Sec. 5. (a) Notwithstanding IC 27-13-1-12, as used in this section, "enrollee" refers only to an enrollee who requires dialysis treatment.
(b) As used in this section, "health maintenance organization" includes the following:
(1) A limited service health maintenance organization.
(2) An agent of a health maintenance organization or a limited service health maintenance organization.
(c) A health maintenance organization shall not require an enrollee, as a condition of coverage or reimbursement, to:
(1) if the nearest dialysis facility is located within thirty (30) miles of the enrollee's home, travel more than thirty (30) miles from the enrollee's home to obtain dialysis treatment; or
(2) if the nearest dialysis facility is located more than thirty (30) miles from the enrollee's home, travel a greater distance than the distance to the nearest dialysis facility to obtain dialysis treatment;
regardless of whether the enrollee chooses to receive dialysis treatment at a dialysis facility that is a participating provider or a dialysis facility that is not a participating provider.
As added by P.L.111-2008, SEC.6.
Structure Indiana Code
Article 13. Health Maintenance Organizations
Chapter 15. Participating Providers; Contracts and Legal Actions
27-13-15-0.1. Application of Certain Amendments to Chapter
27-13-15-1. Contract Requirements; Enrollee Coverage; Payment of Provider; Application
27-13-15-3. Actions Against Subscribers; Costs and Attorney's Fees
27-13-15-4. Participating Provider Agreement Prohibitions