Ind. Code § 27-1-37.5-1.5

Current through P.L. 171-2024

Section 27-1-37.5-1.5 - "Adverse determination"

As used in this chapter, "adverse determination" means a denial of a request for benefits on the grounds that the health service or item:

(1) is not medically necessary, appropriate, effective, or efficient;

(2) is not being provided in or at an appropriate health care setting or level of care; or

(3) is experimental or investigational.

IC 27-1-37.5-1.5

Added by P.L. 190-2023,SEC. 14, eff. 7/1/2023.