1. (a) If a health maintenance organization denies coverage for a treatment, procedure, drug, or device on the grounds that the treatment, procedure, drug, or device is experimental, the health maintenance organization shall provide the enrollee with a written explanation that includes the following:

   1. (1) The basis for the denial.
   2. (2) The enrollee's right to appeal the health maintenance organization's decision as provided in IC 27-8-16-8 , IC 27-8-17-12 , and IC 27-13-10 .

   3. (3) The telephone number of:

      1. (A) an individual employed by the health maintenance organization whom; or

      2. (B) a department of the health maintenance organization that;

         the enrollee may contact for assistance in initiating an appeal of the health maintenance organization's decision.

2. (b) An enrollee is entitled to a review that takes not more than seventy-two (72) hours if the enrollee's health situation is life threatening or is an emergency.

As added by P.L.69-1998, SEC.17.