Terms Used In Indiana Code > Title 4 > Article 32.3 > Chapter 8 - Penalties

• Charity: An agency, institution, or organization in existence and operating for the benefit of an indefinite number of persons and conducted for educational, religious, scientific, medical, or other beneficent purposes.
• Commissioner: means the "insurance commissioner" of this state. See Indiana Code 27-1-2-3
• Contract: A legal written agreement that becomes binding when signed.
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• covered individual: means an individual who is entitled to health insurance coverage. See Indiana Code 27-1-50-1
• covered individual: means an individual who is entitled to health insurance coverage. See Indiana Code 27-1-49-1
• covered individual: means an individual who is entitled to coverage under a health plan. See Indiana Code 27-1-48-1
• CPT code: refers to the medical billing code that applies to a specific health care service, as published in the Current Procedural Terminology code set maintained by the American Medical Association. See Indiana Code 27-1-48-2
• defined cost sharing: means a deductible payment or coinsurance amount imposed on a covered individual for a covered prescription drug under the covered individual's health insurance coverage. See Indiana Code 27-1-50-2
• defined cost sharing: means a deductible payment or coinsurance amount imposed on a covered individual for a covered prescription drug under the covered individual's health insurance coverage. See Indiana Code 27-1-49-2
• Department: means "the department of insurance" of this state. See Indiana Code 27-1-2-3
• Dependent: A person dependent for support upon another.
• Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
• Fraud: Intentional deception resulting in injury to another.
• governmental hospital: means an acute care hospital licensed under IC 16-21-2 that is governed by:

  Indiana Code 27-1-47.5-1

• health care service: means a health care related service or product rendered or sold by a health care provider within the scope of the health care provider's license or legal authorization, including hospital, medical, surgical, mental health, and substance abuse services or products. See Indiana Code 27-1-48-3
• health insurance coverage: includes :

  Indiana Code 27-1-49-3

• health insurance coverage: includes :

  Indiana Code 27-1-50-3

• health plan: means any of the following that provides coverage for health care services:

  Indiana Code 27-1-48-4

• independent hospital: means a private nonprofit acute care hospital licensed under IC 16-21-2 that meets the following criteria:

  Indiana Code 27-1-47.5-2

• Indiana nonprofit hospital system: means a hospital that:

  Indiana Code 27-1-47.5-3

• Insurance: means a contract of insurance or an agreement by which one (1) party, for a consideration, promises to pay money or its equivalent or to do an act valuable to the insured upon the destruction, loss or injury of something in which the other party has a pecuniary interest, or in consideration of a price paid, adequate to the risk, becomes security to the other against loss by certain specified risks; to grant indemnity or security against loss for a consideration. See Indiana Code 27-1-2-3
• insurer: means an insurer that provides health insurance coverage to a covered individual. See Indiana Code 27-1-49-4
• insurer: means a company, firm, partnership, association, order, society or system making any kind or kinds of insurance and shall include associations operating as Lloyds, reciprocal or inter-insurers, or individual underwriters. See Indiana Code 27-1-2-3
• insurer: means an insurer that provides health insurance coverage to a covered individual. See Indiana Code 27-1-50-4
• Oversight: Committee review of the activities of a Federal agency or program.
• participating provider: refers to the following:

  Indiana Code 27-1-48-5

• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• patient service revenue: includes similar terms, including net patient service revenue and patient care service revenue. See Indiana Code 27-1-47.5-3
• person: includes individuals, corporations, associations, and partnerships; personal pronoun includes all genders; the singular includes the plural and the plural includes the singular. See Indiana Code 27-1-2-3
• plan sponsor: means an employer or organization that offers health insurance coverage to its employees or members through an insurer. See Indiana Code 27-1-50-5
• prices: means allowables that are paid for patient care services. See Indiana Code 27-1-47.5-4
• prior authorization: means a practice implemented by a health plan through which coverage of a health care service is dependent on the covered individual or health care provider obtaining approval from the health plan before the health care service is rendered. See Indiana Code 27-1-48-6
• Property: includes personal and real property. See Indiana Code 1-1-4-5
• rebate: means :

  Indiana Code 27-1-49-6

• rebate: means :

  Indiana Code 27-1-50-7

• Statute: A law passed by a legislature.
• Year: means a calendar year, unless otherwise expressed. See Indiana Code 1-1-4-5