Indiana Code 27-1-37.6-17. Notice of participation requirements
Current as of: 2023 | Check for updates
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Sec. 17. (a) A health plan shall notify a health care provider of any requirements that a health care provider must meet to participate in a program under section 16 of this chapter.
(1) A statement that the health care provider qualifies to participate in the program.
(b) If a health plan determines that a health care provider is qualified to participate in a program established under section 16 of this chapter, the health plan shall send a notice to the health care provider that contains the following information:
Terms Used In Indiana Code 27-1-37.6-17
- health care provider: means an individual or entity that is:
Indiana Code 27-1-37.6-7
- health care service: means a medical or surgical service for the diagnosis, prevention, treatment, cure, or relief of illness, injury, or disease that is measured at the diagnosis and procedure level for an individual health care provider. See Indiana Code 27-1-37.6-8
- health plan: means any of the following:
Indiana Code 27-1-37.6-9
- prior authorization: means a practice implemented by a health plan through which coverage of a health care service is dependent on the covered individual or health care provider obtaining approval from the health plan before the health care service is rendered. See Indiana Code 27-1-37.6-12
(2) A list of each type of health care service that is subject to the elimination or reduction of prior authorization requirements under the program.
As added by P.L.203-2023, SEC.19.