405 Ind. Admin. Code 10-9-6

Current through December 25, 2024

Section 405 IAC 10-9-6 - Member payment liability

Authority: IC 12-15-44.5-9

Affected: IC 12-15-44.5

Sec. 6.

A provider shall accept plan reimbursement as payment in full. A provider cannot collect from a member any portion of the provider's charge for a covered service that is not reimbursed by the managed care organization, with the exception of the following:

(1) Emergency room copayments authorized under this article.

(2) Payments made with POWER account funds before the deductible of the member's health plan is met.

(3) Copayments authorized under 405 IAC 10-10-3(c).

405 IAC 10-9-6

Filed 5/18/2015, 12:34 p.m.: 20150617-IR-405140339FRA

Filed 1/19/2018, 8:42 a.m.: 20180214-IR-405170484FRA

Errata Filed 2/22/2018, 9:36 a.m: 20180307-IR-405180114ACA