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Terms Used In Indiana Code 27-8-17-16

  • enrollee: means an individual who has contracted for or who participates in coverage under an insurance policy issued under insurance classes 1(b) and 2(a) of IC 27-1-5-1, health maintenance organization contract, or other benefit program providing payment, reimbursement, or indemnification for the costs of health care for:

    Indiana Code 27-8-17-3

  • provider of record: means the physician or other licensed practitioner identified to a utilization review agent as having primary responsibility for the care, treatment, and services rendered to a covered individual. See Indiana Code 27-8-17-5
   Sec. 16. A provider of record, an enrollee, or the agent of a provider of record or an enrollee who provides fraudulent or misleading information is subject to appropriate administrative, civil, and criminal penalties, including criminal penalties under IC 35-43-5.

As added by P.L.128-1992, SEC.1. Amended by P.L.174-2021, SEC.25.