Sec. 3. As used in this chapter, “health provider contract” means an agreement with a provider or a health provider facility 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.);

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Terms Used In Indiana Code 27-1-37-3

  • Contract: A legal written agreement that becomes binding when signed.
  • 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. See Indiana Code 27-1-37-2
  • health provider facility: means any of the following:

    Indiana Code 27-1-37-3.2

  • 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
  • provider: means an individual or entity licensed or legally authorized to provide health care services. See Indiana Code 27-1-37-5
(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.197-2001, SEC.1. Amended by P.L.198-2021, SEC.18.