised Code.	729

Assessments shall be levied according to the following	730
schedule:	731

(1) Private fund employers, except self-insuring	732
employers--in January and July of each year upon gross payrolls of	733
the preceding six months;	734

(2) Counties and taxing district employers therein, except	735
county hospitals that are self-insuring employers--in January of	736
each year upon gross payrolls of the preceding twelve months;	737

(3) The state as an employer--in January, April, July, and	738
October of each year upon gross payrolls of the preceding three	739
months.	740

Amounts assessed in accordance with this section shall be	741
collected from each employer as prescribed in rules the	742
administrator adopts.	743

The moneys derived from the assessment provided for in this	744
section shall be credited to the disabled workers' relief fund	745
created by section 4123.412 of the Revised Code. The administrator	746
shall establish by rule classifications of employers within	747
divisions (A)(1) to (3) of this section and shall determine rates	748
for each class so as to fairly apportion the costs of carrying out	749
sections 4123.412 to 4123.418 of the Revised Code.	750

(B) For all injuries and disabilities occurring on or after	751
January 1, 1987, the administrator, for the purposes of carrying	752
out sections 4123.412 to 4123.418 of the Revised Code, shall levy	753
an assessment against all employers at a rate per one hundred	754
dollars of payroll, such rate to be determined annually for each	755
classification of employer in each employer group listed in	756
divisions (A)(1) to (3) of this section, which will produce an	757
amount no greater than the amount the administrator estimates to	758
be necessary to carry out such sections for the period for which	759
the assessment is levied. The administrator annually shall	760
establish the contributions due from employers for the disabled	761
workers' relief fund at rates as low as possible but that will	762
assure sufficient moneys to guarantee the payment of any claims	763
against that fund.	764

Amounts assessed in accordance with this division shall be	765
billed at the same time premiums are billed and credited to the	766
disabled workers' relief fund created by section 4123.412 of the	767
Revised Code. The administrator shall determine the rates for each	768
class in the same manner as the administrator fixes the rates for	769
premiums pursuant to section 4123.29 of the Revised Code.	770

(C) For a self-insuring employer, the bureau of workers'	771
compensation shall pay to employees who are participants	772
regardless of the date of injury, any amounts due to the	773
participants under section 4123.414 of the Revised Code and shall	774
bill the self-insuring employer, semiannually, for all amounts	775
paid to a participant.	776

Sec. 4123.47. (A) The administrator of workers' compensation	777
shall have an actuarial ~~audits~~analysis of the state insurance	778
fund and all other funds specified in this chapter and Chapters	779
4121., 4127., and 4131. of the Revised Code made at least once	780
each year. The ~~audits~~analysis shall be made and certified by	781
recognized ~~insurance~~, credentialed property or casualty actuaries	782
who shall be selected by the bureau of workers' compensation board	783
of directors. ~~The audits shall cover the premium rates,~~	784
~~classifications, and all other matters involving the~~	785
~~administration of the state insurance fund and all other funds~~	786
~~specified in this chapter and Chapters 4121., 4127., and 4131. of~~	787
~~the Revised Code.~~ The expense of the ~~audits~~analysis shall be paid	788
from the state insurance fund. The administrator shall make copies	789
of the ~~audits~~analysis available to the workers' compensation	790
audit committee at no charge and to the public at cost.	791

(B) The auditor of state annually shall conduct an audit of	792
the administration of this chapter by the industrial commission	793
and the bureau of workers' compensation and the safety and hygiene	794
fund. The cost of the audit shall be charged to the administrative	795
costs of the bureau as defined in section 4123.341 of the Revised	796
Code. The audit shall include audits of all fiscal activities,	797
claims processing and handling, and employer premium collections.	798
The auditor shall prepare a report of the audit together with	799
recommendations and transmit copies of the report to the	800
industrial commission, the board, the administrator, the governor,	801
and to the general assembly. The auditor shall make copies of the	802
report available to the public at cost.	803

(C) The administrator may retain the services of a recognized	804
actuary on a consulting basis for the purpose of evaluating the	805
actuarial soundness of premium rates and classifications and all	806
other matters involving the administration of the state insurance	807
fund. The expense of services provided by the actuary shall be	808
paid from the state insurance fund.	809

Sec. 4123.511. (A) Within seven days after receipt of any	810
claim under this chapter, the bureau of workers' compensation	811
shall notify the claimant and the employer of the claimant of the	812
receipt of the claim and of the facts alleged therein. If the	813
bureau receives from a person other than the claimant written or	814
facsimile information or information communicated verbally over	815
the telephone indicating that an injury or occupational disease	816
has occurred or been contracted which may be compensable under	817
this chapter, the bureau shall notify the employee and the	818
employer of the information. If the information is provided	819
verbally over the telephone, the person providing the information	820
shall provide written verification of the information to the	821
bureau according to division (E) of section 4123.84 of the Revised	822
Code. The receipt of the information in writing or facsimile, or	823
if initially by telephone, the subsequent written verification,	824
and the notice by the bureau shall be considered an application	825
for compensation under section 4123.84 or 4123.85 of the Revised	826
Code, provided that the conditions of division (E) of section	827
4123.84 of the Revised Code apply to information provided verbally	828
over the telephone. Upon receipt of a claim, the bureau shall	829
advise the claimant of the claim number assigned and the	830
claimant's right to representation in the processing of a claim or	831
to elect no representation. If the bureau determines that a claim	832
is determined to be a compensable lost-time claim, the bureau	833
shall notify the claimant and the employer of the availability of	834
rehabilitation services. No bureau or industrial commission	835
employee shall directly or indirectly convey any information in	836
derogation of this right. This section shall in no way abrogate	837
the bureau's responsibility to aid and assist a claimant in the	838
filing of a claim and to advise the claimant of the claimant's	839
rights under the law.	840

The administrator of workers' compensation shall assign all	841
claims and investigations to the bureau service office from which	842
investigation and determination may be made most expeditiously.	843

The bureau shall investigate the facts concerning an injury	844
or occupational disease and ascertain such facts in whatever	845
manner is most appropriate and may obtain statements of the	846
employee, employer, attending physician, and witnesses in whatever	847
manner is most appropriate.	848

The administrator, with the advice and consent of the bureau	849
of workers' compensation board of directors, may adopt rules that	850
identify specified medical conditions that have a historical	851
record of being allowed whenever included in a claim. The	852
administrator may grant immediate allowance of any medical	853
condition identified in those rules upon the filing of a claim	854
involving that medical condition and may make immediate payment of	855
medical bills for any medical condition identified in those rules	856
that is included in a claim. If an employer contests the allowance	857
of a claim involving any medical condition identified in those	858
rules, and the claim is disallowed, payment for the medical	859
condition included in that claim shall be charged to and paid from	860
the surplus fund created under section 4123.34 of the Revised	861
Code.	862

