OH SB165

Health insuring corporations and sickness/accident insurers prohibited from reducing or denying claims based solely on diagnosis codes, ICD codes, appointment duration deemed clinically necessary by the provider, or procedure codes on reimbursement forms

Insurers cannot deny emergency service claims based on the absence of an emergency medical condition if a prudent layperson would have reasonably expected an emergency to be present

Expands the definition of "emergency medical condition" to include both physical and mental health conditions with acute symptoms severe enough that a reasonable person would expect serious health consequences without immediate attention

Applies to both health insuring corporations (HMOs) and individual/group sickness and accident insurance policies providing hospital, surgical, or medical expense coverage

Insurers remain subject to existing prompt payment requirements under Ohio Revised Code sections 3901.381 to 3901.3814