Indiana Code 34-30-15-7. Health care providers under investigation; health maintenance organizations
(1) a health maintenance organization (as defined in IC 27-13-1-19); or
Terms Used In Indiana Code 34-30-15-7
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Contract: A legal written agreement that becomes binding when signed.
- Oral argument: An opportunity for lawyers to summarize their position before the court and also to answer the judges' questions.
(b) Before:
(1) taking corrective action against a professional health care provider who is under contract with but not employed by the health maintenance organization or limited service health maintenance organization; or
(2) taking action to terminate a contract with a professional health care provider who is not employed by the health maintenance organization or limited service health maintenance organization;
based upon an evaluation of patient care rendered by the professional health care provider, the organization shall grant the health care provider affected by the action one (1) evidentiary hearing before a peer review committee of the organization and, at the health provider’s request, an appeal of the peer review committee’s decision.
(c) Unless otherwise agreed to by the organization and the health care provider, the appeal must be limited to a review of the record of the hearing before the peer review committee and a review of all or part of the peer review committee’s decision.
(d) The appeal must be held before the governing board of the organization or, at the governing board’s discretion, before a committee of the governing board.
(e) The health care provider is entitled to submit written materials in support of the appeal and, at the discretion of the governing board or committee of the board conducting the appeal, the health care provider may be allowed to present oral argument in support of the appeal.
[Pre-1998 Recodification Citation: 34-4-12.6-2(g).]
As added by P.L.1-1998, SEC.26.