Indiana Code 27-1-37.5-1.5. “Adverse determination”
Current as of: 2024 | Check for updates
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Sec. 1.5. As used in this chapter, “adverse determination” means a denial of a request for benefits on the grounds that the health service or item:
(2) is not being provided in or at an appropriate health care setting or level of care; or
(1) is not medically necessary, appropriate, effective, or efficient;
(3) is experimental or investigational.
As added by P.L.190-2023, SEC.14.