Ohio Code 3922.20 – Admissibility of written decision or medicare reimbursement standards
Consistent with the Rules of Evidence, a written decision or opinion prepared by an independent review organization under this chapter shall be admissible in any civil action related to the coverage decision that was the subject of the decision or opinion. The independent review organization‘s decision or opinion shall be presumed to be a scientifically valid and accurate description of the state of medical knowledge at the time it was written.
Terms Used In Ohio Code 3922.20
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Independent review organization: means an entity that is accredited to conduct independent external reviews of adverse benefit determinations pursuant to section 3922. See Ohio Code 3922.01
- state: means the state of Ohio. See Ohio Code 1.59
Consistent with the Rules of Evidence, any party to a civil action related to a plan’s decision involving an investigational or experimental drug, device, or treatment may introduce into evidence any applicable medicare reimbursement standards established under Title XVIII of the “Social Security Act,” 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended.