Ind. Code §§ 27-13-36-1 through 27-13-36-12: Health Maintenance Organizations — Patient Protection; Clinical Decision Making; Access to Personnel and Facilities – Indiana

Status: Enacted
Year Enacted: 1998
Year Amended: 2018
File: Download

Statutes require each HMO to demonstrate to the department that the HMO offers an adequate number of acute hospital services, primary care providers and other appropriate providers. When an enrollee receives health care service from an out of network provider to whom they were referred, the provider may collect from the enrollee only the deductible or copayment the enrollee would be responsible for if the services had been provided by a participating provider. See definition section Ind. Code §§ 27-13-1-1 through 27-13-1-34.

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