Indiana § 27-8-11-9 Preferred provider agreement prohibitions

Indiana Statutes

§ 27-8-11-9 — Preferred provider agreement prohibitions

Indiana § 27-8-11-9

Title 27INSURANCE

Art. 8LIFE, ACCIDENT, AND HEALTH

Ch. 11Accident and Sickness Insurance─Reimbursement

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Bluebook

Ind. Code § 27-8-11-9 (2026).

Text

(a)As used in this section, "insurer" includes the following:

(1)An administrator licensed under IC 27-1-25.

(2)A person that pays or administers claims on behalf of an insurer.

(b)An agreement between an insurer and a provider under this chapter may not contain a provision that:

(1)prohibits, or grants the insurer an option to prohibit, the provider from contracting with another insurer to accept lower payment for health care services than the payment specified in the agreement;

(2)requires, or grants the insurer an option to require, the provider to accept a lower payment from the insurer if the provider agrees with another insurer to accept lower payment for health care services;

(3)requires, or grants the insurer an option of, termination or renegotiation of the agreement if the

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(a) As used in this section, "insurer" includes
the following:
(1) An administrator licensed under IC 27-1-25.
(2) A person that pays or administers claims on behalf of an
insurer.
(b) An agreement between an insurer and a provider under this
chapter may not contain a provision that:
(1) prohibits, or grants the insurer an option to prohibit, the
provider from contracting with another insurer to accept lower
payment for health care services than the payment specified in the
agreement;
(2) requires, or grants the insurer an option to require, the
provider to accept a lower payment from the insurer if the
provider agrees with another insurer to accept lower payment for
health care services;
(3) requires, or grants the insurer an option of, termination or
renegotiation of the agreement if the provider agrees with another
insurer to accept lower payment for health care services; or
(4) requires the provider to disclose the provider's reimbursement
rates under contracts with other insurers.
(c) A provision that:
(1) is contained in an agreement between an insurer and a
provider under this chapter; and
(2) violates this section;
is void.