Sec. 2. Beginning July 1, 1999, each health maintenance organization shall include a sufficient number and type of primary care providers and other appropriate providers throughout the health maintenance organization's service area to:
(1) meet the needs of; and
(2) provide a choice of primary care providers and other appropriate providers to;
enrollees and subscribers of the health maintenance organization. Compliance with the National Committee on Quality Assurance standards or guidelines is sufficient to meet the requirements of this section.
As added by P.L.69-1998, SEC.14. Amended by P.L.124-2018, SEC.99.
Structure Indiana Code
Article 13. Health Maintenance Organizations
Chapter 36. Patient Protection; Clinical Decision Making; Access to Personnel and Facilities
27-13-36-2. Sufficient Number and Type of Primary Care Providers
27-13-36-2.5. Discrimination on Basis of Provider's License or Certification Prohibited
27-13-36-3. Adequate Number of Services and Providers Within Reasonable Proximity of Subscribers
27-13-36-4. Specialty Areas of Primary Care Providers
27-13-36-5. Referrals to Out of Network Providers
27-13-36-6. Continuation of Care Provisions
27-13-36-7. Telephone Access for Authorization of Care
27-13-36-8. Guidelines for Establishing Reasonable Periods for Appointments
27-13-36-9. Coverage and Reimbursement for Expenses for Care Obtained in an Emergency
27-13-36-11. Standards for Continuity of Care
27-13-36-12. Payment to Enrollee for Service Rendered by Nonparticipating Provider; Requirements