Sec. 13.5. (a) This section applies only to the state employee health plan (as defined in IC 5-10-8-6.7(a)).
(b) The state employee health plan may not require a participating provider to obtain prior authorization for the following CPT codes:
(1) 11200.
(2) 11201.
(3) 17311.
(4) 17312.
(5) 17313.
(6) 17314.
(7) 44140.
(8) 44160.
(9) 44970.
(10) 49505.
(11) 70450.
(12) 70551.
(13) 70552.
(14) 70553.
(15) 71250.
(16) 71260.
(17) 71275.
(18) 72141.
(19) 72148.
(20) 72158.
(21) 73221.
(22) 73721.
(23) 74150.
(24) 74160.
(25) 74176.
(26) 74177.
(27) 74178.
(28) 74179.
(29) 74181.
(30) 74183.
(31) 78452.
(32) 92507.
(33) 92526.
(34) 92609.
(35) 93303.
(36) 93306.
(37) 95044.
(38) 95806.
(39) 95810.
(40) 97110.
(41) 97112.
(42) 97116.
(43) 97129.
(44) 97130.
(45) 97140.
(46) 97530.
(47) V5010.
(48) V5256.
(49) V5261.
(50) V5275.
(c) The state employee health plan may not issue a retroactive denial for medical necessity for a CPT code listed in subsection (b).
(d) Before November 1, 2025, the:
(1) interim study committee on public health, behavioral health, and human services; and
(2) interim study committee on financial institutions and insurance;
shall jointly review the impact of this section, including any relief on the administrative burdens to participating providers and any differences in utilization of the CPT codes listed in subsection (b).
(e) This section expires June 30, 2026.