Ohio § 1739.061

§ 1739.061.

(A)(1) This section applies to both of the following: (a) A multiple employer welfare arrangement that issues or requires the use of a standardized

identification card or an electronic technology for submission and routing of prescription

drug claims; (b) A person or entity that a multiple employer welfare arrangement contracts with to

issue a standardized identification card or an electronic technology described in

division (A)(1)(a) of this section. (2) Notwithstanding division (A)(1) of this section, this section does not apply to the

issuance or required use of a standardized identification card or an electronic technology

for the submission and routing of prescription drug claims in connection with any

of the following: (a) Any program or arrangement covering only accident, credit, dental, disability income,

long-term care, hospital indemnity, medicare supplement, medicare, tricare, specified

disease, or vision care;  coverage under a one-time-limited-duration policy that is

less than twelve months;  coverage issued as a supplement to liability insurance;

 insurance arising out of workers' compensation or similar law;  automobile medical

payment insurance;  or insurance under which benefits are payable with or without

regard to fault and which is statutorily required to be contained in any liability

insurance policy or equivalent self-insurance. (b) Coverage provided under the medicaid program. (c) Coverage provided under an employer's self-insurance plan or by any of its administrators,

as defined in section 3959.01 of the Revised Code , to the extent that federal law supersedes, preempts, prohibits, or otherwise precludes

the application of this section to the plan and its administrators. (B) A standardized identification card or an electronic technology issued or required

to be used as provided in division (A)(1) of this section shall contain uniform prescription

drug information in accordance with either division (B)(1) or (2) of this section. (1) The standardized identification card or the electronic technology shall be in a format

and contain information fields approved by the national council for prescription drug

programs or a successor organization, as specified in the council's or successor organization's

pharmacy identification card implementation guide in effect on the first day of October

most immediately preceding the issuance or required use of the standardized identification

card or the electronic technology. (2) If the multiple employer welfare arrangement or person under contract with it to

issue a standardized identification card or an electronic technology requires the

information for the submission and routing of a claim, the standardized identification

card or the electronic technology shall contain any of the following information: (a) The name of the multiple employer welfare arrangement; (b) The individual's name, group number, and identification number; (c) A telephone number to inquire about pharmacy-related issues; (d) The issuer's international identification number, labeled as “ANSI BIN” or “RxBIN”; (e) The processor's control number, labeled as “RxPCN”; (f) The individual's pharmacy benefits group number if different from the insured's medical

group number, labeled as “RxGrp.” (C) If the standardized identification card or the electronic technology issued or required

to be used as provided in division (A)(1) of this section is also used for submission

and routing of nonpharmacy claims, the designation “Rx” is required to be included

as part of the labels identified in divisions (B)(2)(d) and (e) of this section if

the issuer's international identification number or the processor's control number

is different for medical and pharmacy claims. (D) Each multiple employer welfare arrangement described in division (A) of this section

shall annually file a certificate with the superintendent of insurance certifying

that it or any person it contracts with to issue a standardized identification card

or electronic technology for submission and routing of prescription drug claims complies

with this section. (E)(1) Except as provided in division (E)(2) of this section, if there is a change in the

information contained in the standardized identification card or the electronic technology

issued to an individual, the multiple employer welfare arrangement or person under

contract with it to issue a standardized identification card or an electronic technology

shall issue a new card or electronic technology to the individual. (2) A multiple employer welfare arrangement or person under contract with it is not required

under division (E)(1) of this section to issue a new card or electronic technology

to an individual more than once during a twelve-month period. (F) Nothing in this section shall be construed as requiring a multiple employer welfare

arrangement to produce more than one standardized identification card or one electronic

technology for use by individuals accessing health care benefits provided under a

multiple employer welfare arrangement.