Sec. 11. (a) This section does not apply to an individual who is a Medicaid recipient.

     (b) An individual for whom a nonemergency health care service has been ordered, scheduled, or referred may request from the practitioner who may provide the nonemergency health care service a good faith estimate of the total price the practitioner will charge for providing the nonemergency health care service.

Terms Used In Indiana Code 25-1-9.8-11

  • good faith estimate: means a reasonable estimate of the price each provider anticipates charging for an episode of care for nonemergency health care services that:

    Indiana Code 25-1-9.8-2

  • nonemergency health care service: means a discrete service or series of services ordered by a practitioner for an episode of care for the:

    Indiana Code 25-1-9.8-7

  • practitioner: means the following:

    Indiana Code 25-1-9.8-8

  • price: means the negotiated rate between the:

    Indiana Code 25-1-9.8-8.5

     (c) A practitioner who receives a request from a patient under subsection (b) shall, not more than five (5) business days after receiving relevant information from the individual, provide to the individual a good faith estimate of the price that the practitioner will charge for providing the nonemergency health care service.

     (d) A practitioner must ensure that a good faith estimate provided to an individual under this section is accompanied by a notice stating that:

(1) an estimate provided under this section is not binding on the practitioner;

(2) the price the practitioner charges the individual may vary from the estimate based on the individual’s medical needs; and

(3) the estimate provided under this section is only valid for thirty (30) days.

     (e) A practitioner may not charge an individual for information provided under this section.

As added by P.L.93-2020, SEC.7.