Indiana Code
Chapter 15. Participating Providers; Contracts and Legal Actions
27-13-15-4. Participating Provider Agreement Prohibitions

Sec. 4. (a) As used in this section, "health maintenance organization" includes the following:
(1) A limited service health maintenance organization.
(2) A person that pays or administers claims on behalf of a health maintenance organization or a limited service health maintenance organization.
(b) An agreement between a health maintenance organization and a participating provider under this chapter may not contain a provision that:
(1) prohibits, or grants the health maintenance organization an option to prohibit, the participating provider from contracting with another health maintenance organization to accept lower payment for health care services than the payment specified in the agreement;
(2) requires, or grants the health maintenance organization an option to require, the participating provider to accept a lower payment from the health maintenance organization if the participating provider agrees with another health maintenance organization to accept lower payment for health care services;
(3) requires, or grants the health maintenance organization an option of, termination or renegotiation of the agreement if the participating provider agrees with another health maintenance organization to accept lower payment for health care services; or
(4) requires the participating provider to disclose the participating provider's reimbursement rates under contracts with other health maintenance organizations.
(c) A contract provision that violates this section is void.
As added by P.L.74-2007, SEC.2.

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