Ohio § 3901.83 Definitions for sections 3901.83 to 3901.833

Ohio Statutes

§ 3901.83 — Definitions for sections 3901.83 to 3901.833

Ohio § 3901.83

Title 39Insurance

Ch. 3901Superintendent Of Insurance

This text of Ohio § 3901.83 (Definitions for sections 3901.83 to 3901.833) is published on Counsel Stack Legal Research, covering Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ohio Rev. Code Ann. § 3901.83 (2026).

Text

As used in sections3901.83to3901.833of the Revised Code:

(A)"Clinical practice guidelines" means a systematically developed statement to assist health care provider and patient decisions with regard to appropriate health care for specific clinical circumstances and conditions.

(B)"Clinical review criteria" means the written screening procedures, decision abstracts, clinical protocols, and clinical practice guidelines used by a health plan issuer or utilization review organization to determine whether or not health care services or drugs are appropriate and consistent with medical or scientific evidence.

(C)"Health benefit plan" and "health plan issuer" have the same meanings as in section3922.01of the Revised Code.

(D)"Medical or scientific evidence" has the same meaning as in sect

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As used in sections3901.83to3901.833of the Revised Code:

(A) "Clinical practice guidelines" means a systematically developed statement to assist health care provider and patient decisions with regard to appropriate health care for specific clinical circumstances and conditions.

(B) "Clinical review criteria" means the written screening procedures, decision abstracts, clinical protocols, and clinical practice guidelines used by a health plan issuer or utilization review organization to determine whether or not health care services or drugs are appropriate and consistent with medical or scientific evidence.

(C) "Health benefit plan" and "health plan issuer" have the same meanings as in section3922.01of the Revised Code.

(D) "Medical or scientific evidence" has the same meaning as in section3922.01of the Revised Code.

(E) "Step therapy exemption" means an overriding of a step therapy protocol in favor of immediate coverage of the health care provider's selected prescription drug.

(F) "Step therapy protocol" means a protocol or program that establishes a specific sequence in which prescription drugs that are for a specified medical condition and that are consistent with medical or scientific evidence for a particular patient are covered, under either a medical or prescription drug benefit, by a health benefit plan, including both self- administered and physician-administered drugs.

(G) "Urgent care services" has the same meaning as in section3923.041of the Revised Code.

(H) "Utilization review organization" has the same meaning as in section1751.77of the Revised Code.