Indiana § 27-1-46-5 "Network"

Indiana Statutes

§ 27-1-46-5 — "Network"

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

(a)As used in this chapter, "network" means a group of provider facilities and practitioners that:

(1)provide health care services to covered individuals; and

(2)have agreed to, or are otherwise subject to, maximum limits on the prices for the health care services to be provided to the covered individuals.

(b)The term includes the following:

(1)A network described in subsection (a) that is established pursuant to a contract between an insurer providing coverage under a group health policy and:

(A)individual provider facilities and practitioners;

(B)a preferred provider organization; or

(C)an entity that employs or represents providers, including:

(i)an independent practice association; and

(ii)a physician-hospital organization.

(2)A health maintenance organization, as defined in

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(a) As used in this chapter, "network" means
a group of provider facilities and practitioners that:
(1) provide health care services to covered individuals; and
(2) have agreed to, or are otherwise subject to, maximum limits
on the prices for the health care services to be provided to the
covered individuals.
(b) The term includes the following:
(1) A network described in subsection (a) that is established
pursuant to a contract between an insurer providing coverage
under a group health policy and:
(A) individual provider facilities and practitioners;
(B) a preferred provider organization; or
(C) an entity that employs or represents providers, including:
(i) an independent practice association; and
(ii) a physician-hospital organization.
(2) A health maintenance organization, as defined in IC 27-13-1-19.

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