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Indiana Statutes, Title 27

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Indiana/Statutes

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Title 27, INSURANCE

344 chapters · 3,652 sections in this title.

All chapters in Title 273,652 Ch 1, Department Created215 Ch 2, Application of Article; Definitions199 Ch 3, General Powers and Duties of the Dep…199 Ch 4, Prohibited Activities106 Ch 6, Formation of Domestic Companies100 Ch 10, Voluntary Dissolution99 Ch 5, Classification of Insurance97 Ch 9, Merger, Consolidation, and Reinsurance97 Ch 8, Procedures for Amending Articles of …96 Ch 12, Life Insurance Company Powers and Po…92 Ch 7, General Corporate Powers and Respons…84 Ch 36, Risk Based Capital Requirements75 Ch 15, Participating Providers; Contracts a…68 Ch 13, Casualty, Fire, and Marine Insurance…66

13 sections·Filtered byTitle 27✕Ch 45.2✕

Ind. Code § 27-1-45.2-1 Application of chapter
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Sec. 1. This chapter applies to any dispute subject to the federal independent dispute resolution process established under Section 2799A-1 of the Public Health Service Act (42 U.S.C. 300gg-111) and its implementing regulations. As added by P.L.119-2026, SEC.1.
Ind. Code § 27-1-45.2-10 Notice of request for independent dispute resolution
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Sec. 10. (a) An initiating party that submits a request for independent dispute resolution shall provide written notice to the facility not later than three (3) business days after submitting the request. (b) The notice required under subsection (a) must, at a minimum, include a …
Ind. Code § 27-1-45.2-11 Notice; good faith negotiation
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Sec. 11. (a) If, during any ninety (90) day period, an initiating party submits requests for independent dispute resolutions that, in the aggregate, include twenty-five (25) or more qualified disputes, the health carrier may: (1) provide written notice to the out of network provi…
Ind. Code § 27-1-45.2-12 Memorandum of conference
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Sec. 12. (a) A conference under section 11(b) of this chapter must result in a written memorandum of conference. (b) The memorandum must include the following information for the disputes reviewed: (1) Identification of the disputes. (2) The initial paid claim amount made by the …

Ind. Code § 27-1-45.2-13 Prohibition on administrative fees or penalties for care involving out of network providers

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Sec. 13. (a) A health carrier may not assess a facility or a provider an administrative fee or penalty related to the provision of care to an individual that involves an out of network provider. (b) If a health carrier assesses an administrative fee or penalty under subsection (a…

Ind. Code § 27-1-45.2-2 "Claim specific payment information"

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Sec. 2. (a) As used in this chapter, "claim specific payment information" means billed charges, allowed amounts, payment amounts, cost sharing amounts, and any other monetary amounts associated with the adjudication of an identifiable health care claim. (b) The term does not incl…

Ind. Code § 27-1-45.2-3 "Facility"

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Sec. 3. As used in this chapter, "facility" means a licensed health care facility in which health care services are provided to individuals. As added by P.L.119-2026, SEC.1.

Ind. Code § 27-1-45.2-4 "Health carrier"

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Sec. 4. (a) As used in this chapter, "health carrier" means an entity: (1) that is subject to this title and the administrative rules adopted under this title; and (2) that enters into a contract to: (A) provide health care services; (B) deliver health care services; (C) arrange …

Ind. Code § 27-1-45.2-5 "Independent dispute resolution"

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Sec. 5. As used in this chapter, "independent dispute resolution" means the federal independent dispute resolution process established under 42 U.S.C. 300gg-111 and 45 CFR Part 149, Subpart F. As added by P.L.119-2026, SEC.1.

Ind. Code § 27-1-45.2-6 "Initiating party"

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Sec. 6. As used in this chapter, "initiating party" means a health carrier or out of network provider that submits a request for independent dispute resolution under federal law. As added by P.L.119-2026, SEC.1.

Ind. Code § 27-1-45.2-7 "Out of network provider"

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Sec. 7. As used in this chapter, "out of network provider" means a provider that is not contracted with a health carrier to provide health care services to covered individuals at not more than a preestablished rate or amount of compensation. As added by P.L.119-2026, SEC.1.

Ind. Code § 27-1-45.2-8 "Provider"

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Sec. 8. As used in this chapter, "provider" means an individual licensed or legally authorized to provide health care services. As added by P.L.119-2026, SEC.1.

Ind. Code § 27-1-45.2-9 "Qualified dispute"

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Sec. 9. As used in this chapter, "qualified dispute" means a distinct item or service that is included in a request for independent dispute resolution. As added by P.L.119-2026, SEC.1.