Title 12, TITLE 12. HUMAN SERVICES

Sec. 20. (a) The division and office may adopt rules under IC 4-22-2 that are necessary to implement this chapter. (b) The office shall apply for any federal waivers necessary to implement this chapter. As added by P.L.141-2006, SEC.44.

Sec. 21. The division shall adopt rules under IC 4-22-2 concerning the following: (1) The receipt, review, and investigation of complaints concerning the: (A) neglect; (B) abuse; (C) mistreatment; or (D) misappropriation of property; of an individual in need of self-directed in-h…

Sec. 3. As used in this chapter, "attendant care services" means those basic and ancillary services that the individual chooses to direct and supervise a personal services attendant to perform and that enable an individual in need of self-directed in-home care to live in the indi…

Sec. 4. As used in this chapter, "basic services" means a function that could be performed by the individual in need of self-directed in-home care if the individual did not have a physical disability. The term includes the following: (1) Assistance in getting in and out of beds, …

Sec. 5. As used in this chapter, "health related services" means those medical activities that, in the written opinion of the attending physician submitted to the case manager of the individual in need of self-directed in-home care, could be performed by the individual if the ind…

Sec. 6. As used in this chapter, "individual in need of self-directed in-home care" means an individual with a disability, or person responsible for making health related decisions for the individual with a disability, who: (1) is approved to receive Medicaid waiver services unde…

Sec. 7. As used in this chapter, "licensed health professional" means any of the following: (1) A registered nurse. (2) A licensed practical nurse. (3) A physician with an unlimited license to practice medicine or osteopathic medicine. (4) A licensed dentist. (5) A licensed chiro…

Sec. 8. As used in this chapter, "personal services attendant" means an individual who is registered to provide attendant care services under this chapter and who has entered into a contract with an individual and acts under the individual's direction to provide attendant care se…

Sec. 9. As used in this chapter, "self-directed in-home health care" means the process by which an individual, who is prevented by a disability from performing basic and ancillary services that the individual would perform if the individual did not have a disability, chooses to d…

Sec. 1. As used in this chapter, "addiction treatment team" means a group of providers consisting of at least: (1) either: (A) an advanced practice registered nurse licensed under IC 25-23 with prescriptive authority to prescribe a legend drug; or (B) a physician assistant licens…

Sec. 2. An addiction treatment team shall provide addiction treatment services with a goal of patient abstinence. An addiction treatment team shall provide the following services, when appropriate: (1) Addiction counseling. (2) Detoxification. (3) Medication assisted treatment, i…

Sec. 3. When considered necessary, an addiction treatment team shall enter into a memorandum of understanding with the following: (1) A pharmacy licensed under IC 25-26, for purposes of accessing medication assisted treatment drugs. (2) A mental health provider that treats patien…

Sec. 4. (a) The division shall reimburse for the use of addiction treatment teams from mental health and addiction forensic treatment services grants under IC 12-23-19 for those entities that have been approved by a community corrections advisory board (IC 11-12-2-2). (b) The div…

Sec. 5. An addiction treatment team may supplement treatment infrastructure shortages by providing services in a mobile unit or temporary location, including in the following locations: (1) Geographically high risk areas for substance use disorders. (2) Medically underserved area…

of state laws Sec. 1. The office is not required to implement or continue to implement IC 12-15-16, IC 12-15-17, IC 12-15-18, IC 12-15-19, or IC 12-15-20 if the means of financial matching described is or becomes contrary to federal law. As added by P.L.27-1992, SEC.25.

Sec. 1. As used in this chapter: (1) "Medicaid inpatient payments for safety-net hospitals" means the payments provided for in the Medicaid state plan for inpatient services provided by hospitals that satisfy the definition of a safety-net hospital under the Medicaid state plan; …

Sec. 2. (a) This section does not apply during the period that the office is assessing a hospital fee authorized by IC 16-21-10. For each state fiscal year ending before July 1, 2005, and subject to section 3 of this chapter (repealed), the office shall make the payments identifi…

As added by P.L.255-2003, SEC.23. Repealed by P.L.212-2007, SEC.31; P.L.218-2007, SEC.52.

grant program Sec. 1. The division shall establish: (1) a comprehensive addiction recovery center certification for eligible entities that meet the requirements of this chapter; and (2) a comprehensive addiction recovery center grant program for the purpose of assisting in the es…

Sec. 2. (a) The division may award a grant in accordance with this chapter to an eligible entity or group of entities working in cooperation to establish or operate a comprehensive addiction recovery center. In order for an entity to be certified as a comprehensive addiction reco…

Sec. 3. (a) Not later than September 1, 2020, each entity that is awarded a grant under this chapter to establish or operate a comprehensive addiction recovery center must submit to the division the following data: (1) The programs and activities funded by the grant. (2) The heal…

Sec. 4. (a) The comprehensive addiction recovery center fund is established for the purpose of carrying out this chapter. The fund shall be administered by the division. The expenses of administering the fund shall be paid from money in the fund. (b) The fund shall consist of the…

Sec. 1. As used in this chapter, "covered entity" has the meaning set forth in 45 CFR 160.103. As added by P.L.187-2007, SEC.3.