(B)(1) Except as provided in division (B)(2) of this section,	863
in claims other than those in which the employer is a	864
self-insuring employer, if the administrator determines under	865
division (A) of this section that a claimant is or is not entitled	866
to an award of compensation or benefits, the administrator shall	867
issue an order no later than twenty-eight days after the sending	868
of the notice under division (A) of this section, granting or	869
denying the payment of the compensation or benefits, or both as is	870
appropriate to the claimant. After conducting an investigation	871
pursuant to division (A) of this section and not later than	872
twenty-eight days after sending the notice pursuant to division	873
(A) of this section, if the administrator determines that	874
insufficient information exists to grant or deny the payment of	875
compensation, benefits, or both to the claimant, the administrator	876
may, with notice to both parties, issue an order dismissing the	877
claim without prejudice. A claim that has been dismissed without	878
prejudice pursuant to this division shall not constitute notice to	879
the industrial commission or bureau of workers' compensation for	880
purposes of division (A) of section 4123.84 of the Revised Code	881
and shall not constitute an application to the industrial	882
commission or bureau of workers' compensation for purposes of	883
section 4123.85 of the Revised Code. Notwithstanding the time	884
limitation specified in this division for the issuance of an	885
order, if a medical examination of the claimant is required by	886
statute, the administrator promptly shall schedule the claimant	887
for that examination and shall issue an order no later than	888
twenty-eight days after receipt of the report of the examination.	889
The administrator shall notify the claimant and the employer of	890
the claimant and their respective representatives in writing of	891
the nature of the order and the amounts of compensation and	892
benefit payments involved. The employer or claimant may appeal the	893
order pursuant to division (C) of this section within fourteen	894
days after the date of the receipt of the order. The employer and	895
claimant may waive, in writing, their rights to an appeal under	896
this division.	897

(2) Notwithstanding the time limitation specified in division	898
(B)(1) of this section for the issuance of an order, if the	899
employer certifies a claim for payment of compensation or	900
benefits, or both, to a claimant, and the administrator has	901
completed the investigation of the claim, the payment of benefits	902
or compensation, or both, as is appropriate, shall commence upon	903
the later of the date of the certification or completion of the	904
investigation and issuance of the order by the administrator,	905
provided that the administrator shall issue the order no later	906
than the time limitation specified in division (B)(1) of this	907
section.	908

(3) If an appeal is made under division (B)(1) or (2) of this	909
section, the administrator shall forward the claim file to the	910
appropriate district hearing officer within seven days of the	911
appeal. In contested claims other than state fund claims, the	912
administrator shall forward the claim within seven days of the	913
administrator's receipt of the claim to the industrial commission,	914
which shall refer the claim to an appropriate district hearing	915
officer for a hearing in accordance with division (C) of this	916
section.	917

(C) If an employer or claimant timely appeals the order of	918
the administrator issued under division (B) of this section or in	919
the case of other contested claims other than state fund claims,	920
the commission shall refer the claim to an appropriate district	921
hearing officer according to rules the commission adopts under	922
section 4121.36 of the Revised Code. The district hearing officer	923
shall notify the parties and their respective representatives of	924
the time and place of the hearing.	925

The district hearing officer shall hold a hearing on a	926
disputed issue or claim within forty-five days after the filing of	927
the appeal under this division and issue a decision within seven	928
days after holding the hearing. The district hearing officer shall	929
notify the parties and their respective representatives in writing	930
of the order. Any party may appeal an order issued under this	931
division pursuant to division (D) of this section within fourteen	932
days after receipt of the order under this division.	933

(D) Upon the timely filing of an appeal of the order of the	934
district hearing officer issued under division (C) of this	935
section, the commission shall refer the claim file to an	936
appropriate staff hearing officer according to its rules adopted	937
under section 4121.36 of the Revised Code. The staff hearing	938
officer shall hold a hearing within forty-five days after the	939
filing of an appeal under this division and issue a decision	940
within seven days after holding the hearing under this division.	941
The staff hearing officer shall notify the parties and their	942
respective representatives in writing of the staff hearing	943
officer's order. Any party may appeal an order issued under this	944
division pursuant to division (E) of this section within fourteen	945
days after receipt of the order under this division.	946

(E) Upon the filing of a timely appeal of the order of the	947
staff hearing officer issued under division (D) of this section,	948
the commission or a designated staff hearing officer, on behalf of	949
the commission, shall determine whether the commission will hear	950
the appeal. If the commission or the designated staff hearing	951
officer decides to hear the appeal, the commission or the	952
designated staff hearing officer shall notify the parties and	953
their respective representatives in writing of the time and place	954
of the hearing. The commission shall hold the hearing within	955
forty-five days after the filing of the notice of appeal and,	956
within seven days after the conclusion of the hearing, the	957
commission shall issue its order affirming, modifying, or	958
reversing the order issued under division (D) of this section. The	959
commission shall notify the parties and their respective	960
representatives in writing of the order. If the commission or the	961
designated staff hearing officer determines not to hear the	962
appeal, within fourteen days after the expiration of the period in	963
which an appeal of the order of the staff hearing officer may be	964
filed as provided in division (D) of this section, the commission	965
or the designated staff hearing officer shall issue an order to	966
that effect and notify the parties and their respective	967
representatives in writing of that order.	968

Except as otherwise provided in this chapter and Chapters	969
4121., 4127., and 4131. of the Revised Code, any party may appeal	970
an order issued under this division to the court pursuant to	971
section 4123.512 of the Revised Code within sixty days after	972
receipt of the order, subject to the limitations contained in that	973
section.	974

(F) Every notice of an appeal from an order issued under	975
divisions (B), (C), (D), and (E) of this section shall state the	976
names of the claimant and employer, the number of the claim, the	977
date of the decision appealed from, and the fact that the	978
appellant appeals therefrom.	979

(G) All of the following apply to the proceedings under	980
divisions (C), (D), and (E) of this section:	981

(1) The parties shall proceed promptly and without	982
continuances except for good cause;	983

(2) The parties, in good faith, shall engage in the free	984
exchange of information relevant to the claim prior to the conduct	985
of a hearing according to the rules the commission adopts under	986
section 4121.36 of the Revised Code;	987

