Ohio Code 4731.72 – Physician’s bill for anatomical pathology services
(A) As used in this section:
Terms Used In Ohio Code 4731.72
- Another: when used to designate the owner of property which is the subject of an offense, includes not only natural persons but also every other owner of property. See Ohio Code 1.02
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Person: includes an individual, corporation, business trust, estate, trust, partnership, and association. See Ohio Code 1.59
(1) “Anatomic pathology services,” “assignment of benefits,” “histologic processing,” “insurer,” “physician,” and “referring clinical laboratory” have the same meanings as in section 3701.86 of the Revised Code.
(2) “Professional component of an anatomic pathology service” means the entire anatomic pathology service other than histologic processing.
(3) “Technical component of an anatomic pathology service” means only histologic processing.
(B) No physician shall present or cause to be presented a claim, bill, or demand for payment for anatomic pathology services to any person or entity other than the following:
(1) The patient who receives the services or another individual, such as a parent, spouse, or guardian, who is responsible for the patient’s bills;
(2) A responsible insurer or other third-party payor of a patient who receives the services;
(3) A hospital, public health clinic, or not-for-profit health clinic ordering the services;
(4) A referring clinical laboratory;
(5) A governmental agency or any person acting on behalf of a governmental agency;
(6) A physician who is permitted to bill for the services under division (D) of this section.
(C) Except as provided in division (D) of this section, no physician shall charge, bill, or otherwise solicit payment, directly or indirectly, for anatomic pathology services unless the services are personally rendered by the physician or rendered under the on-site supervision of the physician.
(D) A physician who performs the professional component of an anatomic pathology service on a patient specimen may bill for the amount incurred in doing either of the following:
(1) Having a clinical laboratory or another physician perform the technical component of the anatomic pathology service;
(2) Obtaining another physician’s consultation regarding the patient specimen.
(E) A violation of division (B) or (C) of this section constitutes a reason for taking action under division (B)(20) of section 4731.22 of the Revised Code.
(F) Nothing in this section shall be construed to mandate the assignment of benefits for anatomic pathology services.