IC 27-13-39-3 — Written explanation of denial of coverage of experimental treatment; review
Chapter 39. Patient Protection; Experimental Treatments
Section text
Sec. 3. (a) If a health maintenance organization denies coverage for a treatment, procedure, drug, or device on the grounds that the treatment, procedure, drug, or device is experimental, the health maintenance organization shall provide the enrollee with a written explanation that includes the following: (1) The basis for the denial. (2) The enrollee's right to appeal the health maintenance organization's decision as provided in IC 27-8-16-8, IC 27-8-17-12, and IC 27-13-10. (3) The telephone number of: (A) an individual employed by the health maintenance organization whom; or (B) a department of the health maintenance organization that; the enrollee may contact for assistance in initiating an appeal of the health maintenance organization's decision. (b) An enrollee is entitled to a review that takes not more than seventy-two (72) hours if the enrollee's health situation is life threatening or is an emergency.
As added by P.L.69-1998, SEC.17.
Source: official publisher (2026 edition)