(3) The administrator is a party and may appear and	988
participate at all administrative proceedings on behalf of the	989
state insurance fund. However, in cases in which the employer is	990
represented, the administrator shall neither present arguments nor	991
introduce testimony that is cumulative to that presented or	992
introduced by the employer or the employer's representative. The	993
administrator may file an appeal under this section on behalf of	994
the state insurance fund; however, except in cases arising under	995
section 4123.343 of the Revised Code, the administrator only may	996
appeal questions of law or issues of fraud when the employer	997
appears in person or by representative.	998

(H) Except as provided in section 4121.63 of the Revised Code	999
and division (K) of this section, payments of compensation to a	1000
claimant or on behalf of a claimant as a result of any order	1001
issued under this chapter shall commence upon the earlier of the	1002
following:	1003

(1) Fourteen days after the date the administrator issues an	1004
order under division (B) of this section, unless that order is	1005
appealed;	1006

(2) The date when the employer has waived the right to appeal	1007
a decision issued under division (B) of this section;	1008

(3) If no appeal of an order has been filed under this	1009
section or to a court under section 4123.512 of the Revised Code,	1010
the expiration of the time limitations for the filing of an appeal	1011
of an order;	1012

(4) The date of receipt by the employer of an order of a	1013
district hearing officer, a staff hearing officer, or the	1014
industrial commission issued under division (C), (D), or (E) of	1015
this section.	1016

(I) ~~Payments~~Except as otherwise provided in division (B) or	1017
(C) of section 4123.66 of the Revised Code, payments of medical	1018
benefits payable under this chapter or Chapter 4121., 4127., or	1019
4131. of the Revised Code shall commence upon the earlier of the	1020
following:	1021

(1) The date of the issuance of the staff hearing officer's	1022
order under division (D) of this section;	1023

(2) The date of the final administrative or judicial	1024
determination.	1025

(J) The administrator shall charge the compensation payments	1026
made in accordance with division (H) of this section or medical	1027
benefits payments made in accordance with division (I) of this	1028
section to an employer's experience immediately after the employer	1029
has exhausted the employer's administrative appeals as provided in	1030
this section or has waived the employer's right to an	1031
administrative appeal under division (B) of this section, subject	1032
to the adjustment specified in division (H) of section 4123.512 of	1033
the Revised Code.	1034

(K) Upon the final administrative or judicial determination	1035
under this section or section 4123.512 of the Revised Code of an	1036
appeal of an order to pay compensation, if a claimant is found to	1037
have received compensation pursuant to a prior order which is	1038
reversed upon subsequent appeal, the claimant's employer, if a	1039
self-insuring employer, or the bureau, shall withhold from any	1040
amount to which the claimant becomes entitled pursuant to any	1041
claim, past, present, or future, under Chapter 4121., 4123.,	1042
4127., or 4131. of the Revised Code, the amount of previously paid	1043
compensation to the claimant which, due to reversal upon appeal,	1044
the claimant is not entitled, pursuant to the following criteria:	1045

(1) No withholding for the first twelve weeks of temporary	1046
total disability compensation pursuant to section 4123.56 of the	1047
Revised Code shall be made;	1048

(2) Forty per cent of all awards of compensation paid	1049
pursuant to sections 4123.56 and 4123.57 of the Revised Code,	1050
until the amount overpaid is refunded;	1051

(3) Twenty-five per cent of any compensation paid pursuant to	1052
section 4123.58 of the Revised Code until the amount overpaid is	1053
refunded;	1054

(4) If, pursuant to an appeal under section 4123.512 of the	1055
Revised Code, the court of appeals or the supreme court reverses	1056
the allowance of the claim, then no amount of any compensation	1057
will be withheld.	1058

The administrator and self-insuring employers, as	1059
appropriate, are subject to the repayment schedule of this	1060
division only with respect to an order to pay compensation that	1061
was properly paid under a previous order, but which is	1062
subsequently reversed upon an administrative or judicial appeal.	1063
The administrator and self-insuring employers are not subject to,	1064
but may utilize, the repayment schedule of this division, or any	1065
other lawful means, to collect payment of compensation made to a	1066
person who was not entitled to the compensation due to fraud as	1067
determined by the administrator or the industrial commission.	1068

(L) If a staff hearing officer or the commission fails to	1069
issue a decision or the commission fails to refuse to hear an	1070
appeal within the time periods required by this section, payments	1071
to a claimant shall cease until the staff hearing officer or	1072
commission issues a decision or hears the appeal, unless the	1073
failure was due to the fault or neglect of the employer or the	1074
employer agrees that the payments should continue for a longer	1075
period of time.	1076

(M) Except as otherwise provided in this section or section	1077
4123.522 of the Revised Code, no appeal is timely filed under this	1078
section unless the appeal is filed with the time limits set forth	1079
in this section.	1080

(N) No person who is not an employee of the bureau or	1081
commission or who is not by law given access to the contents of a	1082
claims file shall have a file in the person's possession.	1083

(O) Upon application of a party who resides in an area in	1084
which an emergency or disaster is declared, the industrial	1085
commission and hearing officers of the commission may waive the	1086
time frame within which claims and appeals of claims set forth in	1087
this section must be filed upon a finding that the applicant was	1088
unable to comply with a filing deadline due to an emergency or a	1089
disaster.	1090

As used in this division:

1091

(1) "Emergency" means any occasion or instance for which the	1092
governor of Ohio or the president of the United States publicly	1093
declares an emergency and orders state or federal assistance to	1094
save lives and protect property, the public health and safety, or	1095
to lessen or avert the threat of a catastrophe.	1096

(2) "Disaster" means any natural catastrophe or fire, flood,	1097
or explosion, regardless of the cause, that causes damage of	1098
sufficient magnitude that the governor of Ohio or the president of	1099
the United States, through a public declaration, orders state or	1100
federal assistance to alleviate damage, loss, hardship, or	1101
suffering that results from the occurrence.	1102

Sec. 4123.512. (A) The claimant or the employer may appeal	1103
an order of the industrial commission made under division (E) of	1104
section 4123.511 of the Revised Code in any injury or occupational	1105
disease case, other than a decision as to the extent of disability	1106
to the court of common pleas of the county in which the injury was	1107
inflicted or in which the contract of employment was made if the	1108
injury occurred outside the state, or in which the contract of	1109
employment was made if the exposure occurred outside the state. If	1110
no common pleas court has jurisdiction for the purposes of an	1111
appeal by the use of the jurisdictional requirements described in	1112
this division, the appellant may use the venue provisions in the	1113
Rules of Civil Procedure to vest jurisdiction in a court. If the	1114
claim is for an occupational disease, the appeal shall be to the	1115
court of common pleas of the county in which the exposure which	1116
caused the disease occurred. Like appeal may be taken from an	1117
order of a staff hearing officer made under division (D) of	1118
section 4123.511 of the Revised Code from which the commission has	1119
refused to hear an appeal. The appellant shall file the notice of	1120
appeal with a court of common pleas within sixty days after the	1121
date of the receipt of the order appealed from or the date of	1122
receipt of the order of the commission refusing to hear an appeal	1123
of a staff hearing officer's decision under division (D) of	1124
section 4123.511 of the Revised Code. The filing of the notice of	1125
the appeal with the court is the only act required to perfect the	1126
appeal.	1127

