Indiana Statutes
§ 12-16-1-3 — Rules; adoption; requisites
(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
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Legislative History
As added by P.L.2-1992, SEC.10.
Nearby Sections
15
§ 12-10-1-1
Establishment of bureau§ 12-10-1-2
Purpose§ 12-10-1-3
Administration of programs§ 12-10-1-4
Duties§ 12-10-1-5
Coordination of services with area agencies§ 12-10-1-6
Area agencies; duties; coverage area changes§ 12-10-10-1
"Case management"§ 12-10-10-1.5
"Activities of daily living"§ 12-10-10-10
Services funding; source§ 12-10-10-12
Negotiation of reimbursement rates§ 12-10-10-2
"Community and home care services"