§ 27-13-7-24.5 — Coverage for chronic pain management

Indiana § 27-13-7-24.5

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 13: HEALTH MAINTENANCE ORGANIZATIONS
• Ch. 7: Requirements for Group Contracts, Individual Contracts,

Text

5. (a) This section applies to each of the
following:
(1) An individual contract.
(2) A group contract.
(b) As used in this section, "chronic pain" means pain that:
(1) persists beyond the usual course of an acute disease or healing
of an injury; or
(2) may be associated with an acute or chronic pathologic process
that causes continuous or intermittent pain for a period of months
or years.
(c) As used in this section, "chronic pain management" means
evidence based health care products and services intended to relieve
chronic pain that has lasted for at least three (3) months. The term
includes:
(1) prescription drugs;
(2) physical therapy;
(3) occupational therapy;
(4) chiropractic care;
(5) osteopathic manipulative treatment; and
(6) athletic trainer services.
(d) An individual contract and a group contract must provide
coverage for medically necessary chronic pain management prescribed
by an enrollee's treating practitioner.
(e) The coverage required by this section may not be subject to
annual or lifetime limitation, deductible, copayment, or coinsurance
provisions that are more restrictive than the annual or lifetime
limitation, deductible, copayment, or coinsurance provisions that apply
generally under the individual contract or group contract.

Legislative History

As added by P.L.149-2019, SEC.6.