Ohio § 5121.43 Insurance covering patient expenses - payment over to department

Ohio Statutes

§ 5121.43 — Insurance covering patient expenses - payment over to department

Ohio § 5121.43

Title 51Public Welfare

Ch. 5121Welfare Institutions - Generally

This text of Ohio § 5121.43 (Insurance covering patient expenses - payment over to department) 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. § 5121.43 (2026).

Text

(A)If a patient is covered by an insurance policy or other contract that provides for payment of expenses for care and treatment for mental illness at or from a hospital operated by the department of mental health and addiction services, all of the following apply with respect to the amount owed to the department for such care and treatment:

(1)The insured, policy owner, or other person having an interest in the policy or other contract shall assign payment directly to the department of all assignable benefits under the policy or other contract and shall pay to the department, within ten days of receipt, all insurance or other benefits received as reimbursement or payment for expenses incurred by the patient or for any other reason.

(2)(a) Regardless of the coverage provided by the polic

Free access — add to your briefcase to read the full text and ask questions with AI

(A) If a patient is covered by an insurance policy or other contract that provides for payment of expenses for care and treatment for mental illness at or from a hospital operated by the department of mental health and addiction services, all of the following apply with respect to the amount owed to the department for such care and treatment:(1) The insured, policy owner, or other person having an interest in the policy or other contract shall assign payment directly to the department of all assignable benefits under the policy or other contract and shall pay to the department, within ten days of receipt, all insurance or other benefits received as reimbursement or payment for expenses incurred by the patient or for any other reason.

(2)(a) Regardless of the coverage provided by the policy or other contract, the patient, patient's estate, or patient's liable relative is liable to the department for the actual cost of care and treatment calculated under section5121.33of the Revised Code.

(b) If the amount the department receives through the assignment of benefits, as required by division (A)(1) of this section, is less than the actual cost of care and treatment that is calculated under section5121.33of the Revised Code, the department shall charge the patient, patient's estate, or liable relative the lesser of the following:

(i) The amount calculated under section5121.33of the Revised Code that remains after subtracting the amount the department receives through the assignment of benefits;

(ii) The amount calculated under section5121.33of the Revised Code that applies after the department takes into consideration the exceptions described in sections5121.35,5121.46,5121.47,5121.49, and5121.52of the Revised Code.

(3) In no event shall a patient, patient's estate, or liable relative have liability under this section for an amount that exceeds either, as the case may be, the department's actual cost of providing care and treatment to a patient calculated under section5121.33of the Revised Code or the amount that is charged under division (A)(2)(b) of this section.

(B) With respect to the requirements of division (A)(1) of this section, both of the following apply:

(1) The department may disqualify patients and liable relatives who have failed to assign benefits in accordance with division (A)(1) of this section, and retained third party funds, from future discounts that otherwise may have been available.

(2) The department may request that the attorney general petition a court of competent jurisdiction to compel an insured, policy owner, or other person having an interest in the policy or other contract to comply with the assignment requirements of division (A)(1) of this section.

Last updated October 17, 2025 at 10:45 AM