Learn About The Law
Get help with your legal needs
FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.
Current as of January 02, 2024 | Updated by Findlaw Staff
Sec. 23. (a) As used in this section, “covered individual” means an individual who is entitled to coverage under a state employee health plan.
(b) As used in this section, “emergency medical services provider organization” means a provider of emergency medical services that is certified by the Indiana emergency medical services commission as an advanced life support provider organization under rules adopted under IC 16-31-3.
(c) As used in this section, “state employee health plan” means either of the following that provides coverage for emergency medical services:
(1) A self-insurance program established under section 7(b) of this chapter to provide group health coverage.
(2) A contract with a prepaid health care delivery plan that is entered into or renewed under section 7(c) of this chapter.
(d) A state employee health plan that provides coverage for emergency medical services must at least provide reimbursement, subject to applicable deductible and coinsurance, for a covered individual for emergency medical services that are:
(1) rendered by an emergency medical services provider organization;
(2) within the emergency medical services provider organization's scope of practice;
(3) performed or provided as advanced life support services; and
(4) performed or provided during a response initiated through the 911 system, regardless of whether the patient was transported.
(e) The director of the state personnel department may make a determination to provide coverage for emergency medical services as part of a mobile integrated healthcare program described in IC 16-31-12.
(f) If multiple emergency medical services provider organizations qualify and submit a claim for reimbursement under this section for an encounter, the state employee health plan:
(1) may only reimburse, subject to applicable deductible and coinsurance, under this section for one (1) claim per patient encounter; and
(2) shall reimburse, subject to applicable deductible and coinsurance, the claim submitted by the emergency medical services provider organization that performed or provided the majority of advanced life support services for the patient.
(g) The state personnel department may adopt rules under IC 4-22-2 to implement this section.
(h) This section does not restrict the state employee health plan from providing coverage beyond the requirements in this section.
Cite this article: FindLaw.com - Indiana Code Title 5. State and Local Administration § 5-10-8-23 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-5-state-and-local-administration/in-code-sect-5-10-8-23/
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.
A free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw’s Learn About the Law.
Get help with your legal needs
FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.
Search our directory by legal issue
Enter information in one or both fields (Required)