Coverage for Chronic Pain Management

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Sec. 24.5. (a) This section applies to each of the following:

(1) An individual contract.

(2) A group contract.

(b) As used in this section, "chronic pain" means pain that:

(1) persists beyond the usual course of an acute disease or healing of an injury; or

(2) may be associated with an acute or chronic pathologic process that causes continuous or intermittent pain for a period of months or years.

(c) As used in this section, "chronic pain management" means evidence based health care products and services intended to relieve chronic pain that has lasted for at least three (3) months. The term includes:

(1) prescription drugs;

(2) physical therapy;

(3) occupational therapy;

(4) chiropractic care;

(5) osteopathic manipulative treatment; and

(6) athletic trainer services.

(d) An individual contract and a group contract must provide coverage for medically necessary chronic pain management prescribed by an enrollee's treating practitioner.

(e) The coverage required by this section may not be subject to annual or lifetime limitation, deductible, copayment, or coinsurance provisions that are more restrictive than the annual or lifetime limitation, deductible, copayment, or coinsurance provisions that apply generally under the individual contract or group contract.

As added by P.L.149-2019, SEC.6.


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