{"data":{"id":"us-oh/ohio-rev.-code-3901.831","jurisdiction":"us-oh","citation":"Ohio Rev. Code § 3901.831","heading":"Implementation of step therapy protocol.","body":"(A) If a health plan issuer or a utilization review organization implements a step therapy protocol, that protocol shall be implemented via clinical review criteria that are based on clinical practice guidelines or medical or scientific evidence.\n(B) When establishing a step therapy protocol, a health plan issuer and a utilization review organization shall also take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria.\n(C) This section shall not be construed as requiring either a health plan issuer or the state to set up a new entity to develop clinical review criteria for step therapy protocols.","path":["Title 39 Insurance","Chapter 3901 Superintendent Of Insurance"],"source_url":"https://codes.ohio.gov/ohio-revised-code/section-3901.831","current_through":"2019-04-05 (Senate Bill 265 - 132nd General Assembly)","vintage":"","retrieved_at":"2026-09-14T19:24:35Z","sha256":"bd728b1481949ef0f7027d340de98fadc6e26c3cfa2669c41c4792eac60893bc","source_id":"us-oh","stale":false,"prev":"us-oh/ohio-rev.-code-3901.83","next":"us-oh/ohio-rev.-code-3901.832"},"notice":"GroundRules: Original legal text. Not legal advice."}