"Out-of-Plan Covered Services"

1. Law
2. Indiana Code
3. Insurance
4. Health Maintenance Organizations
5. Definitions
6. "Out-of-Plan Covered Services"

Sec. 23. (a) "Out-of-plan covered services" means nonemergency, self-referred covered health care services that:

(1) are obtained from a provider who is:

(A) not otherwise employed by;

(B) not under contract with; and

(C) not otherwise affiliated with;

the health maintenance organization; or

(2) are obtained from a participating provider without a referral.

(b) The term does not include uncovered services.

As added by P.L.26-1994, SEC.25.

Download our app to see the most-to-date content.