(a) As used in this section:(1) “Health carrier” means a:(A) Health maintenance organization;(B) Hospital medical service corporation; and(C) Disability insurance company;(2) “Health carrier” includes a:(A) Self-insured governmental or church plan; and(B) Third-party administrator that administers or adjusts disability benefits for a disability insurer, hospital medical service corporation, health maintenance organization, self-insured governmental plan, or self-insured church plan; and(3) “Health carrier” does not include:(A) An automobile insurer paying medical or hospital benefits under § 23-89-202(1) or a self-insured employer health benefits plan; or(B) A person, company, or organization licensed or registered to issue or that issues an insurance policy or insurance contract in this state as described in §§ 23-62-102 and 23-62-104 — 23-62-107 providing medical or hospital benefits for accidental injury or disability.
(1) “Health carrier” means a:(A) Health maintenance organization;(B) Hospital medical service corporation; and(C) Disability insurance company;
(A) Health maintenance organization;
(B) Hospital medical service corporation; and
(C) Disability insurance company;
(2) “Health carrier” includes a:(A) Self-insured governmental or church plan; and(B) Third-party administrator that administers or adjusts disability benefits for a disability insurer, hospital medical service corporation, health maintenance organization, self-insured governmental plan, or self-insured church plan; and
(A) Self-insured governmental or church plan; and
(B) Third-party administrator that administers or adjusts disability benefits for a disability insurer, hospital medical service corporation, health maintenance organization, self-insured governmental plan, or self-insured church plan; and
(3) “Health carrier” does not include:(A) An automobile insurer paying medical or hospital benefits under § 23-89-202(1) or a self-insured employer health benefits plan; or(B) A person, company, or organization licensed or registered to issue or that issues an insurance policy or insurance contract in this state as described in §§ 23-62-102 and 23-62-104 — 23-62-107 providing medical or hospital benefits for accidental injury or disability.
(A) An automobile insurer paying medical or hospital benefits under § 23-89-202(1) or a self-insured employer health benefits plan; or
(B) A person, company, or organization licensed or registered to issue or that issues an insurance policy or insurance contract in this state as described in §§ 23-62-102 and 23-62-104 — 23-62-107 providing medical or hospital benefits for accidental injury or disability.
(b) A health carrier that excludes or denies coverage for a specific surgical product or medical device approved for marketing by the United States Food and Drug Administration as experimental or investigational, or both, shall develop a process by which a surgeon, before utilizing the surgical product or medical device, may present medical evidence to obtain a review for the individual patient for coverage of the surgical product or medical device.