Indiana § 27-8-16-8 - Appeals procedure; written description; minimum standards; notice of appeal procedure on limitation or reduction of benefits
Full text of Indiana Indiana Code § 27-8-16-8 — Appeals procedure; written description; minimum standards; notice of appeal procedure on limitation or reduction of benefits, with citation guidance and answers to common questions.
§ 27-8-16-8. Appeals procedure; written description; minimum standards; notice of appeal procedure on limitation or reduction of benefits
Sec. 8. (a) An insurance company, a health maintenance organization, or another benefit program providing payment, reimbursement, or indemnification for health care costs that contracts with a claim review agent for medical claims review services shall maintain and make available upon request a written description of the appeals procedure by which an enrollee may seek a review of a determination by the claim review agent.
(b) The appeals procedure referred to in subsection (a) must meet the following requirements:
(1) On appeal, the determination must be made by a provider who holds a license in the same discipline as the provider who rendered the service.
(2) The adjudication of an appeal of a determination must be completed within thirty (30) days after:
(A) the appeal is filed; and
(B) all information necessary to complete the appeal is received.
(c) If a medical review determination results in a limitation or reduction of benefits, a notice of the appeals procedure shall be provided by the claim review agent to the provider who rendered the health care services.
As added by P.L.128-1992, SEC.2.
Source: official Indiana text · Last verified 2026-08-27
Frequently Asked Questions About Indiana § 27-8-16-8
What does Indiana Code § 27-8-16-8 cover?
Section 27-8-16-8 ("Appeals procedure; written description; minimum standards; notice of appeal procedure on limitation or reduction of benefits") is part of the Indiana Code, the codified statutory law of Indiana. It sets out the legal rule or procedure described in the text above. Statutes are amended regularly, so always verify against the official source.
How do I cite Indiana § 27-8-16-8?
A common citation format is "Indiana Code § 27-8-16-8" (Indiana). Legal writing may require the code abbreviation, section number, and year or edition. Match the style required by your court, professor, or publisher.
Is this the official text of Indiana law?
No. This page is for research and education and may not include the most recent amendments. For official current law, check the Indiana official source linked on this page or consult a licensed Indiana attorney.
How does Indiana § 27-8-16-8 apply to my situation?
Statutes are interpreted in context, and application depends on your specific facts. Only a licensed attorney in Indiana can advise on how this section applies to you. Contact your state or local bar association for a referral.
Sources & Verification
Not legal advice. Verify against the official source and consult a licensed attorney in Indiana.