Sec. 2. (a) Before January 1, 2008, the office shall: (1) examine all Medicaid claims paid after January 1, 2001, and before July 1, 2007; (2) determine which claims examined under subdivision (1) were eligible for payment by a third party other than Medicaid; and (3) recover the…

Sec. 3. If at least one percent (1%) of the claims were determined under section 2 of this chapter to be eligible for payment by a third party other than Medicaid, the office shall develop and implement a procedure to improve the coordination of benefits between: (1) the Medicaid…

Sec. 4. If a procedure is developed and implemented under section 3 of this chapter, the procedure: (1) must be automated; and (2) must provide a system for determining whether a Medicaid claim is eligible for payment by another third party before the claim is paid under the Medi…

Sec. 1. (a) The division may establish and administer a community and faith based substance abuse transportation assistance grant program for the purpose of supporting individuals in: (1) avoiding abuse of; or (2) overcoming addiction to; at least one (1) substance by reimbursing…

Sec. 1. As used in this chapter, "broker" means a contractor of the office that administers the Medicaid fee-for-service nonemergency medical transportation program. As added by P.L.116-2019, SEC.4.

Sec. 2. As used in this chapter, "commission" refers to the nonemergency medical transportation commission established by section 7 of this chapter. As added by P.L.116-2019, SEC.4.

Sec. 3. As used in this chapter, "nonemergency medical transportation" means medically necessary transportation to Medicaid covered services for an eligible Medicaid recipient who: (1) participates in the Medicaid fee-for-service program; and (2) does not have available transport…

within 48 hours Sec. 4. (a) A broker must do the following: (1) Submit monthly reports to the office of the secretary for the office of the secretary to post on the office of the secretary's Internet web site of the following: (A) A list and map by county of the number of vehicle…

Sec. 5. (a) A broker shall establish, implement, and maintain the following: (1) One (1) toll free telephone number clearly identified for the handling of complaints concerning the nonemergency medical transportation services. (2) A link on the home page of the broker's Internet …

Sec. 6. (a) Before October 1, 2019, the office of the secretary shall prepare a report containing the number of Medicaid fee-for-service nonemergency medical transportation claims paid by: (1) vehicle type; (2) Medicaid recipient category; and (3) whether the recipient for which …

Sec. 7. (a) The nonemergency medical transportation commission is established for the purpose of overseeing the provision of nonemergency medical transportation services to ensure that Medicaid fee-for-service recipients are receiving satisfactory service and to ensure that broke…

Sec. 8. (a) Each member of the commission who is not a state employee is entitled to the minimum salary per diem provided by IC 4-10-11-2.1(b). Such a member is also entitled to reimbursement for traveling expenses and other expenses actually incurred in connection with the membe…

Sec. 9. The commission shall meet at least two (2) times per year at a public meeting to do the following: (1) Review a report submitted under this chapter. (2) Provide feedback and make recommendations to the office of the secretary concerning the provision of nonemergency medic…

Sec. 1. At least once every two (2) years, the office shall conduct a survey of pharmacy providers to assess the appropriate level of dispensing fees to be paid to providers for prescribed drugs. As added by P.L.15-2002, SEC.1.

Sec. 2. A survey under section 1 of this chapter must include an evaluation of dispensing fees in other states and the policies of the federal Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration). As added by P.L.15-2002, SEC.1.

Sec. 3. A dispensing fee shall be evaluated based upon the following information concerning the costs of pharmacy operation: (1) Operational data. (2) Professional services data. (3) Overhead data. (4) Profit data. As added by P.L.15-2002, SEC.1.

Sec. 4. If an adjustment in dispensing fees is made following a survey conducted under section 1 of this chapter, the secretary shall commence the rulemaking process under IC 4-22-2 to make the adjustment not later than November 1 of the year in which the survey was conducted. As…

Sec. 1. As used in this chapter, "committee" refers to the Medicaid clinical advisory committee established under this chapter. As added by P.L.42-1995, SEC.25.

Sec. 2. The office shall establish a clinical advisory committee to provide clinical insights and applications of clinical policy issues related to programs administered by the office, including issues related to: (1) current standards of care; (2) quality of care; (3) accessibil…

committee Sec. 3. (a) The committee consists of at least seven (7) members and not more than thirteen (13) members. (b) The office's medical consultant shall serve as the chairperson of the committee. (c) The committee shall include at least seven (7) physicians who are: (1) lice…

Sec. 1. This chapter applies to: (1) the Medicaid program under this article; and (2) the children's health insurance program under IC 12-17.6. As added by P.L.6-2002, SEC.4. Amended by P.L.101-2005, SEC.5.

Sec. 2. As used in this chapter, "cross-indicated drug" means a drug that is used for a purpose generally held to be reasonable, appropriate, and within the community standards of practice even though the use is not included in the federal Food and Drug Administration's approved …

Sec. 2.5. As used in this chapter, "unrestricted access" means the ability of a recipient to obtain a prescribed drug without being subject to limits or preferences imposed by the office or the board for the purpose of cost savings except as provided under section 7 of this chapt…

Sec. 2.6. As used in this chapter, "waste" means inappropriate: (1) overprescribing; (2) underprescribing; (3) overutilization; (4) underutilization; (5) recipient noncompliance with the prescribed regimen; or (6) clinically unjustified utilization; of a prescription drug. As add…

exception Sec. 3. (a) Except as provided in subsection (b), the office may establish prior authorization requirements for drugs covered under a program described in section 1 of this chapter. (b) With the exception of prior authorization for "brand medically necessary" of a brand…

Sec. 4. Prior authorization requirements developed under this chapter must: (1) comply with all applicable state and federal laws, including the provisions of 405 IAC 5-3 and 42 U.S.C. 1396r-8(d)(5); and (2) provide that the prior authorization number assigned to an approved requ…

Sec. 5. Before requiring prior authorization for a single source drug, the office shall seek the advice of the drug utilization review board, established by IC 12-15-35-19, at a public meeting of the board. As added by P.L.6-2002, SEC.4.