Indiana Code 27-1-37.5-7. “Prior authorization”
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Terms Used In Indiana Code 27-1-37.5-7
- covered individual: means an individual who is covered under a health plan. See Indiana Code 27-1-37.5-2
- Dependent: A person dependent for support upon another.
- 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 27-1-37.5-4
- health plan: means any of the following that provides coverage for health care services:
Indiana Code 27-1-37.5-5
Sec. 7. As used in this chapter, “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. The term includes prospective or utilization review procedures conducted before a health care service is rendered.
As added by P.L.77-2018, SEC.2.