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Current as of January 02, 2024 | Updated by Findlaw Staff
Sec. 8. (a) This section applies to a health provider contract entered into, amended, or renewed after June 30, 2025.
(b) A health provider contract, including a contract with a pharmacy benefit manager, may not contain a provision that does any of the following:
(1) Limits the ability of the health carrier, the health provider facility, or the provider to disclose the allowed amount and fees of services to any insured (as defined in IC 27-8-5.8-3) or enrollee (as defined in IC 27-13-1-12), or to the treating health provider facility or provider of the insured or enrollee.
(2) Limits the ability of the health carrier, the health provider facility, or the provider to disclose out-of-pocket costs to an insured (as defined in IC 27-8-5.8-3) or an enrollee (as defined in IC 27-13-1-12).
(3) Limits the ability of the health carrier to introduce or modify a select network plan or tiered network plan by granting the provider a guaranteed right of participation.
(4) Requires the health carrier to place all facilities in the same tier of a tiered network plan.
(5) Requires the health carrier to include all facilities in a select network plan on an all-or-nothing basis.
(6) Requires a provider to participate in a new select network or tiered network plan that the health carrier introduces without granting the provider the right to opt out of the new plan at least sixty (60) days before the new plan is submitted to the commissioner for approval.
(c) Any provision of a health provider contract that includes a provision described in subsection (b) in violation of this section is severable and the provision in violation is null and void. The remaining provisions of the health provider contract, excluding the provision in violation of this section, remain in effect and are enforceable.
(d) The attorney general may issue a civil investigative demand to obtain information from a party of, or pertaining to, a health provider contract and compliance of this section.
Cite this article: FindLaw.com - Indiana Code Title 27. Insurance § 27-1-37-8 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-27-insurance/in-code-sect-27-1-37-8/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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