CHAPTER 11. PROVIDER AGREEMENTS AND COMPETITIVE BIDDING
IC 12-15-11
Chapter 11. Provider Agreements and Competitive Bidding
IC 12-15-11-1
Physician services defined
Sec. 1. (a) As used in this chapter, "physician services" means
services provided by an individual licensed under IC 25-22.5 while
engaged in the practice of medicine (as defined in
IC 25-22.5-1-1.1(a)).
(b) The term does not include the decision to admit a patient to a
hospital.
As added by P.L.2-1992, SEC.9.
IC 12-15-11-2
Services other than physician services provided by managed care
provider; provider agreement; filing; form
Sec. 2. A provider desiring to participate in the Medicaid program
by providing to individuals eligible for Medicaid services, other than
physician services provided by a managed care provider, shall file a
provider agreement with the office on forms provided by the office.
As added by P.L.2-1992, SEC.9.
IC 12-15-11-3
Provider agreements; required contents
Sec. 3. A provider agreement must do the following:
(1) Include information that the office determines necessary to
facilitate carrying out of IC 12-15.
(2) Prohibit the provider from requiring payment from a
recipient of Medicaid, except where a copayment is required by
law.
As added by P.L.2-1992, SEC.9.
IC 12-15-11-4
Providing physician services as managed care provider; provider
agreement
Sec. 4. A provider desiring to participate in the Medicaid program
by providing physician services as a managed care provider must
enter into a provider agreement with the office or the contractor
under IC 12-15-30 to provide Medicaid services.
As added by P.L.2-1992, SEC.9.
IC 12-15-11-5
Compliance with enrollment requirements
Sec. 5. A provider who participates in the Medicaid program must
comply with the enrollment requirements that are established under
rules adopted under IC 4-22-2 by the secretary.
As added by P.L.2-1992, SEC.9.
IC 12-15-11-6
Execution of provider agreement; authority of office to exclude
provider from participation by entry into exclusive contract with
another provider
Sec. 6. After a provider signs a provider agreement under this
chapter, the office may not exclude the provider from participating
in the Medicaid program by entering into an exclusive contract with
another provider or group of providers, except as provided under
section 7 of this chapter.
As added by P.L.2-1992, SEC.9.
IC 12-15-11-7
Competitive bids; services and items for which bids may be sought
Sec. 7. The office may seek competitive bids for the following
items or services provided under Medicaid:
(1) Prescribed drugs and services for state operated institutions.
(2) Physical therapy and other therapeutic services.
(3) Prescribed laboratory and x-ray services.
(4) Eyeglasses and prosthetic devices.
(5) Medical equipment and supplies.
(6) Transportation services.
As added by P.L.2-1992, SEC.9.