Indiana § 27-7-18-17 Nonapplicability

Indiana Statutes

§ 27-7-18-17 — Nonapplicability

Indiana·Title 27 INSURANCE·Art. 7 SPECIAL TYPES OF INSURANCE·Ch. 18 Third Party Access to Dental Provider Networks

(a)Section 11 of this chapter does not apply to access as described in section 11(a) of this chapter if granted by a contracting entity to:

(1)a dental carrier or other entity operating in accordance with the same brand licensee program as the contracting entity;

(2)an entity that is an affiliate of the contracting entity; or

(3)a third party if the contracting entity is a dental carrier that retains responsibility for administering the dental plan in accordance with its applicable provider network contracts, including all fee schedules and processing policies.

(b)For the purposes of this section, a contracting entity shall make a list of the contracting entity's affiliates available to providers on the contracting entity's website.

(c)Section 11 of this chapter does not apply to a p

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(a) Section 11 of this chapter does not apply
to access as described in section 11(a) of this chapter if granted by a
contracting entity to:
(1) a dental carrier or other entity operating in accordance with
the same brand licensee program as the contracting entity;
(2) an entity that is an affiliate of the contracting entity; or
(3) a third party if the contracting entity is a dental carrier that
retains responsibility for administering the dental plan in
accordance with its applicable provider network contracts,
including all fee schedules and processing policies.
(b) For the purposes of this section, a contracting entity shall make
a list of the contracting entity's affiliates available to providers on the
contracting entity's website.
(c) Section 11 of this chapter does not apply to a provider network
contract for dental services provided to beneficiaries of health
programs established or maintained by local, state, or federal
government, such as:
(1) Medicaid established under Title XIX of the federal Social
Security Act (42 U.S.C. 1396 et seq.);
(2) the children's health insurance program established under
Title XXI of the federal Social Security Act (42 U.S.C.
1397aa-1397mm); or
(3) Medicare Advantage.