Sec. 0.5. This chapter does not apply to a managed care organization that, on or before July 1, 2000, did not directly contract with a hospital (as defined in section 1 of this chapter) for the provision of services under the office’s managed care program. As added by P.L.141-2001, SEC.1. Amended by P.L.152-2017, SEC.7.
Sec. 1. As used in this chapter, “hospital” refers to an acute care hospital provider that: (1) is licensed under IC 16-21; (2) qualifies as a disproportionate share hospital under IC 12-15-16; and (3) is the sole disproportionate share hospital in a city located in a county having a population of more than four hundred […]
Sec. 10. A hospital and the managed care organization of the office shall use the arbitration procedure in section 8 of this chapter for the resolution of all disputed claims that have accrued as of March 17, 2000. As added by P.L.220-2011, SEC.265. Amended by P.L.152-2017, SEC.13.
Sec. 2. The office’s managed care organization shall regard a hospital as a contracted provider in the office’s managed care program, which provides a capitated prepayment managed care system, for the provision of medical services to each individual who: (1) is eligible to receive services under IC 12-15 and has enrolled in the office’s managed […]
As added by P.L.142-2000, SEC.2. Amended by P.L.141-2001, SEC.3; P.L.122-2002, SEC.1. Repealed by P.L.145-2005, SEC.30.
As added by P.L.145-2005, SEC.1. Repealed by P.L.1-2007, SEC.248.
As added by P.L.142-2000, SEC.2. Repealed by P.L.1-2002, SEC.172.
As added by P.L.141-2001, SEC.4. Amended by P.L.122-2002, SEC.2. Repealed by P.L.145-2005, SEC.30.
As added by P.L.145-2005, SEC.2. Repealed by P.L.1-2007, SEC.248.
As added by P.L.142-2000, SEC.2. Repealed by P.L.1-2002, SEC.172.
Sec. 6. A claim for reimbursement for services shall be treated as a disputed claim under this chapter if: (1) it is submitted within one hundred twenty (120) days after the date that services are rendered; (2) it is denied by the managed care organization; (3) the hospital submits a written notice of dispute for […]
Sec. 7. The office’s managed care organization must conclude an appeal under section 6(4) of this chapter and notify the hospital of its decision not more than thirty-five (35) days after the managed care organization receives a notice from the hospital disputing the managed care organization’s denial of a claim. As added by P.L.142-2000, SEC.2. […]
Sec. 8. (a) A contract entered into by a hospital with the office’s managed care organization for the provision of services under the office’s managed care program must include a dispute resolution procedure for all disputed claims. Unless agreed to in writing by the hospital and the office’s managed care organization, the dispute resolution procedure […]
Sec. 9. The arbitration process described in section 8 of this chapter shall also be followed for resolution of disputed claims between a hospital and the office’s managed care organization, if the hospital is not a contracted provider in the office’s managed health care program. As added by P.L.142-2000, SEC.2. Amended by P.L.152-2017, SEC.12.
