Sec. 5. (a) Except as provided in subsection (b), a provider shall not present a bill, claim, or other demand for payment for an anatomic pathology service unless the anatomic pathology service was performed:

(1) within the provider’s office;

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Terms Used In Indiana Code 16-48-1-5

  • anatomic pathology service: means any of the following performed by a physician or under the supervision of a physician on a sample taken from a human body:

    Indiana Code 16-48-1-1

  • physician: includes a physician group practice. See Indiana Code 16-48-1-2
  • provider: means a health care provider or a clinical laboratory. See Indiana Code 16-48-1-3
  • second opinion: means consultation, histologic processing, or additional testing performed on a sample by a second provider after an anatomic pathology service is performed on the sample by a first provider. See Indiana Code 16-48-1-4
(2) by a physician or under the direct supervision of a physician; and

(3) in accordance with Section 353 of the federal Public Health Service Act (42 U.S.C. § 263a).

     (b) If a sample taken from a human body is sent:

(1) by a provider that has performed an anatomic pathology service; and

(2) to a second provider for a second opinion;

the provider described in subdivision (1) may present a bill, claim, or other demand for payment for the second opinion.

As added by P.L.222-2011, SEC.1.