CHAPTER 1. MEDICAL SERVICES FOR INMATES AND PATIENTS
IC 12-16
ARTICLE 16. PAYMENT FOR HEALTH SERVICES
OTHER THAN MEDICAID
IC 12-16-1
Chapter 1. Medical Services for Inmates and Patients
IC 12-16-1-1
"Affected agency" defined
Sec. 1. As used in this chapter, "affected agency" means any of
the following:
(1) The department of correction.
(2) The state department of health.
(3) The division of mental health and addiction.
(4) The division of disability and rehabilitative services.
As added by P.L.2-1992, SEC.10. Amended by P.L.40-1994, SEC.22;
P.L.215-2001, SEC.46; P.L.141-2006, SEC.56.
IC 12-16-1-2
"Covered medical services" defined
Sec. 2. As used in this chapter, "covered medical services" refers
to medical services that meet the following qualifications:
(1) Cost more than one hundred fifty dollars ($150).
(2) Are provided to a committed individual or patient of an
institution under the jurisdiction of an affected agency.
(3) Are provided outside of an institution under the jurisdiction
of an affected agency.
As added by P.L.2-1992, SEC.10.
IC 12-16-1-3
Rules; adoption; requisites
Sec. 3. (a) The division shall, with the advice of the division's
medical staff, representatives of affected agencies, and other
individuals selected by the director of the division, adopt rules under
IC 4-22-2 to do the following:
(1) Provide for prior review and approval of covered medical
services, including special review and approval procedures for
emergency covered medical services.
(2) Establish limitations consistent with medical necessity on
the duration of services to be provided.
(3) Specify the amount of and method for reimbursement for
services.
(4) Specify the conditions under which payments will be denied
and improper payments will be recovered.
(b) To the extent possible, rules adopted under this section must
be consistent with Title XIX of the federal Social Security Act and
with IC 12-15-21-2 and IC 12-15-21-3.
As added by P.L.2-1992, SEC.10.
IC 12-16-1-4
Contract for services; same contractor requirement
Sec. 4. (a) The division shall contract with the same contractor
with which the office contracts under IC 12-15-30 to provide
administrative and fiscal services to implement this chapter.
(b) A contract for services is not subject to IC 5-22.
As added by P.L.2-1992, SEC.10. Amended by P.L.49-1997, SEC.45.
IC 12-16-1-5
Payment for covered medical services; requirements
Sec. 5. Payment for covered medical services approved by the
fiscal agent shall be paid:
(1) from money for the Medicaid program if the requirements
of IC 12-15 are met; or
(2) if a payment cannot be made under subdivision (1), from a
state appropriation either made for an affected agency or for
covered medical services for all affected agencies.
As added by P.L.2-1992, SEC.10.