Sec. 16. (a) Except as provided in subsection (b), the department shall establish, post, and maintain on the department's Internet web site a standardized prior authorization form for use by health care providers and health plans for purposes of any notice or authorization required by a health plan with respect to payment for a health care service rendered to a covered individual.
(b) After December 31, 2020, a Medicaid managed care organization (as defined in IC 12-7-2-126.9) shall use a standardized prior authorization form prescribed by the office of the secretary of family and social services.
As added by P.L.77-2018, SEC.2. Amended by P.L.265-2019, SEC.4.
Structure Indiana Code
Article 1. Department of Insurance
Chapter 37.5. Health Care Service Prior Authorization
27-1-37.5-1. Application of Chapter
27-1-37.5-2. "Covered Individual"
27-1-37.5-4. "Health Care Service"
27-1-37.5-6. "Participating Provider"
27-1-37.5-7. "Prior Authorization"
27-1-37.5-8. "Urgent Care Situation"
27-1-37.5-10. Request for Prior Authorization; Electronic Transmission; Standardized Form
27-1-37.5-11. Response to Request for Prior Authorization; Timing; Incomplete Request
27-1-37.5-12. Claim for Which Prior Authorization Was Given; Denial; Resubmission of Claim
27-1-37.5-14. Contrary Contract Provision Void
27-1-37.5-15. Violation of Chapter
27-1-37.5-16. Department of Insurance; Standardized Prior Authorization Form