2006 Indiana Code - CHAPTER 29. INSURANCE

IC 12-15-29
     Chapter 29. Insurance

IC 12-15-29-1
Insurers; authorization to release information
     Sec. 1. An applicant for or a recipient of Medicaid is considered to have authorized an insurer to release to the office information needed by the office to secure or enforce the office's rights under Medicaid.
As added by P.L.2-1992, SEC.9.

IC 12-15-29-2
Requests for information from insurers; limitation
     Sec. 2. (a) Subject to subsection (b), an insurer shall furnish records or information pertaining to the coverage of an individual for the individual's medical costs under an individual or a group policy or other obligation, or the medical benefits paid or claims made under a policy or an obligation, if the office does the following:
        (1) Requests the information in writing.
        (2) Certifies that the individual is:
            (A) a Medicaid applicant or recipient; or
            (B) a person who is legally responsible for the applicant or recipient.
    (b) The office may request only the records or information necessary to determine whether insurance benefits have been or should have been claimed and paid with respect to items of medical care and services that were received by a particular individual and for which Medicaid coverage would otherwise be available.
As added by P.L.2-1992, SEC.9.

IC 12-15-29-3
Guidelines for information requests
     Sec. 3. The administrator and the insurance commissioner shall establish guidelines for information requests under this chapter.
As added by P.L.2-1992, SEC.9.

IC 12-15-29-4
Direct payments by insurers to office; amount of payments
     Sec. 4. (a) If:
        (1) an insurer has not discharged the insurer's obligation to make payments to an individual for medical services;
        (2) the individual has received Medicaid from the office; and
        (3) the insurer has received notice that Medicaid has been furnished to the individual;
the insurer shall make payments directly to the office.
    (b) The payments under subsection (a) may not exceed the amount of Medicaid paid by the office.
As added by P.L.2-1992, SEC.9.

IC 12-15-29-5 Medicaid furnished by office; insurer put on notice of claim by office; insurer paying person or entity other than office; office's claim not discharged
     Sec. 5. An insurer:
        (1) that is put on notice of a claim by the office under section 4 of this chapter; and
        (2) proceeds to pay the claim to a person or an entity other than the office;
is not discharged from payment of the office's claim.
As added by P.L.2-1992, SEC.9.

IC 12-15-29-6
Payment by insurer to office; discharge of obligation
     Sec. 6. Payment to the office by an insurer under section 4 of this chapter discharges the insurer's obligation with respect to further payment on the claim for the amount paid.
As added by P.L.2-1992, SEC.9.

IC 12-15-29-7
Notice to insurer that Medicaid has been furnished; requirements; notification given office by insurer; payment of claim
     Sec. 7. (a) The notice requirements of section 4 of this chapter are satisfied if:
        (1) the insurer receives from the office, by certified or registered mail, a statement of the claims paid or medical services rendered by the office, together with a claim for reimbursement; or
        (2) the insurer receives a claim from a beneficiary stating that the beneficiary has applied for or has received Medicaid from the office in connection with the same claim.
    (b) An insurer that receives a claim under subsection (a)(2) shall notify the office of the insurer's obligation on the claim and shall:
        (1) pay the obligation to the provider of service; or
        (2) if the office has provided Medicaid, pay the office.
As added by P.L.2-1992, SEC.9.

IC 12-15-29-8
Unlawful insurance clause
     Sec. 8. A clause of an insurance contract, plan, or agreement administered by an insurer is void if the clause limits or excludes enrollment or payments to an individual who is eligible for Medicaid.
As added by P.L.2-1992, SEC.9. Amended by P.L.46-1995, SEC.41.

IC 12-15-29-9
State's acquisition of person's right to payment
     Sec. 9. (a) IC 27-8-23 applies to this section.
    (b) To the extent that payment for covered medical expenses has been made under the state Medicaid program for health care items or services furnished to a person, in a case where a third party has a legal liability to make payments, the state is considered to have

acquired the rights of the person to payment by any other party for the health care items or services.
As added by P.L.46-1995, SEC.42.

IC 12-15-29-10
Employer sponsored health insurance to include coverage for child
     Sec. 10. (a) IC 27-8-23 applies to this section.
    (b) This section does not apply if an employer has eliminated family health coverage for all of its employees.
    (c) Whenever a parent is required by a court or an administrative order to provide health coverage for a child and the parent is eligible for family health coverage through an employer doing business in Indiana, the employer shall provide family health coverage to the child in the manner described under IC 27-8-23-6. In addition, the employer shall:
        (1) withhold from the employee's compensation the employee's share, if any, of premiums for health coverage; and
        (2) pay that amount to the insurer.
    (d) Upon the initiation of withholding under subsection (c), an employee whose applicable child support order did not include a deduction from weekly available income for the cost of the health care premium is entitled to a modification of the child support order, taking into account the payments made as of the date withholding began.
As added by P.L.46-1995, SEC.43.