Indiana § 12-16-5.5-3 Denial of eligibility claim; notice; eligibility information

Indiana Statutes

§ 12-16-5.5-3 — Denial of eligibility claim; notice; eligibility information

Indiana § 12-16-5.5-3

Art. 16PAYMENT FOR HEALTH SERVICES OTHER

Ch. 5.5Hospital Care for the Indigent; Eligibility

This text of Indiana § 12-16-5.5-3 (Denial of eligibility claim; notice; eligibility information) is published on Counsel Stack Legal Research, covering Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ind. Code § 12-16-5.5-3 (2026).

Text

(a)Subject to subsection (b) and IC 12-16-6.5-1.5, if the division is unable after prompt and diligent efforts to verify information contained in the application that is reasonably necessary to determine eligibility, the division may deny assistance under the hospital care for the indigent program. The pending expiration of the period specified in IC 12-16-6.5-1.5 is not a valid reason for denying a person's eligibility for the hospital care for the indigent program.

(b)Before denying assistance under the hospital care for the indigent program, the division must provide the person and the provider who submitted a claim under IC 12-16-4.5-8.5 written notice of:

(1)the specific information or verification needed to determine eligibility;

(2)the specific efforts undertaken to obtain the i

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(a) Subject to subsection (b) and IC 12-16-6.5-1.5, if the division is unable after prompt and diligent efforts
to verify information contained in the application that is reasonably
necessary to determine eligibility, the division may deny assistance
under the hospital care for the indigent program. The pending
expiration of the period specified in IC 12-16-6.5-1.5 is not a valid
reason for denying a person's eligibility for the hospital care for the
indigent program.
(b) Before denying assistance under the hospital care for the
indigent program, the division must provide the person and the
provider who submitted a claim under IC 12-16-4.5-8.5 written notice
of:
(1) the specific information or verification needed to determine
eligibility;
(2) the specific efforts undertaken to obtain the information or
verification; and
(3) the statute or rule requiring the information or verification
identified under subdivision (1).
(c) The division must provide the provider who submitted a claim
under IC 12-16-4.5-8.5 a period of time, not less than ten (10) days
beyond the deadline established under IC 12-16-6.5-1.5, to submit to
the division information concerning the person's eligibility. If the
division does not make a determination of the person's eligibility within
ten (10) days after receiving the information under this subsection, the
person is eligible without the division's determination of the person's
eligibility for the hospital care for the indigent care program under this
article.