IC 27-13-36-3: Adequate number of services and providers within reasonable proximity of subscribers

Sec. 3. (a) The provisions of this section do not apply until July 1, 1999.

(b) Each health maintenance organization shall demonstrate to the department that the health maintenance organization offers an adequate number of:

(1) acute care hospital services;

(2) primary care providers; and

(3) other appropriate providers;

that are located within a reasonable proximity of subscribers of the health maintenance organization. Compliance with the National Committee on Quality Assurance standards or guidelines is sufficient to meet the requirements of this subsection.

(c) If a health maintenance organization provides coverage for:

(1) specialty medical services, including physical therapy, occupational therapy, and rehabilitation services;

(2) mental and behavioral care services; or

(3) pharmacy services;

the health maintenance organization shall demonstrate to the department that the offered services are located within a reasonable proximity of subscribers of the health maintenance organization. Compliance with the National Committee on Quality Assurance standards or guidelines is sufficient to meet the requirements of this subsection.