Indiana § 12-16-6.5-1.2 Appeal; notice

Indiana Statutes

§ 12-16-6.5-1.2 — Appeal; notice

Indiana § 12-16-6.5-1.2

Art. 16PAYMENT FOR HEALTH SERVICES OTHER

Ch. 6.5Hospital Care for the Indigent; Denial of Eligibility;

This text of Indiana § 12-16-6.5-1.2 (Appeal; notice) 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 § 12-16-6.5-1.2 (2026).

Text

2.

(a)If the division determines that an item or service identified in a claim:

(1)was not necessitated by one (1) or more of the medical conditions listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3) or IC 12-16-3.5-2(a)(1) through IC 12-16-3.5-2(a)(3); or

(2)was not a direct consequence of one (1) or more of the medical conditions listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3); the affected person or provider may appeal to the division not later than ninety (90) days after the mailing of the notice of that determination to the affected person or provider to the last known address of the person or provider.

(b)If the division determines that an item or service identified in a claim:

(1)was necessitated by one (1) or more of the medical conditions listed in IC 12-

Free access — add to your briefcase to read the full text and ask questions with AI

2. (a) If the division determines that an item
or service identified in a claim:
(1) was not necessitated by one (1) or more of the medical
conditions listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3) or IC 12-16-3.5-2(a)(1) through IC 12-16-3.5-2(a)(3); or
(2) was not a direct consequence of one (1) or more of the
medical conditions listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3);
the affected person or provider may appeal to the division not later than
ninety (90) days after the mailing of the notice of that determination to
the affected person or provider to the last known address of the person
or provider.
(b) If the division determines that an item or service identified in a
claim:
(1) was necessitated by one (1) or more of the medical conditions
listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3) or IC 12-16-3.5-2(a)(1) through IC 12-16-3.5-2(a)(3); or
(2) was a direct consequence of one (1) or more of the medical
conditions listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3);
but the affected provider disagrees with the amount of the claim
calculated by the division under IC 12-16-5.5-1.2(b), the affected
provider may appeal the calculation to the division not later than ninety
(90) days after the mailing of the notice of that calculation to the
affected provider to the last known address of the provider.