IC 5-10-8-22: Coverage for chronic pain management

Sec. 22. (a) As used in this section, "chronic pain" means pain that:

(1) persists beyond the usual course of an acute disease or healing of an injury; or

(2) may be associated with an acute or chronic pathologic process that causes continuous or intermittent pain for a period of months or years.

(b) As used in this section, "chronic pain management" means evidence based health care products and services intended to relieve chronic pain that has lasted for at least three (3) months. The term includes:

(1) prescription drugs;

(2) physical therapy;

(3) occupational therapy;

(4) chiropractic care; and

(5) osteopathic manipulative treatment.

(c) As used in this section, "covered individual" means an individual entitled to coverage under a state employee health plan.

(d) As used in this section, "state employee health plan" means the following:

(1) A self-insurance program established under section 7(b) of this chapter.

(2) A contract for prepaid health care services entered into under section 7(c) of this chapter.

The term does not include a dental plan.

(e) A state employee health plan must provide coverage for medically necessary chronic pain management prescribed by a covered individual's treating practitioner.

(f) The coverage required by this section may not be subject to annual or lifetime limitation, deductible, copayment, or coinsurance provisions that are more restrictive than the annual or lifetime limitation, deductible, copayment, or coinsurance provisions that apply generally under the state employee health plan.