Indiana § 27-13-36-3 Adequate number of services and providers within reasonable
proximity of subscribers

Indiana Statutes

§ 27-13-36-3 — Adequate number of services and providers within reasonable proximity of subscribers

Indiana·Title 27 INSURANCE·Art. 13 HEALTH MAINTENANCE ORGANIZATIONS·Ch. 36 Patient Protection; Clinical Decision Making; Access

(a)The provisions of this section do not apply until July 1, 1999.

(b)Each health maintenance organization shall demonstrate to the department that the health maintenance organization offers an adequate number of:

(1)acute care hospital services;

(2)primary care providers; and

(3)other appropriate providers; that are located within a reasonable proximity of subscribers of the health maintenance organization. Compliance with the National Committee on Quality Assurance standards or guidelines is sufficient to meet the requirements of this subsection.

(c)If a health maintenance organization provides coverage for:

(1)specialty medical services, including physical therapy, occupational therapy, and rehabilitation services;

(2)mental and behavioral care services; or

(3)pharmacy services

Free access — add to your briefcase to read the full text and ask questions with AI

(a) The provisions of this section do not apply
until July 1, 1999.
(b) Each health maintenance organization shall demonstrate to the
department that the health maintenance organization offers an adequate
number of:
(1) acute care hospital services;
(2) primary care providers; and
(3) other appropriate providers;
that are located within a reasonable proximity of subscribers of the
health maintenance organization. Compliance with the National
Committee on Quality Assurance standards or guidelines is sufficient
to meet the requirements of this subsection.
(c) If a health maintenance organization provides coverage for:
(1) specialty medical services, including physical therapy,
occupational therapy, and rehabilitation services;
(2) mental and behavioral care services; or
(3) pharmacy services;
the health maintenance organization shall demonstrate to the
department that the offered services are located within a reasonable
proximity of subscribers of the health maintenance organization.
Compliance with the National Committee on Quality Assurance
standards or guidelines is sufficient to meet the requirements of this
subsection.

Indiana § 27-13-36-3 (Adequate number of services and providers within reasonable proximity of subscribers) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.