As used in this chapter, "medically necessary" means a health care service that a prudent health care provider would provide to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, disease, or symptoms in a manner that is:

1. (1) in accordance with generally accepted standards of medical practice;
2. (2) clinically appropriate in terms of type, frequency, extent, site, and duration; and

3. (3) not primarily for:

   1. (A) the economic benefit of the health plan or purchaser; or
   2. (B) the convenience of the health plan, patient, treating physician, or other health care provider.

As added by P.L.144-2025, SEC.13.