If an action has been commenced in a court of a county other	1128
than a court of a county having jurisdiction over the action, the	1129
court, upon notice by any party or upon its own motion, shall	1130
transfer the action to a court of a county having jurisdiction.	1131

Notwithstanding anything to the contrary in this section, if	1132
the commission determines under section 4123.522 of the Revised	1133
Code that an employee, employer, or their respective	1134
representatives have not received written notice of an order or	1135
decision which is appealable to a court under this section and	1136
which grants relief pursuant to section 4123.522 of the Revised	1137
Code, the party granted the relief has sixty days from receipt of	1138
the order under section 4123.522 of the Revised Code to file a	1139
notice of appeal under this section.	1140

(B) The notice of appeal shall state the names of the	1141
administrator of workers' compensation, the claimant, and the	1142
employer,; the number of the claim,; the date of the order	1143
appealed from,; and the fact that the appellant appeals therefrom.	1144

The administrator ~~of workers' compensation~~, the claimant, and	1145
the employer shall be parties to the appeal and the court, upon	1146
the application of the commission, shall make the commission a	1147
party. The party filing the appeal shall serve a copy of the	1148
notice of appeal on the administrator at the central office of the	1149
bureau of workers' compensation in Columbus. The administrator	1150
shall notify the employer that if the employer fails to become an	1151
active party to the appeal, then the administrator may act on	1152
behalf of the employer and the results of the appeal could have an	1153
adverse effect upon the employer's premium rates.	1154

(C) The attorney general or one or more of the attorney	1155
general's assistants or special counsel designated by the attorney	1156
general shall represent the administrator and the commission. In	1157
the event the attorney general or the attorney general's	1158
designated assistants or special counsel are absent, the	1159
administrator or the commission shall select one or more of the	1160
attorneys in the employ of the administrator or the commission as	1161
the administrator's attorney or the commission's attorney in the	1162
appeal. Any attorney so employed shall continue the representation	1163
during the entire period of the appeal and in all hearings thereof	1164
except where the continued representation becomes impractical.	1165

(D) Upon receipt of notice of appeal, the clerk of courts	1166
shall provide notice to all parties who are appellees and to the	1167
commission.	1168

The claimant shall, within thirty days after the filing of	1169
the notice of appeal, file a petition containing a statement of	1170
facts in ordinary and concise language showing a cause of action	1171
to participate or to continue to participate in the fund and	1172
setting forth the basis for the jurisdiction of the court over the	1173
action. Further pleadings shall be had in accordance with the	1174
Rules of Civil Procedure, provided that service of summons on such	1175
petition shall not be required and provided that the claimant may	1176
not dismiss the complaint without the employer's consent if the	1177
employer is the party that filed the notice of appeal to court	1178
pursuant to this section. The clerk of the court shall, upon	1179
receipt thereof, transmit by certified mail a copy thereof to each	1180
party named in the notice of appeal other than the claimant. Any	1181
party may file with the clerk prior to the trial of the action a	1182
deposition of any physician taken in accordance with the	1183
provisions of the Revised Code, which deposition may be read in	1184
the trial of the action even though the physician is a resident of	1185
or subject to service in the county in which the trial is had. The	1186
bureau of workers' compensation shall pay the cost of the	1187
stenographic deposition filed in court and of copies of the	1188
stenographic deposition for each party from the surplus fund and	1189
charge the costs thereof against the unsuccessful party if the	1190
claimant's right to participate or continue to participate is	1191
finally sustained or established in the appeal. In the event the	1192
deposition is taken and filed, the physician whose deposition is	1193
taken is not required to respond to any subpoena issued in the	1194
trial of the action. The court, or the jury under the instructions	1195
of the court, if a jury is demanded, shall determine the right of	1196
the claimant to participate or to continue to participate in the	1197
fund upon the evidence adduced at the hearing of the action.	1198

(E) The court shall certify its decision to the commission	1199
and the certificate shall be entered in the records of the court.	1200
Appeals from the judgment are governed by the law applicable to	1201
the appeal of civil actions.	1202

(F) The cost of any legal proceedings authorized by this	1203
section, including an attorney's fee to the claimant's attorney to	1204
be fixed by the trial judge, based upon the effort expended, in	1205
the event the claimant's right to participate or to continue to	1206
participate in the fund is established upon the final	1207
determination of an appeal, shall be taxed against the employer or	1208
the commission if the commission or the administrator rather than	1209
the employer contested the right of the claimant to participate in	1210
the fund. The attorney's fee shall not exceed forty-two hundred	1211
dollars.	1212

(G) If the finding of the court or the verdict of the jury is	1213
in favor of the claimant's right to participate in the fund, the	1214
commission and the administrator shall thereafter proceed in the	1215
matter of the claim as if the judgment were the decision of the	1216
commission, subject to the power of modification provided by	1217
section 4123.52 of the Revised Code.	1218

(H)(1) An appeal from an order issued under division (E) of	1219
section 4123.511 of the Revised Code or any action filed in court	1220
in a case in which an award of compensation or medical benefits	1221
has been made shall not stay the payment of compensation or	1222
medical benefits under the award, or payment for subsequent	1223
periods of total disability or medical benefits during the	1224
pendency of the appeal. If, in a final administrative or judicial	1225
action, it is determined that payments of compensation or	1226
benefits, or both, made to or on behalf of a claimant should not	1227
have been made, the amount thereof shall be charged to the surplus	1228
fund account under division (B) of section 4123.34 of the Revised	1229
Code. In the event the employer is a state risk, the amount shall	1230
not be charged to the employer's experience, and the administrator	1231
shall adjust the employer's account accordingly. In the event the	1232
employer is a self-insuring employer, the self-insuring employer	1233
shall deduct the amount from the paid compensation the	1234
self-insuring employer reports to the administrator under division	1235
(L) of section 4123.35 of the Revised Code. If an employer is a	1236
state risk and has paid an assessment for a violation of a	1237
specific safety requirement, and, in a final administrative or	1238
judicial action, it is determined that the employer did not	1239
violate the specific safety requirement, the administrator shall	1240
reimburse the employer from the surplus fund account created in	1241
division (B) of section 4123.34 of the Revised Code for the amount	1242
of the assessment the employer paid for the violation.	1243

