CHAPTER 36. PAYMENTS FOR SPECIAL SERVICES
IC 12-15-36
Chapter 36. Payments for Special Services
IC 12-15-36-1
Application of chapter
Sec. 1. This chapter applies to a health facility licensed under
IC 16-28 that has been approved by the office to have more than
eight (8) beds but less than forty (40) beds approved for special
skilled services.
As added by P.L.76-1992, SEC.3. Amended by P.L.2-1993, SEC.103.
IC 12-15-36-2
"Chronically medically dependent" defined
Sec. 2. As used in this chapter, "chronically medically dependent"
means a medical condition of a person who is infected by the human
immunodeficiency virus (HIV) and has been certified by a physician
as, because of the HIV infection, requiring a skilled or intermediate
level of care.
As added by P.L.76-1992, SEC.3.
IC 12-15-36-3
"Special skilled services" defined
Sec. 3. As used in this chapter, "special skilled services" refers to
medical and health services that are provided to a patient who is:
(1) chronically medically dependent; and
(2) in need of a level of care that is less intensive than the care
provided in a hospital licensed under IC 16-21.
As added by P.L.76-1992, SEC.3. Amended by P.L.2-1993, SEC.104.
IC 12-15-36-4
Payment rate; establishment under federal law
Sec. 4. The office shall, under 42 U.S.C. 1396 et seq., establish a
payment rate to a health facility for special skilled services.
As added by P.L.76-1992, SEC.3.
IC 12-15-36-5
Payment standards; costs included
Sec. 5. Payment for special skilled services provided in a health
facility must meet the following conditions:
(1) Be determined in accordance with a prospective payment
rate that is reasonable and adequate to meet the costs that must
be incurred by efficiently and economically operated facilities
to provide care and services in conformity with applicable state
and federal laws, rules, regulations, and quality and safety
standards.
(2) Include the increased costs for respiratory therapy, intensive
case management, social services, physician and nursing care,
linens, and dietary supplements.
As added by P.L.76-1992, SEC.3.
IC 12-15-36-6
Implementation of chapter
Sec. 6. The office shall adopt rules under IC 4-22-2 to implement
this chapter.
As added by P.L.76-1992, SEC.3.
IC 12-15-36-7
Approval of more than 100 beds; necessity of agreement
Sec. 7. The office of Medicaid policy and planning may not
approve more than one hundred (100) beds for special skilled
services under this chapter without the agreement of the
commissioner of the state department of health and the administrator
of the office of Medicaid policy and planning.
As added by P.L.76-1992, SEC.3.