reglab/housing_qa huggingface dataset:
IN Code § 12-15-25-1 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 25. Solicitation of Nonresidents|12-15-25-1. Solicitation Defined; Prohibition

Sec. 1. (a) As used in this section, "solicitation" means a direct communication initiated by a provider doing business in Indiana to an individual or a provider in another state with the intent of inducing a nonresident of Indiana to relocate the person's residence to Indiana for the purpose of obtaining Medicaid under Title XIX of the federal Social Security Act (42 U.S.C. 1396 et seq.).(b) A provider that is:(1) licensed by the state; and(2) doing business in Indiana;may not make a solicitation to a person who is eligible for Medicaid under Title XIX of the federal Social Security Act (42 U.S.C. 1396 et seq.).[Pre-1992 Revision Citation: 12-1-7-16.2(a), (b).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-25-2 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 25. Solicitation of Nonresidents|12-15-25-2. Marketing or Advertising Not Precluded

Sec. 2. This chapter does not preclude a provider from marketing or advertising the following:(1) The provider's services to the general public.(2) Special therapies or services, such as those offered to ventilator-dependent patients or patients with acquired immunodeficiency syndrome (AIDS) or Alzheimer's disease.(3) Children's units.[Pre-1992 Revision Citation: 12-1-7-16.2(c).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-25-3 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 25. Solicitation of Nonresidents|12-15-25-3. Violations; Sanctions

Sec. 3. A provider that violates this chapter is subject to the sanctions imposed under IC 12-15-22.[Pre-1992 Revision Citation: 12-1-7-16.2(d).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-26-1 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 26. Prior Authorization|12-15-26-1. Prior Authorization for Mental Health Services; Providers Licensed Under Ic 25-33-1

Sec. 1. A health service provider in psychology licensed under IC 25-33-1 may submit a request for prior authorization (as defined in 405 IAC 1-6-2) for mental health services provided in the provider's private practice or a community mental health center authorized under IC 12-29 without the supervision or order of a physician.[Pre-1992 Revision Citation: 12-1-7-17.3.]As added by P.L.2-1992, SEC.9. Amended by P.L.140-1993, SEC.2.
IN Code § 12-15-26-2 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 26. Prior Authorization|12-15-26-2. Psychiatrists Practicing in Employment of Community Mental Health Centers

Sec. 2. A psychiatrist practicing in the employment of a community mental health center must not be required to request prior authorization to treat Medicaid eligible patients if the request for prior authorization is not required of psychiatrists in private practice.[Pre-1992 Revision Citation: 12-1-7-59.]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-27-1 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 27. Confidentiality and Release of Information|12-15-27-1. Medicaid Applicants and Recipients; Confidential Records and Documents

Sec. 1. The following concerning a Medicaid applicant or recipient under the Medicaid program are confidential, except as otherwise provided in this chapter:(1) An application.(2) An investigation report.(3) An information.(4) A record.[Pre-1992 Revision Citation: 12-1-7-28(b).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-27-2 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 27. Confidentiality and Release of Information|12-15-27-2. Use and Disclosure of Information; Provision of Information to Legislative Services Agency

Sec. 2. (a) The use and the disclosure of the information described in this chapter to persons authorized by law in connection with the official duties relating to:(1) financial audits;(2) legislative investigations; or(3) other purposes directly connected with the administration of the plan;is permitted.(b) The secretary shall provide to the legislative services agency, in the form and on the schedule specified by the executive director of the legislative services agency, all information or data described in section 1(1) through 1(4) of this chapter (including, but not limited to, applications, enrollments, claims, and encounters) and any additional information or data concerning a program described in this article or concerning the children's health insurance program established under IC 12-17.6 that is requested by the executive director of the legislative services agency. The legislative services agency:(1) shall maintain the confidentiality of confidential information or data received under this subsection; and(2) may use information or data received under this subsection only to estimate the fiscal impact of proposed legislation, prepare program evaluation reports, and forecast enrollment and program costs of the Medicaid program, the healthy Indiana plan, and the children's health insurance program.(c) Unless:(1) redaction of an identifier is required under subsection (d); or(2) the executive director of the legislative services agency requests redaction of an identifier;from the information or data requested under subsection (b), the information or data received under subsection (a) or (b) must include all identifiers specified in 45 CFR 164.514(b).(d) Before information or data with names, addresses, or individualized identification numbers of applicants or individuals receiving services under the Medicaid program, the healthy Indiana plan, or the children's health insurance program is provided to the legislative services agency under subsection (a) or (b), the secretary or office shall as soon as practicable after a request provide the information or data to the legislative services agency after:(1) redacting names, street addresses (other than county and ZIP code information), and individualized identification numbers used in the operation of the Medicaid program, the healthy Indiana plan, or the children's health insurance program; and(2) generating and substituting for each applicant or individual a unique number that is not used in the Medicaid program, the healthy Indiana plan, or the children's health insurance program but is maintained over time and is useful for longitudinal analysis described in subsection (b).The system of numbering under subdivision (2) must be approved by the executive director of the legislative services agency.[Pre-1992 Revision Citation: 12-1-7-28(c).]As added by P.L.2-1992, SEC.9. Amended by P.L.78-2016, SEC.1.
IN Code § 12-15-27-3 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 27. Confidentiality and Release of Information|12-15-27-3. Release and Use of General Information

