§ 27-13-1-23 — "Out-of-plan covered services"

(a) "Out-of-plan covered services" means
nonemergency, self-referred covered health care services that:
(1) are obtained from a provider who is:
(A) not otherwise employed by;
(B) not under contract with; and
(C) not otherwise affiliated with;
the health maintenance organization; or
(2) are obtained from a participating provider without a referral.
(b) The term does not include uncovered services.

Legislative History

As added by P.L.26-1994, SEC.25.