§ 12-20-16-2 — Medical assistance; necessity

(a) Except as provided in subsections (b) and
(c), the township trustee shall, in cases of necessity, do the following:
(1) Promptly provide medical assistance for poor individuals in
the township who are not provided for in public institutions.
(2) See that medicines, medical supplies, special diets, or tests
prescribed by a physician or surgeon in attendance upon poor
individuals in the township are properly furnished.
(b) A township trustee may not provide to an individual medical
assistance under the township assistance program if the individual
could qualify for medical assistance for the same service under:
(1) IC 12-16;
(2) Medicaid;
(3) other governmental medical programs; or
(4) private health insurance that would cover the individual at the
time the assistance was provided. However, if the individual's
insurance does not pay for the medical assistance due to a policy
deductible or other policy limitation, the township trustee shall
pay for medical assistance that the trustee would provide if the
individual did not have insurance.
However, a township trustee may provide interim medical services
during the period that the individual has an application pending for
medical assistance under Medicaid (IC 12-15) or another governmental
medical program if the individual is reasonably complying with all
requirements of the application process.
(c) The township trustee shall pay only for the following medical
services for the poor of the township:
(1) Prescription drugs, not to exceed a thirty (30) day supply at a
time, as prescribed by an attending practitioner (as defined in IC 16-42-19-5) other than a veterinarian. However, if the
prescription drugs are available only in a container that contains
more than a thirty (30) day supply, the township trustee may pay
for the available size.
(2) Office calls to a physician licensed under IC 25-22.5 or
another medical provider.
(3) Dental care needed to relieve pain or infection or to repair
cavities.
(4) Repair or replacement of dentures.
(5) Emergency room treatment that is of an emergency nature.
(6) Preoperation testing prescribed by an attending physician
licensed under IC 25-22.5.
(7) Over-the-counter drugs prescribed by a practitioner (as
defined in IC 16-42-19-5) other than a veterinarian.
(8) X-rays and laboratory testing as prescribed by an attending
physician licensed under IC 25-22.5.
(9) Visits to a medical specialist when referred by an attending
physician licensed under IC 25-22.5.
(10) Physical therapy prescribed by an attending physician
licensed under IC 25-22.5.
(11) Eyeglasses.
(12) Repair or replacement of a prosthesis not provided for by
other tax supported state or federal programs.
(13) Insulin and items needed to administer the biological, not to
exceed a thirty (30) day supply at a time, in accordance with
section 14 of this chapter. However, if the biologicals are
available only in a container that contains more than a thirty (30)
day supply, the township trustee may pay for the available size.
(d) The township trustee may establish a list of approved medical
providers to provide medical services to the poor of the township. Any
medical provider who:
(1) can provide the particular medical services within the scope
of the provider's license issued under IC 25; and
(2) is willing to provide the medical services for the charges
established by the township trustee;
is entitled to be included on the list.
(e) Unless prohibited by federal law, a township trustee who:
(1) provides to an individual medical assistance that is eligible for
payment under any medical program described in subsection (b)
for which payments are administered by an agency of the state
during the pendency of the individual's successful application for
the program; and
(2) submits a timely and proper claim to the agency;
is eligible for reimbursement by the agency to the same extent as any
medical provider.
(f) If a township trustee provides medical assistance for medical
services provided to an individual who is subsequently determined to
be eligible for Medicaid:
(1) the township trustee shall notify the medical provider that
provided the medical services of the individual's eligibility; and
(2) not later than thirty (30) days after the medical provider
receives the notice under subdivision (1), the medical provider
shall file a claim for reimbursement with the office.
(g) A medical provider that is reimbursed under subsection (f) shall,
not later than thirty (30) days after receiving the reimbursement, pay to
the township trustee the lesser of:
(1) the amount of medical assistance received from the trustee to
an individual; or
(2) the amount reimbursed by Medicaid to the medical provider.
[Pre-1992 Revision Citation: 12-2-1-6(a) part.]

Legislative History

As added by P.L.2-1992, SEC.14. Amended by P.L.51-1996, SEC.54; P.L.262-2003, SEC.4; P.L.73-2005, SEC.70.