Sec. 3. (a) The release and use of information of a general nature shall be provided as needed for adequate interpretation or development of the Medicaid program.(b) The information under subsection (a) includes the following:(1) Total Medicaid expenditures.(2) The number of recipients.(3) Statistical and social data used in connection with studies.(4) Reports or surveys on health and welfare problems.[Pre-1992 Revision Citation: 12-1-7-28(d).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-27-5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 27. Confidentiality and Release of Information|12-15-27-5. Eligibility for Federal Financial Participation; Limitations on Chapter; Rules

Sec. 5. (a) If it is established that this chapter causes the state Medicaid plan to be ineligible for federal financial participation, the provision is limited or restricted to the extent that is essential to make the plan eligible for federal financial participation.(b) The secretary shall establish rules under IC 4-22-2 that are necessary to carry out this section.[Pre-1992 Revision Citation: 12-1-7-28(f).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-27-6 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 27. Confidentiality and Release of Information|12-15-27-6. Eligibility Information; Immediate Access Systems

Sec. 6. The office shall make available the following for providing health care providers with immediate access to information indicating whether an individual is eligible for Medicaid:(1) A twenty-four (24) hour telephone system.(2) A computerized data retrieval system.[Pre-1992 Revision Citation: 12-1-7-28.5(a).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-27-7 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 27. Confidentiality and Release of Information|12-15-27-7. Limitations on Eligibility Information Available Through Immediate Access Systems

Sec. 7. Information released under section 6 of this chapter is limited to the following:(1) Disclosure of whether an individual has been determined to be eligible for Medicaid or whether the individual has an application pending.(2) The date the individual became eligible for Medicaid and the individual's Medicaid number.(3) Restrictions, if any, on the scope of services to be reimbursed under the Medicaid program for the individual.(4) Information concerning third party liability.[Pre-1992 Revision Citation: 12-1-7-28.5(b).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-27-8 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 27. Confidentiality and Release of Information|12-15-27-8. Eligibility Information Obtained by Health Care Providers; Confidentiality

Sec. 8. Information obtained by a health care provider under this chapter concerning an individual's eligibility for Medicaid is confidential and may not be disclosed to any person.[Pre-1992 Revision Citation: 12-1-7-28.5(c).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-27-8.5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 27. Confidentiality and Release of Information|12-15-27-8.5. Use and Disclosure of Voter Registration Records

Sec. 8.5. A person may not examine, disclose, or use any record described in this chapter concerning voter registration except in the manner permitted under IC 12-15-1.5.As added by P.L.12-1995, SEC.122.
IN Code § 12-15-27-9 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 27. Confidentiality and Release of Information|12-15-27-9. Eligibility Information Access and Confidentiality; Rules

Sec. 9. The secretary shall adopt rules under IC 4-22-2 necessary to carry out sections 6, 7, and 8 of this chapter.[Pre-1992 Revision Citation: 12-1-7-28.5(d).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-28-1 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 28. Appeals and Hearings|12-15-28-1. Decisions Appealable to Office

Sec. 1. An applicant for or a recipient of Medicaid may appeal to the office if one (1) of the following occurs:(1) An application or a request is not acted upon by the county office within a reasonable time after the application or request is filed.(2) The application is denied.(3) The applicant or recipient is dissatisfied with the action of the county office.(4) The recipient is dissatisfied with a determination made by the office under IC 12-15-8.5.[Pre-1992 Revision Citation: 12-1-7-22.]As added by P.L.2-1992, SEC.9. Amended by P.L.4-1993, SEC.115; P.L.5-1993, SEC.128; P.L.178-2002, SEC.86.
IN Code § 12-15-28-2 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 28. Appeals and Hearings|12-15-28-2. Secretary to Conduct Hearings Under Ic 4-21.5

Sec. 2. The secretary shall conduct hearings and appeals concerning Medicaid under IC 4-21.5.[Pre-1992 Revision Citation: 12-6-6-10(b) part.]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-28-3 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 28. Appeals and Hearings|12-15-28-3. Notice of Appeal; Setting Matter for Hearing; Opportunity for Hearing; Location

