760 IAC 1-83-11 "Health payer" defined

Sec. 11. "Health payer" includes the following: (1) Medicare. (2) Medicaid or a managed care organization (as defined in IC 12-7-2-126.9 [NOTE: IC 12-7-2 is repealed by P.L. 145-2026, SECTION 62, effective July 1, 2026.]) that has contracted with Medicaid to provide services to a Medicaid recipient. (3) An insurer that issues a policy of accident and sickness insurance (as defined in IC 27-8-5-1), except for the following types of coverage: (A) Accident only, credit, dental, vision, long term care, or disability income insurance. (B) Coverage issued as a supplement to liability insurance. (C) Automobile medical payment insurance. (D) A specified disease policy. (E) A policy that provides indemnity benefits not based on any expense incurred requirements, including a plan that provides coverage for: (i) hospital confinement, critical illness, or intensive care; or (ii) gaps for deductibles or copayments. (F) Worker's compensation or similar insurance. (G) A student health plan. (H) A supplemental plan that always pays in addition to other coverage. (4) A health maintenance organization (as defined in IC 27-13-1-19). (5) A pharmacy benefit manager (as defined in IC 27-1-24.5-12). (6) A third party administrator. (7) A multiple employer welfare arrangement (as defined in IC 27-1-34-1). (8) A state employee health plan (as defined in IC 5-10-8-6.7(a)). (9) Any other person identified by the commissioner for participation in the data base.