§ 12-15-5-13 — Coverage for treatment of opioid or alcohol dependence; office requirements; report use of medications to committee

Indiana § 12-15-5-13

• Jurisdiction: Indiana
• Art. 15: MEDICAID
• Ch. 5: Services Provided

Text

(a) The office shall provide coverage for
treatment of opioid or alcohol dependence that includes the following:
(1) Counseling services that address the psychological and
behavioral aspects of addiction.
(2) When medically indicated, drug treatment involving agents
approved by the federal Food and Drug Administration for the:
(A) treatment of opioid or alcohol dependence; or
(B) prevention of relapse to opioids or alcohol after
detoxification.
(3) When determined by the treatment plan to be medically
necessary, inpatient detoxification in accordance with the most
current edition of the American Society of Addiction Medicine
Patient Placement Criteria.
(b) The office shall:
(1) develop quality measures to ensure; and
(2) require a managed care organization to report;
compliance with the coverage required under subsection (a).
(c) The office may implement quality capitation withholding of
reimbursement to ensure that a managed care organization has
provided the coverage required under subsection (a).
(d) The office shall report the clinical use of the medications
covered under this section to the mental health Medicaid quality
advisory committee established by IC 12-15-35-51. The mental health
Medicaid quality advisory committee may make recommendations to
the office concerning this section.

Legislative History

As added by P.L.209-2015, SEC.11. Amended by P.L.8-2016, SEC.1; P.L.152-2017, SEC.6; P.L.179-2019, SEC.1.