Indiana § 27-1-37.6-15 "Value based health care reimbursement agreement"

Indiana Statutes

§ 27-1-37.6-15 — "Value based health care reimbursement agreement"

Indiana § 27-1-37.6-15

Title 27INSURANCE

Art. 1DEPARTMENT OF INSURANCE

Ch. 37.6Program to Reduce or Eliminate Prior Authorization

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Bluebook

Ind. Code § 27-1-37.6-15 (2026).

Text

(a)As used in this chapter, "value based health care reimbursement agreement" may include the following:

(1)An accountable care organization that has a contract with a health plan in which the health plan:

(A)does not assume risk for prior authorization to a provider organization; or

(B)delegates risk to a provider organization to manage prior authorization.

(2)Bundled payments.

(3)A capitated rate reimbursement arrangement.

(4)A pay for performance arrangement.

(5)Any other health care reimbursement arrangement in which the health care provider accepts at most ten percent (10%) of the downside risk.

(b)The term does not include any of the following:

(1)Narrow networks.

(2)Fixed fee schedules.

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(a) As used in this chapter, "value based
health care reimbursement agreement" may include the following:
(1) An accountable care organization that has a contract with a
health plan in which the health plan:
(A) does not assume risk for prior authorization to a provider
organization; or
(B) delegates risk to a provider organization to manage prior
authorization.
(2) Bundled payments.
(3) A capitated rate reimbursement arrangement.
(4) A pay for performance arrangement.
(5) Any other health care reimbursement arrangement in which
the health care provider accepts at most ten percent (10%) of the
downside risk.
(b) The term does not include any of the following:
(1) Narrow networks.
(2) Fixed fee schedules.