(2)(a) Notwithstanding a final determination that payments of	1244
benefits made to or on behalf of a claimant should not have been	1245
made, the administrator or self-insuring employer shall award	1246
payment of medical or vocational rehabilitation services submitted	1247
for payment after the date of the final determination if all of	1248
the following apply:	1249

(i) The services were approved and were rendered by the	1250
provider in good faith prior to the date of the final	1251
determination.	1252

(ii) The services were payable under division (I) of section	1253
4123.511 of the Revised Code prior to the date of the final	1254
determination.	1255

(iii) The request for payment is submitted within the time	1256
limit set forth in section 4123.52 of the Revised Code.	1257

(b) Payments made under division (H)(1) of this section shall	1258
be charged to the surplus fund account under division (B) of	1259
section 4123.34 of the Revised Code. If the employer of the	1260
employee who is the subject of a claim described in division	1261
(H)(2)(a) of this section is a state fund employer, the payments	1262
made under that division shall not be charged to the employer's	1263
experience. If that employer is a self-insuring employer, the	1264
self-insuring employer shall deduct the amount from the paid	1265
compensation the self-insuring employer reports to the	1266
administrator under division (L) of section 4123.35 of the Revised	1267
Code.	1268

(c) Division (H)(2) of this section shall apply only to a	1269
claim under this chapter or Chapter 4121., 4127., or 4131. of the	1270
Revised Code arising on or after ~~the effective date of this~~	1271
~~amendment~~July 29, 2011.	1272

(3) A self-insuring employer may elect to pay compensation	1273
and benefits under this section directly to an employee or an	1274
employee's dependents by filing an application with the bureau of	1275
workers' compensation not more than one hundred eighty days and	1276
not less than ninety days before the first day of the employer's	1277
next six-month coverage period. If the self-insuring employer	1278
timely files the application, the application is effective on the	1279
first day of the employer's next six-month coverage period,	1280
provided that the administrator shall compute the employer's	1281
assessment for the surplus fund account due with respect to the	1282
period during which that application was filed without regard to	1283
the filing of the application. On and after the effective date of	1284
the employer's election, the self-insuring employer shall pay	1285
directly to an employee or to an employee's dependents	1286
compensation and benefits under this section regardless of the	1287
date of the injury or occupational disease, and the employer shall	1288
receive no money or credits from the surplus fund account on	1289
account of those payments and shall not be required to pay any	1290
amounts into the surplus fund account on account of this section.	1291
The election made under this division is irrevocable.	1292

(I) All actions and proceedings under this section which are	1293
the subject of an appeal to the court of common pleas or the court	1294
of appeals shall be preferred over all other civil actions except	1295
election causes, irrespective of position on the calendar.	1296

This section applies to all decisions of the commission or	1297
the administrator on November 2, 1959, and all claims filed	1298
thereafter are governed by sections 4123.511 and 4123.512 of the	1299
Revised Code.	1300

Any action pending in common pleas court or any other court	1301
on January 1, 1986, under this section is governed by former	1302
sections 4123.514, 4123.515, 4123.516, and 4123.519 and section	1303
4123.522 of the Revised Code.	1304

Sec. 4123.66. (A) In addition to the compensation provided	1305
for in this chapter, the administrator of workers' compensation	1306
shall disburse and pay from the state insurance fund the amounts	1307
for medical, nurse, and hospital services and medicine as the	1308
administrator deems proper and, in case death ensues from the	1309
injury or occupational disease, the administrator shall disburse	1310
and pay from the fund reasonable funeral expenses in an amount not	1311
to exceed fifty-five hundred dollars. The bureau of workers'	1312
compensation shall reimburse anyone, whether dependent, volunteer,	1313
or otherwise, who pays the funeral expenses of any employee whose	1314
death ensues from any injury or occupational disease as provided	1315
in this section. The administrator may adopt rules, with the	1316
advice and consent of the bureau of workers' compensation board of	1317
directors, with respect to furnishing medical, nurse, and hospital	1318
service and medicine to injured or disabled employees entitled	1319
thereto, and for the payment therefor. In case an injury or	1320
industrial accident that injures an employee also causes damage to	1321
the employee's eyeglasses, artificial teeth or other denture, or	1322
hearing aid, or in the event an injury or occupational disease	1323
makes it necessary or advisable to replace, repair, or adjust the	1324
same, the bureau shall disburse and pay a reasonable amount to	1325
repair or replace the same.	1326

(B) The administrator, in the rules the administrator adopts	1327
pursuant to division (A) of this section, may adopt rules	1328
specifying the circumstances under which the bureau may make	1329
immediate payment for the first fill of prescription drugs for	1330
medical conditions identified in an application for compensation	1331
or benefits under section 4123.84 or 4123.85 of the Revised Code	1332
that occurs prior to the date the administrator issues an initial	1333
determination order under division (B) of section 4123.511 of the	1334
Revised Code. If the claim is ultimately disallowed in a final	1335
administrative or judicial order, and if the employer is a state	1336
fund employer who pays assessments into the surplus fund account	1337
created under section 4123.34 of the Revised Code, the payments	1338
for medical services made pursuant to this division for the first	1339
fill of prescription drugs shall be charged to and paid from the	1340
surplus fund account and not charged through the state insurance	1341
fund to the employer against whom the claim was filed.	1342

(C) The administrator, in the rules the administrator adopts	1343
pursuant to division (A) of this section, may identify specified	1344
medical services that are presumptively authorized and payable to	1345
a provider who provides any of the services identified in, and	1346
complies with the requirements set forth in, the rules the	1347
administrator adopts for the services rendered. The administrator,	1348
in the rules the administrator adopts under this division, shall	1349
limit the payment for these services to only those services	1350
rendered to a claimant during the time period beginning the date	1351
the administrator issues an order pursuant to division (B) of	1352
section 4123.511 of the Revised Code allowing a claim or allowing	1353
an additional condition to which the services relate and ending	1354
forty-five days after the date the order was issued.	1355

If the claim or additional condition is ultimately disallowed	1356
in a final administrative or judicial order, and if the employer	1357
is a state fund employer who pays assessments into the surplus	1358
fund account created under section 4123.34 of the Revised Code,	1359
the payments for medical services made pursuant to this division	1360
for that claim or condition shall be charged to and paid from the	1361
surplus fund account and not charged through the state insurance	1362
fund to the employer against whom the claim or additional	1363
condition was filed.	1364

