Indiana § 27-13-39-2 Disclosure of coverage limitations

Indiana Statutes

§ 27-13-39-2 — Disclosure of coverage limitations

Indiana·Title 27 INSURANCE·Art. 13 HEALTH MAINTENANCE ORGANIZATIONS·Ch. 39 Patient Protection; Experimental Treatments

(a)A health maintenance organization that limits coverage for experimental treatments, procedures, drugs, or devices must clearly state the limitations in any contract, policy, agreement, or certificate of coverage.

(b)The disclosure required under subsection (a) must include the following:

(1)A description of the process used to make the determination regarding a limitation under subsection (a).

(2)A description of the criteria the health maintenance organization uses to determine whether a treatment, procedure, drug, or device is experimental, as provided in section 1 of this chapter.

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(a) A health maintenance organization that
limits coverage for experimental treatments, procedures, drugs, or
devices must clearly state the limitations in any contract, policy,
agreement, or certificate of coverage.
(b) The disclosure required under subsection (a) must include the
following:
(1) A description of the process used to make the determination
regarding a limitation under subsection (a).
(2) A description of the criteria the health maintenance
organization uses to determine whether a treatment, procedure,
drug, or device is experimental, as provided in section 1 of this
chapter.

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