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.