(D)(1) If an employer or a welfare plan has provided to or on	1365
behalf of an employee any benefits or compensation for an injury	1366
or occupational disease and that injury or occupational disease is	1367
determined compensable under this chapter, the employer or a	1368
welfare plan may request that the administrator reimburse the	1369
employer or welfare plan for the amount the employer or welfare	1370
plan paid to or on behalf of the employee in compensation or	1371
benefits. The administrator shall reimburse the employer or	1372
welfare plan for the compensation and benefits paid if, at the	1373
time the employer or welfare plan provides the benefits or	1374
compensation to or on behalf of employee, the injury or	1375
occupational disease had not been determined to be compensable	1376
under this chapter and if the employee was not receiving	1377
compensation or benefits under this chapter for that injury or	1378
occupational disease. The administrator shall reimburse the	1379
employer or welfare plan in the amount that the administrator	1380
would have paid to or on behalf of the employee under this chapter	1381
if the injury or occupational disease originally would have been	1382
determined compensable under this chapter. If the employer is a	1383
merit-rated employer, the administrator shall adjust the amount of	1384
premium next due from the employer according to the amount the	1385
administrator pays the employer. The administrator shall adopt	1386
rules, in accordance with Chapter 119. of the Revised Code, to	1387
implement this division.	1388

(2) As used in this division, "welfare plan" has the same	1389
meaning as in division (1) of 29 U.S.C.A. 1002.	1390

Sec. 4123.82. (A) All contracts and agreements are void	1391
which undertake to indemnify or insure an employer against loss or	1392
liability for the payment of compensation to workers or their	1393
dependents for death, injury, or occupational disease occasioned	1394
in the course of the workers' employment, or which provide that	1395
the insurer shall pay the compensation, or which indemnify the	1396
employer against damages when the injury, disease, or death arises	1397
from the failure to comply with any lawful requirement for the	1398
protection of the lives, health, and safety of employees, or when	1399
the same is occasioned by the willful act of the employer or any	1400
of the employer's officers or agents, or by which it is agreed	1401
that the insurer shall pay any such damages. No license or	1402
authority to enter into any such agreements or issue any such	1403
policies of insurance shall be granted or issued by any public	1404
authority in this state. Any corporation organized or admitted	1405
under the laws of this state to transact liability insurance as	1406
defined in section 3929.01 of the Revised Code may by amendment of	1407
its articles of incorporation or by original articles of	1408
incorporation, provide therein for the authority and purpose to	1409
make insurance in states, territories, districts, and counties,	1410
other than the state of Ohio, and in the state of Ohio in respect	1411
of contracts permitted by division (B) of this section,	1412
indemnifying employers against loss or liability for payment of	1413
compensation to workers and employees and their dependents for	1414
death, injury, or occupational disease occasioned in the course of	1415
the employment and to insure and indemnify employers against loss,	1416
expense, and liability by risk of bodily injury or death by	1417
accident, disability, sickness, or disease suffered by workers and	1418
employees for which the employer may be liable or has assumed	1419
liability.	1420

(B) Notwithstanding division (A) of this section:

1421

(1) No contract because of that division is void which	1422
undertakes to indemnify a self-insuring employer against all or	1423
part of such employer's loss in excess of at least ~~fifty~~three	1424
hundred thousand dollars from any one disaster or event arising	1425
out of the employer's liability under this chapter, but no	1426
insurance corporation shall, directly or indirectly, represent an	1427
employer in the settlement, adjudication, determination,	1428
allowance, or payment of claims. The superintendent of insurance	1429
shall enforce this prohibition by such disciplinary orders	1430
directed against the offending insurance corporation as the	1431
superintendent of insurance deems appropriate in the circumstances	1432
and the administrator of workers' compensation shall enforce this	1433
prohibition by such disciplinary orders directed against the	1434
offending employer as the administrator deems appropriate in the	1435
circumstances, which orders may include revocation of the	1436
insurance corporation's right to enter into indemnity contracts	1437
and revocation of the employer's status as a self-insuring	1438
employer.	1439

(2) The administrator may enter into a contract of indemnity	1440
with any such employer upon such terms, payment of such premium,	1441
and for such amount and form of indemnity as the administrator	1442
determines and the bureau of workers' compensation board of	1443
directors may procure reinsurance of the liability of the public	1444
and private funds under this chapter, or any part of the liability	1445
in respect of either or both of the funds, upon such terms and	1446
premiums or other payments from the fund or funds as the	1447
administrator deems prudent in the maintenance of a solvent fund	1448
or funds from year to year. When making the finding of fact which	1449
the administrator is required by section 4123.35 of the Revised	1450
Code to make with respect to the financial ability of an employer,	1451
no contract of indemnity, or the ability of the employer to	1452
procure such a contract, shall be considered as increasing the	1453
financial ability of the employer.	1454

(C) Nothing in this section shall be construed to prohibit	1455
the administrator or an other-states' insurer from providing to	1456
employers in this state other-states' coverage in accordance with	1457
section 4123.292 of the Revised Code.	1458

(D) Notwithstanding any other section of the Revised Code,	1459
but subject to division (A) of this section, the superintendent of	1460
insurance shall have the sole authority to regulate any insurance	1461
products, except for the bureau of workers' compensation and those	1462
products offered by the bureau, that indemnify or insure employers	1463
against workers' compensation losses in this state or that are	1464
sold to employers in this state.	1465

Sec. 4123.93. As used in sections 4123.93 and 4123.931 of	1466
the Revised Code:	1467

(A) "Claimant" means a person who is eligible to receive	1468
compensation, medical benefits, or death benefits under this	1469
chapter or Chapter 4121., 4127., or 4131. of the Revised Code.	1470

(B) "Statutory subrogee" means the administrator of workers'	1471
compensation, a self-insuring employer, or an employer that	1472
contracts for the direct payment of medical services pursuant to	1473
division ~~(L)~~(M) of section 4121.44 of the Revised Code.	1474

(C) "Third party" means an individual, private insurer,	1475
public or private entity, or public or private program that is or	1476
may be liable to make payments to a person without regard to any	1477
statutory duty contained in this chapter or Chapter 4121., 4127.,	1478
or 4131. of the Revised Code.	1479

(D) "Subrogation interest" includes past, present, and	1480
estimated future payments of compensation, medical benefits,	1481
rehabilitation costs, or death benefits, and any other costs or	1482
expenses paid to or on behalf of the claimant by the statutory	1483
subrogee pursuant to this chapter or Chapter 4121., 4127., or	1484
4131. of the Revised Code.	1485

