Preferred Provider Agreement Prohibitions

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Sec. 9. (a) As used in this section, "insurer" includes the following:

(1) An administrator licensed under IC 27-1-25.

(2) A person that pays or administers claims on behalf of an insurer.

(b) An agreement between an insurer and a provider under this chapter may not contain a provision that:

(1) prohibits, or grants the insurer an option to prohibit, the provider from contracting with another insurer to accept lower payment for health care services than the payment specified in the agreement;

(2) requires, or grants the insurer an option to require, the provider to accept a lower payment from the insurer if the provider agrees with another insurer to accept lower payment for health care services;

(3) requires, or grants the insurer an option of, termination or renegotiation of the agreement if the provider agrees with another insurer to accept lower payment for health care services; or

(4) requires the provider to disclose the provider's reimbursement rates under contracts with other insurers.

(c) A provision that:

(1) is contained in an agreement between an insurer and a provider under this chapter; and

(2) violates this section;

is void.

As added by P.L.74-2007, SEC.1.


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