§ 27-1-37.5-27 — Utilization review entity's duty to honor certain authorizations

Indiana § 27-1-37.5-27

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 1: DEPARTMENT OF INSURANCE
• Ch. 37.5: Health Care Service Prior Authorization

Text

(a) A utilization review entity shall honor
an authorization that was granted to a covered individual by a previous
utilization review entity for at least the initial ninety (90) days of the
covered individual's coverage under a new health plan if:
(1) the utilization review entity receives information documenting
the authorization from the covered individual or the covered
individual's health care provider; and
(2) the authorization is for a health care service that is covered
under the new health plan.
(b) During the time period described in subsection (a), a utilization
review entity may perform its own review of the prior authorization
request.
(c) If there is a change in:
(1) coverage of; or
(2) approval criteria for;
a previously authorized health care service, the change in coverage or
approval criteria may not affect a covered individual who received
authorization before the effective date of the change for the remainder
of the plan year.
(d) A utilization review entity shall continue to honor an
authorization that the utilization review entity granted to a covered
individual when the covered individual changes products under the
same health insurance company.

Legislative History

As added by P.L.144-2025, SEC.35.