§ 27-1-37.4-1 “Covered individual”
§ 27-1-37.4-2 “Health plan”
§ 27-1-37.4-3 “Prior authorization”
§ 27-1-37.4-4 Electronic transmission of prior authorization request
§ 27-1-37.4-5 Application of chapter
§ 27-1-37.4-6 Contradictory contract provisions
§ 27-1-37.4-7 Rulemaking
§ 27-1-37.4-8 “Step therapy protocol”; notice of denial; required information

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Terms Used In Indiana Code > Title 27 > Article 1 > Chapter 37.4 - Electronic Prescription Drug Prior Authorization

  • Commissioner: means the "insurance commissioner" of this state. See Indiana Code 27-1-2-3
  • Contract: A legal written agreement that becomes binding when signed.
  • covered individual: means an individual who is entitled to coverage under a health plan. See Indiana Code 27-1-37.4-1
  • health plan: means any of the following that provides coverage for prescription drugs:

    Indiana Code 27-1-37.4-2

  • 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
  • medical record: means written or printed information possessed by a provider (as defined in IC 16-18-2-295) concerning any diagnosis, treatment, or prognosis of the patient, unless otherwise defined. See Indiana Code 1-1-4-5
  • person: includes individuals, corporations, associations, and partnerships; personal pronoun includes all genders; the singular includes the plural and the plural includes the singular. See Indiana Code 27-1-2-3
  • prior authorization: includes a health plan requirement that a prescription drug be authorized for payment by the health plan before the prescription drug is provided to a particular covered individual. See Indiana Code 27-1-37.4-3