§ 27-13-15-5 — Coverage for dialysis treatment

Indiana § 27-13-15-5

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 13: HEALTH MAINTENANCE ORGANIZATIONS
• Ch. 15: Participating Providers; Contracts and Legal Actions

Text

(a) Notwithstanding IC 27-13-1-12, as used
in this section, "enrollee" refers only to an enrollee who requires
dialysis treatment.
(b) As used in this section, "health maintenance organization"
includes the following:
(1) A limited service health maintenance organization.
(2) An agent of a health maintenance organization or a limited
service health maintenance organization.
(c) A health maintenance organization shall not require an enrollee,
as a condition of coverage or reimbursement, to:
(1) if the nearest dialysis facility is located within thirty (30) miles
of the enrollee's home, travel more than thirty (30) miles from the
enrollee's home to obtain dialysis treatment; or
(2) if the nearest dialysis facility is located more than thirty (30)
miles from the enrollee's home, travel a greater distance than the
distance to the nearest dialysis facility to obtain dialysis
treatment;
regardless of whether the enrollee chooses to receive dialysis treatment
at a dialysis facility that is a participating provider or a dialysis facility
that is not a participating provider.

Legislative History

As added by P.L.111-2008, SEC.6.