Indiana Code 27-13-36.2-8. Claim payment errors
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Sec. 8. (a) A health maintenance organization may not, more than two (2) years after the date on which an overpayment on a provider claim was made to the provider by the health maintenance organization:
(2) adjust a subsequent claim filed by the provider as a method of obtaining reimbursement of the overpayment from the provider.
(1) request that the provider repay the overpayment; or
Terms Used In Indiana Code 27-13-36.2-8
- Fraud: Intentional deception resulting in injury to another.
- health maintenance organization: includes :
Indiana Code 27-13-36.2-2
(b) A health maintenance organization may not be required to correct a payment error to a provider more than two (2) years after the date on which a payment on a provider claim was made to the provider by the health maintenance organization.
(c) This section does not apply in cases of fraud by the provider, the enrollee, or the health maintenance organization with respect to the claim on which the overpayment or underpayment was made.
As added by P.L.55-2006, SEC.3.