Title 12, TITLE 12. HUMAN SERVICES

As added by P.L.142-2000, SEC.2. Amended by P.L.141-2001, SEC.3; P.L.122-2002, SEC.1. Repealed by P.L.145-2005, SEC.30.

As added by P.L.145-2005, SEC.1. Repealed by P.L.1-2007, SEC.248.

As added by P.L.142-2000, SEC.2. Repealed by P.L.1-2002, SEC.172. IC 12-15-11.5-4.1 Repealed As added by P.L.141-2001, SEC.4. Amended by P.L.122-2002, SEC.2. Repealed by P.L.145-2005, SEC.30.

As added by P.L.145-2005, SEC.2. Repealed by P.L.1-2007, SEC.248.

As added by P.L.142-2000, SEC.2. Repealed by P.L.1-2002, SEC.172.

Sec. 6. A claim for reimbursement for services shall be treated as a disputed claim under this chapter if: (1) it is submitted within one hundred twenty (120) days after the date that services are rendered; (2) it is denied by the managed care organization; (3) the hospital submi…

Sec. 7. The office's managed care organization must conclude an appeal under section 6(4) of this chapter and notify the hospital of its decision not more than thirty-five (35) days after the managed care organization receives a notice from the hospital disputing the managed care…

Sec. 8. (a) A contract entered into by a hospital with the office's managed care organization for the provision of services under the office's managed care program must include a dispute resolution procedure for all disputed claims. Unless agreed to in writing by the hospital and…

and managed care organization Sec. 9. The arbitration process described in section 8 of this chapter shall also be followed for resolution of disputed claims between a hospital and the office's managed care organization, if the hospital is not a contracted provider in the office'…

As added by P.L.120-2002, SEC.27. Repealed by P.L.145-2005, SEC.31.

As added by P.L.120-2002, SEC.27. Repealed by P.L.145-2005, SEC.31.

As added by P.L.120-2002, SEC.27. Repealed by P.L.255-2003, SEC.55.

Sec. 1. As used in this chapter, "office" refers to the office of the secretary of family and social services. As added by P.L.134-2019, SEC.2.

Sec. 2. (a) The office and a managed care organization that has contracted with the office under this article shall perform a recovery audit to ensure the integrity of the Medicaid program. (b) The office shall contract with a recovery auditing entity to perform the recovery audi…

Sec. 3. A recovery audit under this chapter must include the following: (1) Subject to subdivision (2), for audits initiated after June 30, 2019, the audit look back period must be three (3) years and one hundred-eighty (180) days. (2) If the office or a managed care organization…

Sec. 4. The managed care organization or the auditing entity, in conjunction with the office, shall perform educational and training programs annually for providers that include the following: (1) A summary of the managed care organization's auditing entity's past or previous aud…

plans of treatment Sec. 6. (a) Subject to subsection (b), a recovery audit shall not require documentation, at the time of service, for services provided by a community mental health center (as defined in IC 12-7-2-38) when the documentation is part of an ongoing plan of treatmen…

Sec. 1. A hospital, a physician, or an agent or employee of a hospital or physician that provides services in good faith under the hospital care for the indigent program is immune from liability to the extent the liability is attributable to at least one (1) of the following: (1)…

condition permits transfer Sec. 2. Section 1(1) of this chapter does not limit liability for the determination that the patient's medical condition permits a transfer under IC 12-16-12.5 (repealed). As added by P.L.120-2002, SEC.29. Amended by P.L.156-2020, SEC.58.

As added by P.L.120-2002, SEC.29. Repealed by P.L.255-2003, SEC.55.

proposal Sec. 1. (a) Once every three (3) state fiscal years: (1) the state board of accounts; or (2) an independent auditor with experience auditing expenses related to prescription drugs that is hired by the state board of accounts; shall conduct an audit examining prescription…

Sec. 2. (a) For an audit conducted under section 1(a) of this chapter, the audit look back period must be the previous three (3) state fiscal years. (b) For an audit described in section 1(b) of this chapter, the look back period must be the previous five (5) state fiscal years. …

Sec. 4. (a) The results of an audit conducted under section 1(a) of this chapter must be provided to the office of the secretary. (b) Before September 1, 2024, the results of an audit conducted under IC 27-1-3.7 and section 1(b) of this chapter must be provided to the interim stu…

Sec. 1. The division of family resources shall provide to the following entities in the county a list of dentists practicing in the county who provide dental services under the Medicaid program (IC 12-15) or the children's health insurance program (IC 12-17.6): (1) Head Start pro…

Sec. 2. The division shall collaborate with the office of Medicaid policy and planning established by IC 12-8-6.5-1 and the Indiana department of health established by IC 16-19-1-1 to establish programs that facilitate children's access to oral health services. As added by P.L.16…

