§ 12-16-1-3 — Rules; adoption; requisites

Indiana § 12-16-1-3

• Jurisdiction: Indiana
• Art. 16: PAYMENT FOR HEALTH SERVICES OTHER
• Ch. 1: Medical Services for Inmates and Patients

Text

(a) The division shall, with the advice of the
division's medical staff, representatives of affected agencies, and other
individuals selected by the director of the division, adopt rules under
IC 4-22-2 to do the following:
(1) Provide for prior review and approval of covered medical
services, including special review and approval procedures for
emergency covered medical services.
(2) Establish limitations consistent with medical necessity on the
duration of services to be provided.
(3) Specify the amount of and method for reimbursement for
services.
(4) Specify the conditions under which payments will be denied
and improper payments will be recovered.
(b) To the extent possible, rules adopted under this section must be
consistent with Title XIX of the federal Social Security Act and with
IC 12-15-21-2 and IC 12-15-21-3.
[Pre-1992 Revision Citation: 12-5-7-4.]

Legislative History

As added by P.L.2-1992, SEC.10.