Ohio § 3902.53 Out-of-network care rules, prompt pay requirements, violations

Ohio Statutes

§ 3902.53 — Out-of-network care rules, prompt pay requirements, violations

Ohio § 3902.53

Title 39Insurance

Ch. 3902Insurance Policies And Contracts

This text of Ohio § 3902.53 (Out-of-network care rules, prompt pay requirements, violations) 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. § 3902.53 (2026).

Text

(A)(1) Except as provided in division (A)(2) of this section, sections3901.38to3901.3814of the Revised Code shall not apply with respect to a claim during a period of negotiation under section3902.51of the Revised Code or a period of arbitration under section3902.52of the Revised Code. Sections3901.38to3901.3814of the Revised Code shall apply upon the completion of a successful negotiation or upon the rendering of an arbitration decision.

(2)The superintendent of insurance may adopt rules pursuant to division (D) of section3902.54of the Revised Code specifying situations in which sections3901.38to3901.3814of the Revised Code apply during periods of negotiation under section3902.51of the Revised Code.

(B)A pattern of continuous or repeated violations of section3902.51or3902.52of the Rev

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(A)(1) Except as provided in division (A)(2) of this section, sections3901.38to3901.3814of the Revised Code shall not apply with respect to a claim during a period of negotiation under section3902.51of the Revised Code or a period of arbitration under section3902.52of the Revised Code. Sections3901.38to3901.3814of the Revised Code shall apply upon the completion of a successful negotiation or upon the rendering of an arbitration decision.

(2) The superintendent of insurance may adopt rules pursuant to division (D) of section3902.54of the Revised Code specifying situations in which sections3901.38to3901.3814of the Revised Code apply during periods of negotiation under section3902.51of the Revised Code.

(B) A pattern of continuous or repeated violations of section3902.51or3902.52of the Revised Code by a health plan issuer is an unfair and deceptive act or practice in the business of insurance under sections3901.19to3901.26of the Revised Code.

(C) A provider who violates section3902.51or3902.52of the Revised Code shall be subject to professional discipline under Title XLVII of the Revised Code as applicable.