reglab/housing_qa huggingface dataset:
IN Code § 27-1-37-7 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37. Health Provider Contracts|27-1-37-7. Applicability; Prohibition on Preventing Disclosure of Health Care Service Claims Data; Violation an Unfair or Deceptive Act

Sec. 7. (a) This section applies to health provider contracts entered into or renewed after June 30, 2020.(b) A health provider contract, including a contract with a pharmacy benefit manager or a health facility, may not contain a provision that prohibits the disclosure of health care service claims data to:(1) employers providing the coverage; or(2) beginning July 1, 2021, another person for use in the all payer claims data base established by IC 27-1-44.5.However, any disclosure of claims data must comply with health privacy laws, including the federal Health Insurance Portability and Accountability Act (HIPAA) (P.L. 104-191).(c) A violation of this section constitutes an unfair or deceptive act or practice in the business of insurance under IC 27-4-1-4.As added by P.L.50-2020, SEC.5. Amended by P.L.93-2020, SEC.10; P.L.198-2021, SEC.21.
IN Code § 27-1-37-8 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37. Health Provider Contracts|27-1-37-8. Prohibited Contract Provisions; Severable and Void; Investigative Demand by Attorney General

Sec. 8. (a) This section applies to a health provider contract entered into, amended, or renewed after June 30, 2021.(b) A health provider contract, including a contract with a pharmacy benefit manager, may not contain a provision that does any of the following:(1) Limits the ability of either the health carrier or the health provider facility to disclose the allowed amount and fees of services to any insured (as defined in IC 27-8-5.8-3) or enrollee (as defined in IC 27-13-1-12), or to the treating health provider facility or physician of the insured or enrollee.(2) Limits the ability of either the health carrier or the health provider facility to disclose out-of-pocket costs to an insured (as defined in IC 27-8-5.8-3) or an enrollee (as defined in IC 27-13-1-12).(c) Any provision of a health provider contract that includes a provision described in subsection (b) in violation of this section is severable and the provision in violation is null and void. The remaining provisions of the health provider contract, excluding the provision in violation of this section, remain in effect and are enforceable.(d) The attorney general may issue a civil investigative demand to obtain information from a party of, or pertaining to, a health provider contract and compliance of this section.As added by P.L.198-2021, SEC.22.
IN Code § 27-1-37.1-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.1. Termination of Health Provider Contracts|27-1-37.1-1. "Health Maintenance Organization"

Sec. 1. As used in this chapter, "health maintenance organization" means a person that undertakes to provide or arrange for the delivery of health care services to individuals on a prepaid basis, except for the individual's responsibility for copayments or deductibles. The term includes a limited service health maintenance organization. The term does not include a staff-model health maintenance organization that employs a group of providers and that requires the providers to provide health care services solely to individuals who are entitled to coverage under a contract with the staff-model health maintenance organization or an affiliate of the staff-model health maintenance organization.As added by P.L.196-2001, SEC.1.
IN Code § 27-1-37.1-2 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.1. Termination of Health Provider Contracts|27-1-37.1-2. "Health Provider Contract"

Sec. 2. As used in this chapter, "health provider contract" means an agreement with a provider relating to terms and conditions of reimbursement for health care services provided to an individual under:(1) an employee welfare benefit plan (as defined in 29 U.S.C. 1002 et seq.);(2) a policy of accident and sickness insurance (as defined in IC 27-8-5-1);(3) a contract with a health maintenance organization;(4) a self-insurance program established under IC 5-10-8-7(b); or(5) a prepaid health care delivery plan entered into under IC 5-10-8-7(c).As added by P.L.196-2001, SEC.1.
IN Code § 27-1-37.1-3 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.1. Termination of Health Provider Contracts|27-1-37.1-3. "Person"

Sec. 3. (a) As used in this chapter, "person" means an individual, an agency, a political subdivision, a partnership, a corporation, an association, or any other entity that enters into a health provider contract with a provider.(b) The term does not include a health care provider described in IC 16-18-2-163(a)(1), IC 16-18-2-163(a)(2), IC 16-18-2-163(a)(3), or IC 16-18-2-163(a)(4).As added by P.L.196-2001, SEC.1.
IN Code § 27-1-37.1-4 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.1. Termination of Health Provider Contracts|27-1-37.1-4. "Provider"

Sec. 4. As used in this chapter, "provider" means:(1) a physician licensed under IC 25-22.5;(2) a dentist licensed under IC 25-14;(3) an advanced practice registered nurse licensed under IC 25-23;(4) a chiropractor licensed under IC 25-10;(5) a podiatrist licensed under IC 25-29;(6) an optometrist licensed under IC 25-24; or(7) a clinical psychologist licensed under IC 25-33.As added by P.L.196-2001, SEC.1. Amended by P.L.129-2018, SEC.40.
IN Code § 27-1-37.1-5 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.1. Termination of Health Provider Contracts|27-1-37.1-5. Notice of Amendment of Contract

