§ 27-1-46-11 — Right of individual to request good faith estimate from provider facility; duty of provider facility to provide estimate; required contents

Indiana § 27-1-46-11

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 1: DEPARTMENT OF INSURANCE
• Ch. 46: Provider Facility Good Faith Estimates

Text

(a) This section does not:
(1) apply to an individual who is a Medicaid recipient; or
(2) limit the authority of a legal representative of the patient.
(b) An individual for whom a nonemergency health care service has
been ordered, scheduled, or referred may request from the provider
facility in which the nonemergency health care service will be provided
a good faith estimate of the price that will be charged for the
nonemergency health care service.
(c) A provider facility that receives a request from an individual
under subsection (b) shall, not more than two (2) business days after
receiving relevant information from the individual, provide to the
individual a good faith estimate of:
(1) the price that the provider facility in which the health care
service will be performed will charge for:
(A) the use of the provider facility to care for the individual for
the nonemergency health care service;
(B) the services rendered by the employed or contracted staff of
the provider facility in connection with the nonemergency
health care service; and
(C) medication, supplies, equipment, and material items to be
provided to or used by the individual while the individual is
present in the provider facility in connection with the
nonemergency health care service; and
(2) the price charged for the services of all practitioners, support
staff, and other persons who provide professional health services:
(A) who may provide services to or for the individual during the
individual's presence in the provider facility for the
nonemergency health care service; and
(B) for whose services the individual will be charged separately
from the charge of the provider facility.
(d) The price that must be included in a good faith estimate under
this section includes all services under subsection (c)(1) or (c)(2) for
imaging, laboratory services, diagnostic services, therapy, observation
services, and other services expected to be provided to the individual
for the episode of care.
(e) A provider facility shall ensure that a good faith estimate states
that:
(1) an estimate provided under this section is not binding on the
provider facility;
(2) the price the provider facility charges the individual may vary
from the estimate based on the individual's medical needs; and
(3) the estimate provided under this section is only valid for thirty
(30) days.
(f) A provider facility may not charge a patient for information
provided under this section.

Legislative History

As added by P.L.93-2020, SEC.12. Amended by P.L.202-2021, SEC.13; P.L.215-2025, SEC.56.