Sec. 1. As used in this chapter, "task force" refers to the services for individuals with intellectual and other developmental disabilities task force established by section 2 of this chapter. As added by P.L.262-2019, SEC.3.

developmental disabilities task force; establishment; members Sec. 2. (a) The services for individuals with intellectual and other developmental disabilities task force is established. (b) The task force consists of twenty-one (21) members as follows: (1) One (1) member represent…

developmental disabilities task force; member compensation and reimbursement Sec. 3. (a) A member of the task force who is not a state employee is entitled to the minimum salary per diem provided by IC 4-10-11-2.1(b). The member is also entitled to reimbursement for traveling exp…

developmental disabilities task force; meetings Sec. 4. (a) As used in this section, "plan" refers to the comprehensive plan of community based services provided to people with intellectual and other developmental disabilities developed by IC 12-11-15-4 (before its expiration). (…

registry; pilot project Sec. 4.5. (a) Not later than September 1, 2022, the task force shall make recommendations to the legislative council regarding the: (1) establishment of a statewide training curriculum for individuals who provide services to individuals with an intellectua…

requests; pilot program for special service review teams Sec. 4.6. (a) Not later than September 1, 2022, the task force shall make recommendations to the legislative council regarding: (1) current trends related to health and safety requests for the community integration habilita…

As added by P.L.114-2022, SEC.19. Expired 1-1-2023 by P.L.114-2022, SEC.19.

developmental disabilities task force; staffing Sec. 5. The office of the secretary of family and social services shall staff the task force. As added by P.L.262-2019, SEC.3.

Sec. 6. This chapter expires December 31, 2025. As added by P.L.262-2019, SEC.3.

determining eligibility Sec. 1. The division shall review changes made after 1985 in the medical criteria used to establish whether a patient is eligible for assistance under IC 12-16-3.5. As added by P.L.120-2002, SEC.39.

Sec. 2. The division's review under this chapter must include the application of the criteria to specific cases and address whether changes to or clarification of the criteria is necessary so that, in practice, the criteria is consistent with the hospital care for the indigent pr…

Sec. 3. The division shall provide to an interested party a report of the division's review, including the division's findings, conclusions, and recommendations. As added by P.L.120-2002, SEC.39.

As added by P.L.120-2002, SEC.39. Repealed by P.L.255-2003, SEC.55.

Sec. 1. This chapter does not apply to the following: (1) An individual who provides attendant care services and who is employed by and under the direct control of a home health agency (as defined in IC 12-15-34-1). (2) An individual who provides attendant care services and who i…

Sec. 10. (a) An individual may not provide attendant care services for compensation from Medicaid or the community and home options to institutional care for the elderly and disabled program for an individual in need of self-directed in-home care services unless the individual is…

Sec. 11. An individual who desires to provide attendant care services must register with the division or with an organization designated by the division. As added by P.L.141-2006, SEC.44.

Sec. 12. (a) The division shall register an individual who provides the following: (1) A personal resume containing information concerning the individual's qualifications, work experience, and any credentials the individual may hold. The individual must certify that the informati…

Sec. 13. The case manager of an individual in need of self-directed in-home care shall maintain an attending physician's written opinion submitted under section 5 of this chapter in a case file that is maintained for the individual by the case manager. As added by P.L.141-2006, S…

Sec. 14. (a) A personal services attendant who is hired by the individual in need of self-directed in-home care is an employee of the individual in need of self-directed in-home care. (b) The division is not liable for any actions of a personal services attendant or an individual…

care Sec. 15. (a) Except as provided in subsection (b), an individual in need of self-directed in-home care is responsible for recruiting, hiring, training, paying, certifying any employment related documents, dismissing, and supervising in the individual's home during service ho…

Sec. 16. The division shall adopt rules under IC 4-22-2 concerning: (1) the method of payment to a personal services attendant who provides authorized services under this chapter; and (2) record keeping requirements for personal attendant services. As added by P.L.141-2006, SEC.4…

Sec. 17. The individual in need of self-directed in-home care and the personal services attendant must each sign a contract, in a form approved by the division, that includes, at a minimum, the following provisions: (1) The responsibilities of the personal services attendant. (2)…

program; payments not considered income Sec. 18. (a) The office shall amend the home and community based services waiver program under the state Medicaid plan to provide for the payment for attendant care services provided by a personal services attendant for an individual in nee…

Sec. 19. The division may: (1) initiate demonstration projects to test new ways of providing attendant care services; and (2) research ways to best provide attendant care services in urban and rural areas. As added by P.L.141-2006, SEC.44.

Sec. 2. As used in this chapter, "ancillary services" means services ancillary to the basic services provided to an individual in need of self-directed in-home care who needs at least one (1) of the basic services (as defined in section 4 of this chapter). The term includes the f…