Sec. 5. A person who enters into a health provider contract with a provider shall provide written notice to the provider of any amendment to the health provider contract not less than forty-five (45) days before the proposed effective date of the amendment.As added by P.L.196-2001, SEC.1.
IN Code § 27-1-37.1-6 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.1. Termination of Health Provider Contracts|27-1-37.1-6. Termination of Contract Without Penalty

Sec. 6. (a) Subject to subsection (b), a provider who receives notice under section 5 of this chapter may terminate the health provider contract without penalty by informing the person with whom the health care provider contracts that the provider chooses not to approve the amendment.(b) Notice under subsection (a) must be:(1) given not later than fifteen (15) days after the provider receives notice under section 5 of this chapter; and(2) in writing.As added by P.L.196-2001, SEC.1.
IN Code § 27-1-37.1-7 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.1. Termination of Health Provider Contracts|27-1-37.1-7. Effective Date of Termination

Sec. 7. The termination of a contract under section 6 of this chapter is effective:(1) ninety (90) days after the person with whom the provider contracts receives written notice from the provider that the provider does not approve the amendment; or(2) on a date earlier than the date described in subdivision (1), if agreed to by the person with whom the provider contracts and the provider.As added by P.L.196-2001, SEC.1.
IN Code § 27-1-37.1-8 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.1. Termination of Health Provider Contracts|27-1-37.1-8. Compliance With Proposed Amendment Not Required

Sec. 8. If a person with whom a provider contracts receives notice from a provider under section 6 of this chapter, the person with whom a provider contracts may not require the provider to comply with the proposed amendment.As added by P.L.196-2001, SEC.1.
IN Code § 27-1-37.1-9 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.1. Termination of Health Provider Contracts|27-1-37.1-9. Notification to Patient That Provider's Contract Terminated

Sec. 9. Except in an emergency, a provider who elects to terminate a health provider contract under this section shall, before providing services to a patient who is covered by the contract, notify the patient that the provider's contract has been or will be terminated.As added by P.L.196-2001, SEC.1.
IN Code § 27-1-37.1-10 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.1. Termination of Health Provider Contracts|27-1-37.1-10. Contrary Contract Provisions Void

Sec. 10. Except as provided in section 7(2) of this chapter, a health provider contract provision that is contrary to this chapter is void.As added by P.L.196-2001, SEC.1.
IN Code § 27-1-37.1-11 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.1. Termination of Health Provider Contracts|27-1-37.1-11. Chapter Inapplicable to Compliance With State or Federal Laws

Sec. 11. This chapter does not apply to an amendment to a health provider contract that is required to comply with a state or federal law.As added by P.L.196-2001, SEC.1.
IN Code § 27-1-37.2-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.2. Health Insurance Educator|27-1-37.2-1. "Health Benefit Plan" Defined

Sec. 1. As used in this chapter, "health benefit plan" means coverage for health care services provided under:(1) a policy of accident and sickness insurance (as defined in IC 27-8-5-1);(2) a contract with a health maintenance organization under IC 27-13; or(3) any other benefit program that provides payment, reimbursement, or indemnification for the costs of health care except:(A) worker's compensation or similar insurance; or(B) benefits provided under a certificate of exemption issued by the worker's compensation board under IC 22-3-2-5.As added by P.L.258-2001, SEC.1.
IN Code § 27-1-37.2-2 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.2. Health Insurance Educator|27-1-37.2-2. "Health Benefit Plan Provider" Defined

Sec. 2. As used in this chapter, "health benefit plan provider" means a person that provides coverage under a health benefit plan.As added by P.L.258-2001, SEC.1.
IN Code § 27-1-37.2-3 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.2. Health Insurance Educator|27-1-37.2-3. "Health Insurance Educator" Defined

Sec. 3. As used in this chapter, "health insurance educator" refers to the health insurance educator appointed under section 6 of this chapter.As added by P.L.258-2001, SEC.1.
IN Code § 27-1-37.2-4 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.2. Health Insurance Educator|27-1-37.2-4. "Position" Defined

Sec. 4. As used in this chapter, "position" means the position of health insurance educator established under section 5 of this chapter.As added by P.L.258-2001, SEC.1.
IN Code § 27-1-37.2-5 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.2. Health Insurance Educator|27-1-37.2-5. Establishment of Position

Sec. 5. The department shall establish the position of health insurance educator within the department.As added by P.L.258-2001, SEC.1.
IN Code § 27-1-37.2-6 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.2. Health Insurance Educator|27-1-37.2-6. Qualifications