(E) "Net amount recovered" means the amount of any award,	1486
settlement, compromise, or recovery by a claimant against a third	1487
party, minus the attorney's fees, costs, or other expenses	1488
incurred by the claimant in securing the award, settlement,	1489
compromise, or recovery. "Net amount recovered" does not include	1490
any punitive damages that may be awarded by a judge or jury.	1491

(F) "Uncompensated damages" means the claimant's demonstrated	1492
or proven damages minus the statutory subrogee's subrogation	1493
interest.	1494

Sec. 4729.80. (A) If the state board of pharmacy establishes	1495
and maintains a drug database pursuant to section 4729.75 of the	1496
Revised Code, the board is authorized or required to provide	1497
information from the database in accordance with the following:	1498

(1) On receipt of a request from a designated representative	1499
of a government entity responsible for the licensure, regulation,	1500
or discipline of health care professionals with authority to	1501
prescribe, administer, or dispense drugs, the board may provide to	1502
the representative information from the database relating to the	1503
professional who is the subject of an active investigation being	1504
conducted by the government entity.	1505

(2) On receipt of a request from a federal officer, or a	1506
state or local officer of this or any other state, whose duties	1507
include enforcing laws relating to drugs, the board shall provide	1508
to the officer information from the database relating to the	1509
person who is the subject of an active investigation of a drug	1510
abuse offense, as defined in section 2925.01 of the Revised Code,	1511
being conducted by the officer's employing government entity.	1512

(3) Pursuant to a subpoena issued by a grand jury, the board	1513
shall provide to the grand jury information from the database	1514
relating to the person who is the subject of an investigation	1515
being conducted by the grand jury.	1516

(4) Pursuant to a subpoena, search warrant, or court order in	1517
connection with the investigation or prosecution of a possible or	1518
alleged criminal offense, the board shall provide information from	1519
the database as necessary to comply with the subpoena, search	1520
warrant, or court order.	1521

(5) On receipt of a request from a prescriber or the	1522
prescriber's delegate approved by the board, the board may provide	1523
to the prescriber information from the database relating to a	1524
patient who is either of the following, if the prescriber	1525
certifies in a form specified by the board that it is for the	1526
purpose of providing medical treatment to the patient who is the	1527
subject of the request;	1528

(a) A current patient of the prescriber;

1529

(b) A potential patient of the prescriber based on a referral	1530
of the patient to the prescriber.	1531

(6) On receipt of a request from a pharmacist or the	1532
pharmacist's delegate approved by the board, the board may provide	1533
to the pharmacist information from the database relating to a	1534
current patient of the pharmacist, if the pharmacist certifies in	1535
a form specified by the board that it is for the purpose of the	1536
pharmacist's practice of pharmacy involving the patient who is the	1537
subject of the request.	1538

(7) On receipt of a request from an individual seeking the	1539
individual's own database information in accordance with the	1540
procedure established in rules adopted under section 4729.84 of	1541
the Revised Code, the board may provide to the individual the	1542
individual's own database information.	1543

(8) On receipt of a request from the medical director of a	1544
managed care organization that has entered into a data security	1545
agreement with the board required by section 5111.1710 of the	1546
Revised Code, the board may provide to the medical director	1547
information from the database relating to a medicaid recipient	1548
enrolled in the managed care organization.	1549

(9) On receipt of a request from the director of job and	1550
family services, the board may provide to the director information	1551
from the database relating to a recipient of a program	1552
administered by the department of job and family services.	1553

(10) On receipt of a request from the administrator of	1554
workers' compensation, the board ~~may~~shall provide to the	1555
administrator information from the database relating to a claimant	1556
under Chapter 4121., 4123., 4127., or 4131. of the Revised Code.	1557

(11) On receipt of a request from a requestor described in	1558
division (A)(1), (2), (5), or (6) of this section who is from or	1559
participating with another state's prescription monitoring	1560
program, the board may provide to the requestor information from	1561
the database, but only if there is a written agreement under which	1562
the information is to be used and disseminated according to the	1563
laws of this state.	1564

(B) The state board of pharmacy shall maintain a record of	1565
each individual or entity that requests information from the	1566
database pursuant to this section. In accordance with rules	1567
adopted under section 4729.84 of the Revised Code, the board may	1568
use the records to document and report statistics and law	1569
enforcement outcomes.	1570

The board may provide records of an individual's requests for	1571
database information to the following:	1572

(1) A designated representative of a government entity that	1573
is responsible for the licensure, regulation, or discipline of	1574
health care professionals with authority to prescribe, administer,	1575
or dispense drugs who is involved in an active investigation being	1576
conducted by the government entity of the individual who submitted	1577
the requests for database information;	1578

(2) A federal officer, or a state or local officer of this or	1579
any other state, whose duties include enforcing laws relating to	1580
drugs and who is involved in an active investigation being	1581
conducted by the officer's employing government entity of the	1582
individual who submitted the requests for database information.	1583

(C) Information contained in the database and any information	1584
obtained from it is not a public record. Information contained in	1585
the records of requests for information from the database is not a	1586
public record. Information that does not identify a person may be	1587
released in summary, statistical, or aggregate form.	1588

(D) A pharmacist or prescriber shall not be held liable in	1589
damages to any person in any civil action for injury, death, or	1590
loss to person or property on the basis that the pharmacist or	1591
prescriber did or did not seek or obtain information from the	1592
database.	1593

Section 102. That existing sections 4121.129, 4121.44,	1594
4121.441, 4123.29, 4123.291, 4123.353, 4123.37, 4123.411, 4123.47,	1595
4123.511, 4123.512, 4123.66, 4123.82, 4123.93, and 4729.80 of the	1596
Revised Code are hereby repealed.	1597

Section 201. All items in are hereby appropriated out of any	1598
moneys in the state treasury to the credit of the designated fund.	1599
For all appropriations made in this act, those in the first column	1600
are for fiscal year 2014, and those in the second column are for	1601
fiscal year 2015.	1602

FND

AI TITLE

Appropriations

1603

BWC BUREAU OF WORKERS' COMPENSATION	1604

Workers' Compensation Fund Group	1605

7023	855401	William Green Lease Payments to OBA	$	16,026,100	$	0	1606
7023	855407	Claims, Risk and Medical Management	$	118,338,586	$	118,338,586	1607
7023	855408	Fraud Prevention	$	12,114,226	$	12,114,226	1608
7023	855409	Administrative Services	$	105,857,276	$	105,357,276	1609
7023	855410	Attorney General Payments	$	4,621,850	$	4,621,850	1610
8220	855606	Coal Workers' Fund	$	147,666	$	147,666	1611
8230	855608	Marine Industry	$	75,527	$	75,527	1612
8250	855605	Disabled Workers Relief Fund	$	319,718	$	319,718	1613
8260	855609	Safety and Hygiene Operating	$	19,161,132	$	19,161,132	1614
8260	855610	Gear Program	$	5,000,000	$	5,000,000	1615
8290	855604	Long Term Care Loan Program	$	100,000	$	100,000	1616
TOTAL WCF Workers' Compensation							1617
Fund Group			$	281,762,081	$	265,235,981	1618

