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328 chapters · 3,181 sections in this title.
Ind. Code § 12-15-12.7-1 "Program"
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Sec. 1. As used in this chapter, "program" refers to the pathways for aging risk based managed care program established under IC 12-15-13-1.8 for a covered population. As added by P.L.174-2025, SEC.41.
Ind. Code § 12-15-12.7-2 Determination of reimbursement rates; prohibition
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Sec. 2. (a) The office of the secretary shall determine the base reimbursement rate structure, methodology, and reimbursement rates that may be paid to a provider for the services rendered under the program. (b) A managed care organization may not pay a provider less than the rei…
Ind. Code § 12-15-12.7-3 Contract with nursing facilities
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Sec. 3. (a) A managed care organization shall contract with any nursing facility that is: (1) licensed under IC 16-28; (2) certified by: (A) the United States Department of Health and Human Services to provide services under the Medicare program; or (B) the office of the secretar…
Ind. Code § 12-15-12.7-4 Report concerning denial of claims
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Sec. 4. (a) On a monthly basis, a managed care organization shall provide a report to the office of the secretary concerning the denial of claims. The report must specify denials by claim type for the previous month if the denials for the claim type total at least five percent (5…