4123-6-58. Provider access to the QHP system - provider participation in QHP system and other related health care program not linked

A QHP or vendor that provides medical management and cost containment services shall not require a provider to participate in a workers' compensation network of providers in order to maintain membership in a related health care program. If the QHP utilizes a leased provider network, the QHP shall not apply the discounted payment rates of the leased network to services rendered by the provider in the QHP unless the signed, written consent of the provider has been obtained.

Five Year Review (FYR) Dates: 08/26/2015 and 08/25/2020
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.121, 4121.30, 4121.31, 4121.44, 4121.441, 4121.442, 4123.05
Rule Amplifies: 4121.12, 4121.121, 4121.44, 4121.441, 4121.442
Prior Effective Dates: 9/6/96, 2/1/10

Prior History: (Effective: 02/01/2010
R.C. 119.032 review dates: 11/17/2009 and 11/01/2014
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.30, 4121.31, 4123.05
Rule Amplifies: 4121.121, 4121.44, 4121.441, 4121.442, 4123.66
Prior Effective Dates: 9/5/96 )