Ohio § 3922.06 Reconsideration by issuer

Ohio Statutes

§ 3922.06 — Reconsideration by issuer

Ohio § 3922.06

Title 39Insurance

Ch. 3922External Review

This text of Ohio § 3922.06 (Reconsideration by issuer) 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. § 3922.06 (2026).

Text

Except for when an expedited request is made  under section3922.09or3922.10of the Revised Code, an  independent review organization shall forward upon receipt a copy  of any information received from a covered person pursuant to  division (D)(1) of section3922.05of the Revised Code, as well as  any other information received from the covered person, to the  health plan issuer.

Upon receipt of that information or the information described  in division (K) of section3922.10of the Revised Code, a health  plan issuer may reconsider its adverse benefit determination and  provide coverage for the health service in question.

Reconsideration of an adverse benefit determination by a  health plan issuer based upon receipt of information under this  section shall not delay or terminate an external 

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Except for when an expedited request is made under section3922.09or3922.10of the Revised Code, an independent review organization shall forward upon receipt a copy of any information received from a covered person pursuant to division (D)(1) of section3922.05of the Revised Code, as well as any other information received from the covered person, to the health plan issuer.

Upon receipt of that information or the information described in division (K) of section3922.10of the Revised Code, a health plan issuer may reconsider its adverse benefit determination and provide coverage for the health service in question.

Reconsideration of an adverse benefit determination by a health plan issuer based upon receipt of information under this section shall not delay or terminate an external review.

If a health plan issuer reverses an adverse benefit determination under this section, the health plan issuer shall notify, in writing and within one business day of making such a decision, the covered person, the assigned independent review organization, and the superintendent of insurance.

Upon receipt of such a notification, the assigned independent review organization shall terminate the associated external review.