Indiana Code 27-1-37-6. Requiring provider to provide health care services
(b) A person may require a provider, as a condition of entering into a health provider contract for the provision of health care services other than health care services to enrollees of a health maintenance organization, to provide health care services to enrollees of a health maintenance organization:
Terms Used In Indiana Code 27-1-37-6
- Contract: A legal written agreement that becomes binding when signed.
- emergency: means a medical condition that arises suddenly and unexpectedly and manifests itself by acute symptoms of such severity, including severe pain, that the absence of immediate medical attention could reasonably be expected by a prudent lay person who possesses an average knowledge of health and medicine to:
Indiana Code 27-1-37-1
- health maintenance organization: means a person that undertakes to provide or arrange for the delivery of health care services to individuals on a prepaid basis, except for the individual's responsibility for copayments or deductibles. See Indiana Code 27-1-37-2
- health provider contract: means an agreement with a provider or a health provider facility relating to terms and conditions of reimbursement for health care services provided to an individual under:
Indiana Code 27-1-37-3
- person: means an individual, an agency, a political subdivision, a partnership, a corporation, an association, or any other entity. See Indiana Code 27-1-37-4
- provider: means an individual or entity licensed or legally authorized to provide health care services. See Indiana Code 27-1-37-5
(2) upon referral.
(c) If a person requires a provider to provide health care services to enrollees of a health maintenance organization under subsection (b), the person:
(1) shall reimburse the provider at rates established under the health provider contract; and
(2) may not require the provider to comply with the terms and conditions of the health maintenance organization.
As added by P.L.197-2001, SEC.1.