Ind. Code § 27-1-37.5-7
"Prior authorization"
Redline — January 1, 2018 → current.View current text →
Current — January 1, 2025
As of January 1, 2018
Sec. 7. As used in this chapter, "prior authorization" means a practice implemented by a health plan through which coverage of a health care service is dependent on the covered individual or health care provider obtaining approval from the health plan before the health care service is rendered. The term includes prospective or utilization review procedures conducted before a health care service is rendered.
Sec. 7. As used in this chapter, "prior authorization" means the process by which a utilization review entity determines the medical necessity of an otherwise covered health care service before the health care service is rendered. The term includes a utilization review entity's requirement that a covered individual or health care provider notify the utilization review entity prior to providing a health care service.
Official source: Indiana General Assembly. Reproduced from public-domain Indiana statutes; confirm against the official source for the current text. Not legal advice.