Indiana Code 12-15-12-15. Coverage for emergency services
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Sec. 15. A managed care organization shall:
(2) beginning July 1, 2001, neither deny nor fail to process a claim for reimbursement for emergency services on the basis that the enrollee’s primary care provider’s authorization code for the services was not obtained before or after the services were rendered.
(1) cover and pay for all medically necessary screening services provided to an individual who presents to an emergency department with an emergency medical condition; and
Terms Used In Indiana Code 12-15-12-15
- emergency medical condition: means a medical condition manifesting itself by acute symptoms, including severe pain, of sufficient severity that a prudent lay person with an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in:
Indiana Code 12-15-12-0.3
- emergency services: means covered inpatient and outpatient services that are:
Indiana Code 12-15-12-0.5
As added by P.L.223-2001, SEC.7. Amended by P.L.152-2017, SEC.15.