{"data":{"id":"us-in/ic-27-13-39-3","jurisdiction":"us-in","citation":"IC 27-13-39-3","heading":"Written explanation of denial of coverage of experimental treatment; review","body":"Sec. 3. (a) If a health maintenance organization denies coverage for a treatment, procedure, drug, or device on the grounds that the treatment, procedure, drug, or device is experimental, the health maintenance organization shall provide the enrollee with a written explanation that includes the following:\n(1) The basis for the denial.\n(2) The enrollee's right to appeal the health maintenance organization's decision as provided in IC 27-8-16-8, IC 27-8-17-12, and IC 27-13-10.\n(3) The telephone number of:\n(A) an individual employed by the health maintenance organization whom; or\n(B) a department of the health maintenance organization that;\nthe enrollee may contact for assistance in initiating an appeal of the health maintenance organization's decision.\n(b) An enrollee is entitled to a review that takes not more than seventy-two (72) hours if the enrollee's health situation is life threatening or is an emergency.","path":["TITLE 27. INSURANCE","ARTICLE 13. HEALTH MAINTENANCE ORGANIZATIONS","Chapter 39. Patient Protection; Experimental Treatments"],"source_url":"https://iga.in.gov/ic/2026/Title_27.html#27-13-39-3","current_through":"2026","vintage":"2026","retrieved_at":"2026-09-25T05:39:04Z","sha256":"b455808f1b1982acceecc0ed0714a8805b04954561e29a90c63e7a7f3208378d","source_id":"us-in","stale":false,"prev":"us-in/ic-27-13-39-2","next":"us-in/ic-27-13-40-1"},"notice":"GroundRules: Original legal text. Not legal advice."}