Sec. 7. (a) This section applies to:
(1) a health maintenance organization (as defined in IC 27-13-1-19); or
(2) a limited service health maintenance organization (as defined in IC 27-13-34-4).
(b) Before:
(1) taking corrective action against a professional health care provider who is under contract with but not employed by the health maintenance organization or limited service health maintenance organization; or
(2) taking action to terminate a contract with a professional health care provider who is not employed by the health maintenance organization or limited service health maintenance organization;
based upon an evaluation of patient care rendered by the professional health care provider, the organization shall grant the health care provider affected by the action one (1) evidentiary hearing before a peer review committee of the organization and, at the health provider's request, an appeal of the peer review committee's decision.
(c) Unless otherwise agreed to by the organization and the health care provider, the appeal must be limited to a review of the record of the hearing before the peer review committee and a review of all or part of the peer review committee's decision.
(d) The appeal must be held before the governing board of the organization or, at the governing board's discretion, before a committee of the governing board.
(e) The health care provider is entitled to submit written materials in support of the appeal and, at the discretion of the governing board or committee of the board conducting the appeal, the health care provider may be allowed to present oral argument in support of the appeal.
[Pre-1998 Recodification Citation: 34-4-12.6-2(g).]
As added by P.L.1-1998, SEC.26.
Structure Indiana Code
Title 34. Civil Law and Procedure
Article 30. Immunity From Civil Liability
Chapter 15. Health Care: Privileged Communications of Health Care Provider Peer Review Committees
34-30-15-1. Confidentiality; Peer Review Committee Proceedings
34-30-15-2. Confidentiality; Peer Review Committee Proceedings; Persons Attending
34-30-15-3. Confidentiality; Otherwise Discoverable Information
34-30-15-4. Health Care Providers Under Investigation; Access to Records
34-30-15-5. Health Care Providers Under Investigation; Hearings
34-30-15-6. Health Care Providers Under Investigation; Appeals
34-30-15-7. Health Care Providers Under Investigation; Health Maintenance Organizations
34-30-15-8. Confidentiality; Persons Information May Be Disclosed To
34-30-15-9. Waiver of Privilege
34-30-15-10. Invoking Privilege
34-30-15-11. Limited Waiver of Privilege for Attorney General Investigation
34-30-15-12. Subpoena Powers of Attorney General
34-30-15-13. Subpoena Powers of Attorney General; Requirements
34-30-15-14. Immunities Inapplicable to Persons Violating Confidentiality Requirements
34-30-15-15. Immunity; Peer Review Committee Proceedings
34-30-15-16. Immunity; Disclosure of Information to Peer Review Committee
34-30-15-17. Immunity; Good Faith Determinations Regarding Evaluation of Patient Care
34-30-15-18. Injunctive Relief Unavailable
34-30-15-19. Immunity; Compliance With Federal Health Care Quality Improvement Act
34-30-15-20. Immunity; Inapplicable to Civil Rights Laws
34-30-15-21. Use of Information for Internal Business Purposes
34-30-15-22. Discovery of Financial Incentives Offered Provider