Sec. 6. The commissioner shall appoint a health insurance educator who must possess expertise in the areas of health benefit plans, education, and advocacy.As added by P.L.258-2001, SEC.1.
IN Code § 27-1-37.2-7 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.2. Health Insurance Educator|27-1-37.2-7. Contracts With Nonprofit Organizations

Sec. 7. The department may contract with a nonprofit organization to provide the services required under this chapter.As added by P.L.258-2001, SEC.1.
IN Code § 27-1-37.2-8 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.2. Health Insurance Educator|27-1-37.2-8. Duties; Prohibitions

Sec. 8. (a) The health insurance educator shall do the following:(1) Assist health benefit plan consumers in making informed choices regarding health benefit plans by providing information about the following:(A) The purchase, or enrollment in, a health benefit plan.(B) The manner in which to resolve a dispute with a health benefit plan.(C) The method of filing a claim under a health benefit plan.(D) The availability of resources useful to a health benefit plan consumer.(E) Consumer rights and responsibilities under a health benefit plan.(F) Comparative information about health benefit plans to consumers and purchasers of health benefit plans.(G) Other matters that may further a health benefit plan consumer's knowledge of health insurance benefit plans.(2) Apply to obtain funds through federal grants and any other source. Any funds obtained shall be used to fulfill the purposes described in subdivision (1).(b) Notwithstanding subsection (a)(1), the health insurance educator shall not:(1) recommend a particular company, insurance producer, or product; or(2) interpret or advise an individual regarding a particular contract or disputed claim that is subject to the federal Employee Retirement Income Security Act (29 U.S.C. 1001 et seq.).As added by P.L.258-2001, SEC.1.
IN Code § 27-1-37.3-0.1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-0.1. Application of Chapter

Sec. 0.1. The addition of this chapter by P.L.55-2008 applies to a health care contract that is entered into, amended, or renewed after June 30, 2008.As added by P.L.220-2011, SEC.425.
IN Code § 27-1-37.3-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-1. Application of Definitions

Sec. 1. Unless otherwise specified in this chapter, the definitions in IC 27-8-11-1 apply throughout this chapter.As added by P.L.55-2008, SEC.1.
IN Code § 27-1-37.3-2 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-2. "Affiliate"

Sec. 2. As used in this chapter, "affiliate" has the meaning set forth in IC 27-1-25-1.As added by P.L.55-2008, SEC.1.
IN Code § 27-1-37.3-3 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-3. "Contractor"

Sec. 3. As used in this chapter, "contractor" refers to a person with a primary business purpose of entering into health care contracts with providers.As added by P.L.55-2008, SEC.1.
IN Code § 27-1-37.3-4 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-4. "Covered Individual"

Sec. 4. As used in this chapter, "covered individual" means an individual who is entitled to coverage under a health plan.As added by P.L.55-2008, SEC.1.
IN Code § 27-1-37.3-5 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-5. "Health Plan"

Sec. 5. (a) As used in this chapter, "health plan" means a plan through which coverage is provided for health care services through insurance, prepayment, reimbursement, or otherwise. The term includes the following:(1) An employee welfare benefit plan (as defined in 29 U.S.C. 1002 et seq.).(2) A policy of accident and sickness insurance (as defined in IC 27-8-5-1).(3) An individual contract (as defined in IC 27-13-1-21) or a group contract (as defined in IC 27-13-1-16).(b) The term does not include the following:(1) Accident-only, credit, Medicare supplement, long term care, or disability income insurance.(2) Coverage issued as a supplement to liability insurance.(3) Worker's compensation or similar insurance.(4) Automobile medical payment insurance.(5) A specified disease policy issued as an individual policy.(6) A short term insurance plan that:(A) may be renewed for the greater of:(i) thirty-six (36) months; or(ii) the maximum period permitted under federal law;(B) has a term of not more than three hundred sixty-four (364) days; and(C) has an annual limit of at least two million dollars ($2,000,000).(7) A policy that provides a stipulated daily, weekly, or monthly payment to an insured during hospital confinement, without regard to the actual expense of the confinement.As added by P.L.55-2008, SEC.1. Amended by P.L.288-2019, SEC.1.
IN Code § 27-1-37.3-6 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-6. "Health Care Contract"

Sec. 6. As used in this chapter, "health care contract" means a contract between a person and a provider specifying the rights and responsibilities of the:(1) person; and(2) provider;in relation to payment for and delivery of health care services to a covered individual.As added by P.L.55-2008, SEC.1.
IN Code § 27-1-37.3-7 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-7. Granting Access to Contracted Health Care Services; Requirements

