Bill Text: IN HB1071 | 2011 | Regular Session | Enrolled
Bill Title: Anatomic pathology services.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Passed) 2011-05-16 - Effective 07/01/2011 [HB1071 Detail]
Download: Indiana-2011-HB1071-Enrolled.html
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AN ACT to amend the Indiana Code concerning health.
ARTICLE 48. OTHER HEALTH CARE PROVIDERS AND SERVICES
Chapter 1. Anatomic Pathology Services
Sec. 1. As used in this chapter, "anatomic pathology service" means any of the following performed by a physician or under the supervision of a physician on a sample taken from a human body:
(1) Histopathology or surgical pathology, meaning the gross and microscopic examination and histologic processing of organ tissue.
(2) Cytopathology, meaning the microscopic examination of cells from the following:
(A) Fluids.
(B) Aspirates.
(C) Washings.
(D) Brushings.
(E) Smears.
(3) Hematology, meaning the microscopic evaluation of bone marrow aspirates and biopsies, and peripheral blood smears when the attending or treating physician or technologist
requests that a blood smear be reviewed by a pathologist.
(4) Subcellular pathology and molecular pathology, meaning
the assessment of a specimen for detection, localization,
measurement, or analysis of protein or nucleic acid targets.
(5) Blood banking services performed by pathologists.
Sec. 2. As used in this chapter, "physician" includes a physician
group practice.
Sec. 3. As used in this chapter, "provider" means a health care
provider or a clinical laboratory.
Sec. 4. As used in this chapter, "second opinion" means
consultation, histologic processing, or additional testing performed
on a sample by a second provider after an anatomic pathology
service is performed on the sample by a first provider.
Sec. 5. (a) Except as provided in subsection (b), a provider shall
not present a bill, claim, or other demand for payment for an
anatomic pathology service unless the anatomic pathology service
was performed:
(1) within the provider's office;
(2) by a physician or under the direct supervision of a
physician; and
(3) in accordance with Section 353 of the federal Public
Health Service Act (42 U.S.C. 263a).
(b) If a sample taken from a human body is sent:
(1) by a provider that has performed an anatomic pathology
service; and
(2) to a second provider for a second opinion;
the provider described in subdivision (1) may present a bill, claim,
or other demand for payment for the second opinion.
Sec. 6. (a) Except as provided in subsection (b), a bill, claim, or
other demand for payment permitted by section 5 of this chapter
may be presented only to the following:
(1) The patient.
(2) The patient's insurer or other third party payer.
(3) A government agency, or another agency or organization,
that serves as a payment source on behalf of the patient.
(4) The hospital, health clinic, public health clinic, or rural
health clinic.
(b) If a provider described in section 5(b)(1) of this chapter
presents a bill, claim, or other demand for payment for a second
opinion as permitted by section 5(b) of this chapter, the second
provider may bill the provider described in section 5(b)(1) for the
second opinion.
Sec. 7. A person is not required to reimburse a provider for charges or claims submitted in violation of this chapter.
Sec. 8. If a provider violates this chapter, the state entity that has jurisdiction over licensing or certification of the provider may revoke, suspend, or refuse to renew the license or certification of the provider.
Sec. 9. This chapter does not require assignment of benefits for an anatomic pathology service.
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