Sec. 14. (a) A good faith estimate provided by a provider facility to an individual under this chapter must:
(1) provide a summary of the services and material items that the good faith estimate is based on; and
(2) include a total figure that is a sum of the estimated prices referred to in subdivision (1).
(b) Subsection (a) does not prohibit a provider facility from providing to an individual a good faith estimate that indicates how much of the total figure stated under subsection (a)(2) will be the individual's out-of-pocket expense after the health carrier's payment of charges.
(c) A health carrier or practitioner must provide a provider facility with the information needed by the provider facility to comply with the requirements under this chapter not more than two (2) business days after receiving the request.
(d) A provider facility is not subject to the penalties under section 17 of this chapter if:
(1) a health carrier or practitioner fails to provide the provider facility with the information as required under subsection (c);
(2) the provider facility provides the individual with a good faith estimate based on any information that the provider facility has; and
(3) the provider facility provides the individual with an updated good faith estimate after the health carrier or practitioner has provided the information required under subsection (c).
As added by P.L.93-2020, SEC.12.
Structure Indiana Code
Article 1. Department of Insurance
Chapter 46. Provider Facility Good Faith Estimates
27-1-46-0.5. Provision of Information by Certain Health Plans
27-1-46-1. "Covered Individual"
27-1-46-1.5. "Episode of Care"
27-1-46-2. "Good Faith Estimate"
27-1-46-7. "Nonemergency Health Care Service"
27-1-46-10. "Provider Facility"
27-1-46-10-b. "Provider Facility"
27-1-46-10.5. "Urgent Care Facility"
27-1-46-12. In Network Good Faith Estimates; Out of Network Good Faith Estimates
27-1-46-13. Provision of Good Faith Estimates
27-1-46-16. Good Faith Estimate Request From Patient Eligible for Medicare