Permitted Disclosures by Providers; Coverage of Benefit or Service; Payment of Provider; Application

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Sec. 4.5. (a) An agreement between an insurer and provider under section 3 of this chapter may not prohibit a provider from disclosing:

(1) financial incentives to the provider;

(2) all treatment options available to an insured, including those not covered by the insured's policy.

(b) An insurer may not penalize a provider financially or in any other manner for making a disclosure permitted under subsection (a).

(c) An insured is not entitled to coverage of a benefit or service under a health insurance policy unless that benefit or service is included in the insured's health insurance policy.

(d) A provider is not entitled to payment under a policy for benefits or services provided to an insured unless the provider has a contract or an agreement with the insurer.

(e) This section applies to a contract entered, renewed, or modified after June 30, 1996.

As added by P.L.192-1996, SEC.1.


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