Sec. 8. (a) This section applies to a health provider contract entered into, amended, or renewed after June 30, 2021.

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Terms Used In Indiana Code 27-1-37-8

  • Attorney: includes a counselor or other person authorized to appear and represent a party in an action or special proceeding. See Indiana Code 1-1-4-5
  • Contract: A legal written agreement that becomes binding when signed.
  • health carrier: means an entity:

    Indiana Code 27-1-37-1.5

  • 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:

    Indiana Code 27-1-37-3

  • health provider facility: means any of the following:

    Indiana Code 27-1-37-3.2

  • provider: means an individual or entity licensed or legally authorized to provide health care services. See Indiana Code 27-1-37-5
     (b) A health provider contract, including a contract with a pharmacy benefit manager, may not contain a provision that does any of the following:

(1) Limits the ability of either the health carrier or the health provider facility to disclose the allowed amount and fees of services to any insured (as defined in IC 27-8-5.8-3) or enrollee (as defined in IC 27-13-1-12), or to the treating health provider facility or physician of the insured or enrollee.

(2) Limits the ability of either the health carrier or the health provider facility to disclose out-of-pocket costs to an insured (as defined in IC 27-8-5.8-3) or an enrollee (as defined in IC 27-13-1-12).

     (c) Any provision of a health provider contract that includes a provision described in subsection (b) in violation of this section is severable and the provision in violation is null and void. The remaining provisions of the health provider contract, excluding the provision in violation of this section, remain in effect and are enforceable.

     (d) The attorney general may issue a civil investigative demand to obtain information from a party of, or pertaining to, a health provider contract and compliance of this section.

As added by P.L.198-2021, SEC.22.

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