Sec. 8. (a) Not later than February 1 of each calendar year, a health plan must post on the health plan’s website:

(1) the thirty (30) most frequently submitted CPT codes that were submitted by participating providers for prior authorization during the previous calendar year; and

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Terms Used In Indiana Code 27-1-48-8

  • CPT code: refers to the medical billing code that applies to a specific health care service, as published in the Current Procedural Terminology code set maintained by the American Medical Association. See Indiana Code 27-1-48-2
  • health plan: means any of the following that provides coverage for health care services:

    Indiana Code 27-1-48-4

  • prior authorization: means a practice implemented by a health plan through which coverage of a health care service is dependent on the covered individual or health care provider obtaining approval from the health plan before the health care service is rendered. See Indiana Code 27-1-48-6
  • Year: means a calendar year, unless otherwise expressed. See Indiana Code 1-1-4-5
(2) the percentage of the thirty (30) most frequently submitted CPT codes that were approved in the previous calendar year, disaggregated by CPT code.

     (b) A health plan must maintain the information required under subsection (a) on the health plan’s website, organized by year and on a single and easily accessible web page.

As added by P.L.190-2023, SEC.24.