Ohio Department of Insurance Requires Health Insurers to Update Directories on a Regular Basis

Beginning in January 2016, health insurance plans must comply with new requirements to ensure network information is accessible.  

Beginning in 2016, Ohio’s health insurance companies must meet new expectations regarding their provider directories. The Ohio Department of Insurance will now require health insurers to update their directories of healthcare providers at least every 3 months. 

Another provision of this rule mandates that insurance companies must update their directory to reflect the change within 15 days of a doctor or other provider leaving their network, and they must also notify any of their customers who have received care from that provider in the previous year of the change as well. 

As of right now, there are no official fines or penalties for violations of the new rule; however, if the directories are not kept current, insurers will not be permitted to pass on additional costs of an out-of-network provider if the provider is listed in their directory as “in-network.” 

The insurance directory must also show whether providers are accepting new patients, and it has to include locations where a doctor or provider’s care would be considered “in-network.” The directory also has to include a statement about how an in-network hospital might employ out-of-network providers and specialists, such as anesthesiologists, radiologists, and laboratories.

To view the ODI rule click here.

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