Federal Special Revenue Fund Group	1619

3490	855601	OSHA Enforcement	$	1,731,000	$	1,731,000	1620
3FW0	855614	BLS SOII Grant	$	116,919	$	116,919	1621
TOTAL FED Federal Special Revenue Fund Group			$	1,847,919	$	1,847,919	1622
TOTAL ALL BUDGET FUND GROUPS			$	283,610,000	$	267,083,900	1623

WILLIAM GREEN LEASE PAYMENTS

1624

Of the foregoing appropriation item 855401, William Green	1625
Lease Payments, up to $16,026,100 shall be used to make lease	1626
payments to the Treasurer of State at the times they are required	1627
to be made during the period from July 1, 2013 to June 30, 2015,	1628
pursuant to leases and agreements made under section 154.24 of the	1629
Revised Code. If it is determined that additional appropriations	1630
are necessary for such purpose, such amounts are hereby	1631
appropriated.	1632

WORKERS' COMPENSATION FRAUD UNIT

1633

Of the foregoing appropriation item 855410, Attorney General	1634
Payments, $828,200 in each fiscal year shall be used to fund the	1635
expenses of the Workers' Compensation Fraud Unit within the	1636
Attorney General's Office. These payments shall be processed at	1637
the beginning of each quarter of each fiscal year and deposited	1638
into the Workers' Compensation Section Fund (Fund 1950) used by	1639
the Attorney General.	1640

SAFETY AND HYGIENE

1641

Notwithstanding section 4121.37 of the Revised Code, the	1642
Treasurer of State shall transfer $20,382,567 cash in fiscal year	1643
2014 and $20,161,132 cash in fiscal year 2015 from the State	1644
Insurance Fund to the Safety and Hygiene Fund (Fund 8260).	1645

OSHA ON-SITE CONSULTATION PROGRAM

1646

The Bureau of Workers' Compensation may designate a portion	1647
of appropriation item 855609, Safety and Hygiene Operating, to be	1648
used to match federal funding for the federal Occupational Safety	1649
and Health Administration's (OSHA) on-site consultation program.	1650

VOCATIONAL REHABILITATION

1651

The Bureau of Workers' Compensation and the Rehabilitation	1652
Services Commission shall enter into an interagency agreement for	1653
the provision of vocational rehabilitation services and staff to	1654
mutually eligible clients. The bureau shall provide $605,407 in	1655
fiscal year 2014 and $605,407 in fiscal year 2015 from the State	1656
Insurance Fund to fund vocational rehabilitation services and	1657
staff in accordance with the interagency agreement.	1658

FUND BALANCE

1659

Any unencumbered cash balance in excess of $45,000,000 in the	1660
Workers' Compensation Fund (Fund 7023) on the thirtieth day of	1661
June of each fiscal year shall be used to reduce the	1662
administrative cost rate charged to employers to cover	1663
appropriations for Bureau of Workers' Compensation operations.	1664

Section 211. DEPUTY INSPECTOR GENERAL FOR BWC AND OIC FUNDING

1665

To pay for the FY 2014 costs related to the Deputy Inspector	1666
General for the Bureau of Workers' Compensation and Industrial	1667
Commission, on July 1, 2013, and on January 1, 2014, or as soon as	1668
possible after each date, the Director of Budget and Management	1669
shall transfer $212,500 in cash from the Workers' Compensation	1670
Fund (Fund 7023) to the Deputy Inspector General for the Bureau of	1671
Workers' Compensation and Industrial Commission Fund (Fund 5FT0).	1672

To pay for the FY 2015 costs related to the Deputy Inspector	1673
General for the Bureau of Workers' Compensation and Industrial	1674
Commission, on July 1, 2014, and on January 1, 2015, or as soon as	1675
possible after each date, the Director of Budget and Management	1676
shall transfer $212,500 in cash from the Workers' Compensation	1677
Fund (Fund 7023) to the Deputy Inspector General for the Bureau of	1678
Workers' Compensation and Industrial Commission Fund (Fund 5FT0).	1679

If additional amounts are needed, the Inspector General may	1680
seek Controlling Board approval for additional transfers of cash	1681
and to increase the amount appropriated in appropriation item	1682
965604, Deputy Inspector General for the Bureau of Workers'	1683
Compensation and Industrial Commission.	1684

Section 741.10. Except as otherwise provided in this act,	1685
the amendments to Revised Code sections in Section 101 of this act	1686
apply to all claims filed pursuant to Chapter 4121., 4123., 4127.,	1687
or 4131. of the Revised Code on or after the effective date of	1688
Section 101 of this act.	1689

Section 741.20. Division (B) of section 4123.512 of the	1690
Revised Code, as amended by this act, applies to an appeal filed	1691
pursuant to that section on or after the effective date of that	1692
section.	1693

Section 803.10. Law contained in the Main Operating	1694
Appropriations Act of the 130th General Assembly that applies	1695
generally to the appropriations made in that act also applies	1696
generally to the appropriations made in this act.	1697

Section 806.10. The provisions of law contained in this act,	1698
and their applications, are severable. If any provision of law	1699
contained in this act, or if any application of any provision of	1700
law contained in this act, is held invalid, the invalidity does	1701
not affect other provisions of law contained in this act and their	1702
applications that can be given effect without the invalid	1703
provision or application.	1704

Section 812.10. Except as otherwise specifically provided in	1705
this act, the amendment, enactment, or repeal by this act of a	1706
section of law is exempt from the referendum under Ohio	1707
Constitution, Article II, Section 1d and section 1.471 of the	1708
Revised Code and therefore takes effect immediately when this act	1709
becomes law.	1710

Section 812.20. The amendment, enactment, or repeal by this	1711
act of the divisions and sections of law listed below are subject	1712
to the referendum under Ohio Constitution, Article II, Section 1c	1713
and therefore take effect on the ninety-first day after this act	1714
is filed with the Secretary of State.	1715

All Revised Code sections in Section 101 of this act.

1716

Sections 741.10 and 741.20 of this act.

1717