CHAPTER 6. INDIVIDUAL CONTRIBUTIONS
IC 12-15-6
Chapter 6. Individual Contributions
IC 12-15-6-1
Enrollment fees, premiums, or other charges as condition of
eligibility
Sec. 1. Except as provided in section 2 of this chapter, and
beginning July 1, 2002, except as provided in IC 12-15-41, an
enrollment fee, a premium, or a similar charge may not be imposed
as a condition of an individual's eligibility for Medicaid.
As added by P.L.2-1992, SEC.9. Amended by P.L.287-2001, SEC.8.
IC 12-15-6-2
Copayment; application for certain services
Sec. 2. The office shall apply a copayment for certain types of
Medicaid.
As added by P.L.2-1992, SEC.9.
IC 12-15-6-3
Copayment; time for making
Sec. 3. (a) A copayment shall be made by the recipient of
Medicaid upon receipt of assistance. If a recipient of Medicaid does
not make the copayment, the office may not require the provider to
collect the copayment. However, a provider may not voluntarily
waive the copayment by the recipient under this section.
(b) The office may adopt rules under IC 4-22-2 to prescribe that
the copayment amount is not deducted from the reimbursement to the
provider for services provided by the provider if a recipient of
Medicaid does not make the copayment.
As added by P.L.2-1992, SEC.9. Amended by P.L.114-1996, SEC.1.
IC 12-15-6-4
Services to which copayment applies; exceptions
Sec. 4. A copayment applies to all services except the following:
(1) Services furnished to individuals less than eighteen (18)
years of age.
(2) Services furnished to pregnant women if the services relate
to the pregnancy or to any other medical condition that might
complicate the pregnancy.
(3) Services furnished to individuals who are inpatients in
hospitals, nursing facilities, including intermediate care
facilities for the mentally retarded, and other medical
institutions.
(4) Emergency services as defined by regulations adopted by
the Secretary of the United States Department of Health and
Human Services.
(5) Services furnished to individuals by health maintenance
organizations in which the individuals are enrolled.
(6) Family planning services and supplies described in 42
U.S.C. 1396d(a)(4)(C).
(7) Physical examinations to determine the need for medical
services.
As added by P.L.2-1992, SEC.9.
IC 12-15-6-5
Provider to charge maximum copayment allowable
Sec. 5. A provider shall charge the maximum copayment
allowable under federal statute or regulation.
As added by P.L.2-1992, SEC.9.
IC 12-15-6-6
Repealed
(Repealed by P.L.278-1993(ss), SEC.29.)
IC 12-15-6-7
Repealed
(Repealed by P.L.278-1993(ss), SEC.29.)