IC 34-30-15-7 Health Care Providers Under Investigation; Health Maintenance Organizations

• Library: Indiana Statutes
• Edition: 2023
• Currency: Current through P.L. 255-2023
• Year: 2023
• Citation: IC 34-30-15-7

(a) This section applies to:

(1) a health maintenance organization (as defined in IC <codecitation statecd="IN" sessionyear="2021" datatype="S" title="27" catchline=""Health maintenance organization"">27-13-1-19</codecitation>) ; or

(2) a limited service health maintenance organization (as defined in IC <codecitation statecd="IN" sessionyear="2021" datatype="S" title="27" catchline=""Limited service health maintenance organization" defined">27-13-34-4</codecitation>) .</subsect> </subsect>

(b) Before:

(1) taking corrective action against a professional health care provider who is under contract with but not employed by the health maintenance organization or limited service health maintenance organization; or

(2) taking action to terminate a contract with a professional health care provider who is not employed by the health maintenance organization or limited service health maintenance organization;

based upon an evaluation of patient care rendered by the professional health care provider, the organization shall grant the health care provider affected by the action one (1) evidentiary hearing before a peer review committee of the organization and, at the health provider's request, an appeal of the peer review committee's decision.