Sec. 3. The office shall, upon receipt of notice of appeal under section 1 of this chapter, set the matter for hearing and give the applicant or recipient an opportunity for a fair hearing in the county in which the recipient resides.[Pre-1992 Revision Citation: 12-1-7-23 part.]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-28-4 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 28. Appeals and Hearings|12-15-28-4. Hearing; Introduction of Evidence

Sec. 4. At the hearing, the applicant and county office may introduce additional evidence.[Pre-1992 Revision Citation: 12-1-7-23 part.]As added by P.L.2-1992, SEC.9. Amended by P.L.4-1993, SEC.116; P.L.5-1993, SEC.129.
IN Code § 12-15-28-5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 28. Appeals and Hearings|12-15-28-5. Conduct of Hearing; Rules

Sec. 5. The hearing shall be conducted under rules adopted by the secretary that are not inconsistent with IC 4-21.5 and the Medicaid program.[Pre-1992 Revision Citation: 12-1-7-23 part.]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-28-6 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 28. Appeals and Hearings|12-15-28-6. Additional Investigations by Office; Decision by Office to Grant Medicaid

Sec. 6. The office:(1) may make necessary additional investigations; and(2) shall make decisions relative to the granting of Medicaid and the amount of Medicaid to be granted to the applicant that the office believes are justified and in conformity with the Medicaid program.[Pre-1992 Revision Citation: 12-1-7-23 part.]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-28-7 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 28. Appeals and Hearings|12-15-28-7. Decision by Office to Grant Medicaid Assistance; Effect

Sec. 7. A decision of the office made in conformity with the Medicaid program, including the establishment of dates of eligibility:(1) is binding upon the county office involved;(2) shall be complied with by the county office; and(3) has the same effect as decisions of the county office from which the appeal is taken.[Pre-1992 Revision Citation: 12-1-7-23 part.]As added by P.L.2-1992, SEC.9. Amended by P.L.4-1993, SEC.117; P.L.5-1993, SEC.130.
IN Code § 12-15-29-0.5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-0.5. "Insurer"

Sec. 0.5. As used in this chapter, "insurer" includes a pharmacy benefit manager.As added by P.L.197-2013, SEC.14.
IN Code § 12-15-29-1 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-1. Insurers; Authorization to Release Information

Sec. 1. An applicant for or a recipient of Medicaid is considered to have authorized an insurer to release to the office information needed by the office to secure or enforce the office's rights under Medicaid.[Pre-1992 Revision Citation: 12-1-7-24.1(a).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-29-2 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-2. Requests for Information From Insurers; Limitation

Sec. 2. (a) Subject to subsection (b), an insurer shall furnish records or information pertaining to the coverage of an individual for the individual's medical costs under an individual or a group policy or other obligation, or the medical benefits paid or claims made under a policy or an obligation, if the office or its agent does the following:(1) Requests the information electronically or by United States mail.(2) Certifies that the individual is:(A) a Medicaid applicant or recipient; or(B) a person who is legally responsible for the applicant or recipient.(b) The office may request only the records or information necessary to determine whether insurance benefits have been or should have been claimed and paid with respect to items of medical care and services that were received by a particular individual and for which Medicaid coverage would otherwise be available.[Pre-1992 Revision Citation: 12-1-7-24.1(b).]As added by P.L.2-1992, SEC.9. Amended by P.L.187-2007, SEC.4; P.L.234-2007, SEC.209; P.L.3-2008, SEC.94.
IN Code § 12-15-29-3 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-3. Guidelines for Information Requests

Sec. 3. The administrator and the insurance commissioner shall establish guidelines for information requests under this chapter.[Pre-1992 Revision Citation: 12-1-7-24.1(c).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-29-4 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-4. Direct Payments by Insurers to Office; Amount of Payments

Sec. 4. (a) If:(1) an insurer has not discharged the insurer's obligation to make payments to an individual for medical services;(2) the individual has received Medicaid from the office; and(3) the insurer has received notice that Medicaid has been furnished to the individual;the insurer shall make payments directly to the office.(b) The payments under subsection (a) may not exceed the amount of Medicaid paid by the office.[Pre-1992 Revision Citation: 12-1-7-24.2(a).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-29-4.5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-4.5. Insurer's Acceptance of Medicaid Claims

