OH SB136

Requires health insuring corporations and utilization review organizations to provide written authorization for health care services and prohibits retroactive denial of authorized services unless the authorization was based on fraudulent information provided by the enrollee or provider.

Establishes timeframes for third-party payers to process and pay or deny claims: 15 days for electronically submitted claims and 30 days for non-electronic submissions on standard claim forms, with extensions up to 45 days if supporting documentation is needed.

Requires third-party payers that mandate prior authorization or precertification to maintain current requirements on their websites, provide 60 days' notice of changes to providers, establish web-based authorization systems, and publicly disclose approval and denial statistics by specialty, service type, and reason for denial.

Changes the payment finality period from two years to 180 days, after which third-party payers cannot adjust payments except for fraud, and limits overpayment recovery to claims initiated before the payment becomes final.

Requires 90 days' written notice to providers before material amendments to health care contracts take effect; if providers object within 15 days and no resolution occurs, either party may terminate the contract or the amendment does not become part of the contract.