SB 393 Summary

• Creates the Ohio Health Insurance Oversight Board within the Department of Insurance, consisting of 18 members including physicians, other healthcare professionals, consumer representatives, and hospital/nursing staff appointed by the superintendent of insurance.

• Transfers external review authority from independent review organizations to panels of three clinical peers appointed by the newly created board, with random selection based on medical specialty qualifications.

• Reduces internal review timeframe from 30 days to 14 days for health insuring corporations, and establishes that failure to respond within required timeframes constitutes a denial allowing external review.

• Grants the board authority to oversee health insurance policies for reasonableness and patient safety consistency, with power to issue warnings and recommend fines to the superintendent for non-compliance by insurers.

• Requires the superintendent to impose a fine equal to three times the cost of medical care provided when an adverse benefit determination is overturned through external review.