Sec. 8. (a) A health maintenance organization may not, more than two (2) years after the date on which an overpayment on a provider claim was made to the provider by the health maintenance organization:
(1) request that the provider repay the overpayment; or
(2) adjust a subsequent claim filed by the provider as a method of obtaining reimbursement of the overpayment from the provider.
(b) A health maintenance organization may not be required to correct a payment error to a provider more than two (2) years after the date on which a payment on a provider claim was made to the provider by the health maintenance organization.
(c) This section does not apply in cases of fraud by the provider, the enrollee, or the health maintenance organization with respect to the claim on which the overpayment or underpayment was made.
As added by P.L.55-2006, SEC.3.
Structure Indiana Code
Article 13. Health Maintenance Organizations
Chapter 36.2. Provider Payment
27-13-36.2-1. "Clean Claim" Defined
27-13-36.2-2. "Health Maintenance Organization" Defined
27-13-36.2-3. Notice of Deficiencies in Claims
27-13-36.2-4. Payment or Denial of Claims; Interest