The bill amends section 3901.385 of the Revised Code to enhance protections for health care providers against unfair reimbursement practices by third-party payers. It prohibits these payers from engaging in business practices that unnecessarily delay claim processing or payment, and specifically prohibits them from reducing reimbursement for covered health care services based on their own interpretations of service descriptions or diagnosis codes.

Key insertions in the bill include a new provision that explicitly states third-party payers cannot reduce reimbursements based on their own descriptions of services outside of established coding guidelines, nor can they deny claims based on the timing of additional services billed on the same date. The bill also removes the phrase "either" from the existing language, streamlining the prohibitions against unfair practices. Overall, the legislation aims to ensure timely and fair compensation for health care providers.

Statutes affected:
As Introduced: 3901.385