Sec. 7. A contractor may not lease, rent, or otherwise grant access to a provider's health care services under a health care contract unless the contractor complies with one (1) of the following:(1) The third party to which the access is granted is:(A) an employer or another entity providing coverage for health care services to the employer's or entity's employees or members and the entity has a contract with the contractor or the contractor's affiliate for the administration or processing of claims for payment or service provided under the health care contract; or(B) an affiliate or a subsidiary of the contractor or providing administrative services to or receiving administrative services from the contractor or the contractor's affiliate or subsidiary.(2) The:(A) health care contract specifically states that the contractor may lease, rent, or otherwise grant access to the provider's health care services under the health care contract;(B) third party accessing the health care contract is:(i) a payer or third party administrator or another entity that administers claims on behalf of the payer;(ii) a preferred provider organization or preferred provider network, including a physician-hospital organization; or(iii) an entity engaged in the electronic claims transport between the contractor and the payer; and(C) third party that is granted access to the provider's health care services under the health care contract is obligated to comply with all the applicable terms of the health care contract.As added by P.L.55-2008, SEC.1.
IN Code § 27-1-37.3-8 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-8. List of Third Parties With Access to Contracted Health Care Services

Sec. 8. (a) A contractor that leases, rents, or otherwise grants access to a provider's health care services as described in section 7(2) of this chapter shall maintain an Internet web page or a toll free telephone number through which the provider may obtain a listing, updated at least semiannually, of the third parties to which access to the provider's health care services has been granted.(b) A contractor shall, at the time a health care contract is entered into with a provider, identify and provide any preferred provider organization, preferred provider network, physician hospital organization, or other entity identified in section 7(2)(B)(ii) of this chapter that is known at the time of contracting, to which the contractor will grant access to the provider's health care services under section 7 of this chapter.As added by P.L.55-2008, SEC.1.
IN Code § 27-1-37.3-9 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-9. Identification of Contractual Source of Discounts

Sec. 9. A contractor that leases, rents, or otherwise grants access to a provider's health care services under section 7 of this chapter shall ensure that an explanation of benefits or remittance advice furnished to the provider that delivers health care services under the health care contract identifies the contractual source of any discount that applies.As added by P.L.55-2008, SEC.1.
IN Code § 27-1-37.3-10 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-10. Termination of Third Party Rights

Sec. 10. Subject to applicable continuity of care requirements, a third party's right to exercise a contractor's rights and responsibilities under a health care contract terminates on the date that the health care contract is terminated.As added by P.L.55-2008, SEC.1.
IN Code § 27-1-37.3-11 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.3. Third Party Rights and Responsibilities Under Health Care Contracts|27-1-37.3-11. Arbitration of Disputes

Sec. 11. A health care contract may provide for arbitration of disputes arising under this chapter.As added by P.L.55-2008, SEC.1.
IN Code § 27-1-37.4-1 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.4. Electronic Prescription Drug Prior Authorization|27-1-37.4-1. "Covered Individual"

Sec. 1. As used in this chapter, "covered individual" means an individual who is entitled to coverage under a health plan.As added by P.L.45-2017, SEC.1.
IN Code § 27-1-37.4-2 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.4. Electronic Prescription Drug Prior Authorization|27-1-37.4-2. "Health Plan"

Sec. 2. As used in this chapter, "health plan" means any of the following that provides coverage for prescription drugs:(1) A policy of accident and sickness insurance (as defined in IC 27-8-5-1).(2) A contract with a health maintenance organization (as defined in IC 27-13-1-19).The term includes a person that administers a policy or contract described in subdivision (1) or (2).As added by P.L.45-2017, SEC.1.
IN Code § 27-1-37.4-3 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.4. Electronic Prescription Drug Prior Authorization|27-1-37.4-3. "Prior Authorization"

Sec. 3. As used in this chapter, "prior authorization" includes a health plan requirement that a prescription drug be authorized for payment by the health plan before the prescription drug is provided to a particular covered individual.As added by P.L.45-2017, SEC.1.
IN Code § 27-1-37.4-4 (2021)
2021 Indiana Code|Title 27. Insurance|Article 1. Department of Insurance|Chapter 37.4. Electronic Prescription Drug Prior Authorization|27-1-37.4-4. Electronic Transmission of Prior Authorization Request

Sec. 4. A health plan shall accept and respond to a request for prior authorization delivered to the health plan by a covered individual's:(1) prescribing health care provider; or(2) dispensing pharmacist;through an electronic transmission that complies with the technical standards developed by the National Council for Prescription Drug Programs for electronic prior authorization transactions (NCPDP SCRIPT).As added by P.L.45-2017, SEC.1.