Sec. 1301.155

Sec. 1301.155.  EMERGENCY CARE.  (a)  In this section, "emergency care" means health care services provided in a hospital emergency facility, freestanding emergency medical care facility, or comparable emergency facility to evaluate and stabilize a medical condition of a recent onset and severity, including severe pain, that would lead a prudent layperson possessing an average knowledge of medicine and health to believe that the person's condition, sickness, or injury is of such a nature that failure to get immediate medical care could result in:

(1)  placing the person's health in serious jeopardy;

(2)  serious impairment to bodily functions;

(3)  serious dysfunction of a bodily organ or part;

(4)  serious disfigurement; or

(5)  in the case of a pregnant woman, serious jeopardy to the health of the fetus.

(b)  If an insured cannot reasonably reach a preferred provider, an insurer shall provide reimbursement for the following emergency care services at the preferred level of benefits until the insured can reasonably be expected to transfer to a preferred provider:

(1)  a medical screening examination or other evaluation required by state or federal law to be provided in the emergency facility of a hospital that is necessary to determine whether a medical emergency condition exists;

(2)  necessary emergency care services, including the treatment and stabilization of an emergency medical condition; and

(3)  services originating in a hospital emergency facility or freestanding emergency medical care facility following  treatment or stabilization of an emergency medical condition.