Sec. 4.5. (a) An insurer shall accept a Medicaid claim for a Medicaid recipient for three (3) years from the date the service was provided.(b) An insurer may not deny a Medicaid claim submitted by the office solely on the basis of:(1) the date of submission of the claim;(2) the type or format of the claim form;(3) the method of submission of the claim; or(4) a failure to provide proper documentation at the point of sale that is the basis of the claim;if the claim is submitted by the office within three (3) years from the date the service was provided as required in subsection (a) and the office commences action to enforce the office's rights regarding the claim within six (6) years of the office's submission of the claim.(c) An insurer may not deny a Medicaid claim submitted by the office solely due to a lack of prior authorization. An insurer shall:(1) after December 31, 2020, meet the requirements set forth in IC 27-1-37.5;(2) conduct the prior authorization on a retrospective basis for claims where prior authorization is necessary; and(3) adjudicate any claim authorized in this manner as if the claim received prior authorization.As added by P.L.187-2007, SEC.5. Amended by P.L.265-2019, SEC.2.
IN Code § 12-15-29-5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-5. Medicaid Furnished by Office; Insurer Put on Notice of Claim by Office; Insurer Paying Person or Entity Other Than Office; Office's Claim Not Discharged

Sec. 5. An insurer:(1) that is put on notice of a claim by the office under section 4 of this chapter; and(2) proceeds to pay the claim to a person or an entity other than the office;is not discharged from payment of the office's claim.[Pre-1992 Revision Citation: 12-1-7-24.2(b).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-29-6 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-6. Payment by Insurer to Office; Discharge of Obligation

Sec. 6. Payment to the office by an insurer under section 4 of this chapter discharges the insurer's obligation with respect to further payment on the claim for the amount paid.[Pre-1992 Revision Citation: 12-1-7-24.2(c).]As added by P.L.2-1992, SEC.9.
IN Code § 12-15-29-7 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-7. Notice to Insurer That Medicaid Has Been Furnished; Requirements; Notification Given Office by Insurer; Payment of Claim

Sec. 7. (a) The notice requirements of section 4 of this chapter are satisfied if:(1) the insurer receives from the office, electronically or by United States mail, a statement of the claims paid or medical services rendered by the office, together with a claim for reimbursement; or(2) the insurer receives a claim from a beneficiary stating that the beneficiary has applied for or has received Medicaid from the office in connection with the same claim.(b) An insurer that receives a claim under subsection (a)(2) shall notify the office of the insurer's obligation on the claim and shall:(1) pay the obligation to the provider of service; or(2) if the office has provided Medicaid, pay the office.[Pre-1992 Revision Citation: 12-1-7-24.2(d).]As added by P.L.2-1992, SEC.9. Amended by P.L.187-2007, SEC.6.
IN Code § 12-15-29-8 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-8. Unlawful Insurance Clause

Sec. 8. A clause of an insurance contract, plan, or agreement administered by an insurer is void if the clause limits or excludes enrollment or payments to an individual who is eligible for Medicaid.[Pre-1992 Revision Citation: 12-1-7-24.4.]As added by P.L.2-1992, SEC.9. Amended by P.L.46-1995, SEC.41.
IN Code § 12-15-29-9 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-9. State's Acquisition of Person's Right to Payment

Sec. 9. (a) IC 27-8-23 applies to this section.(b) To the extent that payment for covered medical expenses has been made under the state Medicaid program for health care items or services furnished to a person, in a case where a third party has a legal liability to make payments, the state is considered to have acquired the rights of the person to payment by any other party for the health care items or services.(c) As required under 42 U.S.C. 1396a(a)(25), an insurer shall accept the state's right of recovery and the assignment to the state of any right of the individual or entity to payment for a health care item or service for which payment has been made under the state Medicaid plan.As added by P.L.46-1995, SEC.42. Amended by P.L.187-2007, SEC.7.
IN Code § 12-15-29-10 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 29. Insurance|12-15-29-10. Employer Sponsored Health Insurance to Include Coverage for Child

Sec. 10. (a) IC 27-8-23 and IC 31-16-15 apply to this section.(b) This section does not apply if an employer has eliminated family health coverage for all of its employees.(c) Whenever a parent is required by a court or an administrative order to provide health coverage for a child and the parent is eligible for family health coverage through an employer doing business in Indiana, the employer shall provide family health coverage to the child in the manner described under IC 27-8-23-6 and in the notice under IC 31-16-15-4.5(b). In addition, the employer shall:(1) withhold from the employee's compensation the employee's share, if any, of premiums for health coverage; and(2) pay that amount to the insurer.(d) Upon the initiation of withholding under subsection (c), an employee whose applicable child support order did not include a deduction from weekly available income for the cost of the health care premium is entitled to a modification of the child support order, taking into account the payments made as of the date withholding began.As added by P.L.46-1995, SEC.43. Amended by P.L.80-2010, SEC.20.
IN Code § 12-15-30-1 (2021)
2021 Indiana Code|Title 12. Human Services|Article 15. Medicaid|Chapter 30. Contracting|12-15-30-1. Authorization of Contracts for Administration of Program

Sec. 1. The office may contract with another state agency or other persons to administer any part of the Medicaid program.[Pre-1992 Revision Citation: 12-1-7-17.1(a).]As added by P.L.2-1992, SEC.9.