130th Ohio General Assembly
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S. B. No. 55  As Introduced
As Introduced

129th General Assembly
Regular Session
2011-2012
S. B. No. 55


Senator Tavares 



A BILL
To enact sections 1751.76, 3923.71, and 3923.74 of the Revised Code to prohibit health insurers from denying payment for a service during or after the performance of the service if the insurer provided prior written authorization for the service.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 1751.76, 3923.71, and 3923.74 of the Revised Code be enacted to read as follows:
Sec. 1751.76.  No health insuring corporation that agrees in writing to provide coverage for the performance of a service prior to the performance of the service shall deny payment for the service during or after the performance of the service unless the health insuring corporation's written agreement to provide coverage for the service was based upon inaccurate information provided to the health insuring corporation by the enrollee or health care provider.
Sec. 3923.71.  No sickness and accident insurer that agrees in writing to provide coverage for the performance of a service prior to the performance of the service shall deny payment for the service during or after the performance of the service unless the insurer's written agreement to provide coverage for the service was based upon inaccurate information provided to the insurer by the insured or the health care provider.
Sec. 3923.74.  No public employee benefit plan that agrees in writing to provide coverage for the performance of a service prior to the performance of the service shall deny payment for the service during or after the performance of the service unless the public employee benefit plan's written agreement to provide coverage for the service was based upon inaccurate information provided to the public employee benefit plan by the plan member, covered dependent, or health care provider.
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