reglab/statecodes huggingface dataset:
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 5. Services Provided › 12-15-5-14. Reimbursement for Services Provided by Advanced Practice Registered Nurse; Eligible Provider

Sec. 14. (a) As used in this section, "advanced practice registered nurse" means:
(1) a nurse practitioner; or
(2) a clinical nurse specialist;
who is a registered nurse licensed under IC 25-23 and qualified to practice nursing in a specialty role based upon the additional knowledge and skill gained through a formal organized program of study and clinical experience, or the equivalent as determined by the Indiana state board of nursing.
(b) As used in this section, "office" includes the following:
(1) The office of the secretary of family and social services.
(2) A managed care organization that has contracted with the office of Medicaid policy and planning under this article.
(3) A person that has contracted with a managed care organization described in subdivision (2).
(c) The office shall reimburse eligible Medicaid claims for the following services provided by an advanced practice registered nurse employed by a community mental health center if the services are part of the advanced practice registered nurse's scope of practice:
(1) Mental health services.
(2) Behavioral health services.
(3) Substance abuse treatment.
(4) Primary care services.
(5) Evaluation and management services for inpatient or outpatient psychiatric treatment.
(6) Prescription drugs.
(d) The office shall include an advanced practice registered nurse as an eligible provider for the supervision of a plan of treatment for a patient's outpatient mental health or substance abuse treatment services, if the supervision is in the advanced practice registered nurse's scope of practice, education, and training.
(e) This section:
(1) may not be construed to expand an advanced practice registered nurse's scope of practice; and
(2) is subject to IC 25-23-1-19.4(c) and applies only if the service is included in the advanced practice registered nurse's practice agreement with a collaborating physician.
As added by P.L.87-2016, SEC.4. Amended by P.L.85-2017, SEC.58; P.L.129-2018, SEC.5.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 5. Services Provided › 12-15-5-14.5. Eligible Providers for Supervising Treatment Plan

Sec. 14.5. (a) The office shall include a:
(1) licensed clinical social worker;
(2) licensed mental health counselor;
(3) licensed clinical addiction counselor; and
(4) licensed marriage and family therapist;
as eligible providers for the supervision of a plan of treatment for a patient's outpatient mental health or substance abuse treatment services, if the individual holds at least a master's degree and the supervision is in the scope of practice, education, and training of the clinical social worker, mental health counselor, clinical addiction counselor, or marriage and family therapist.
(b) Before July 1, 2020, the office shall apply to the United States Department of Health and Human Services to amend the state Medicaid plan to implement subsection (a).
As added by P.L.128-2019, SEC.1. Amended by P.L.103-2020, SEC.1.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 5. Services Provided › 12-15-5-15. Reimbursement for Students; Conditions; Policies

Sec. 15. (a) This section is effective upon approval by the federal government of the office's Medicaid state plan amendment to implement the requirements of this section. The office shall submit the Medicaid state plan amendment not later than December 1, 2016.
(b) As used in this section, "office" includes the following:
(1) The office of the secretary of family and social services.
(2) A managed care organization that has contracted with the office of Medicaid policy and planning under this article.
(3) A person that has contracted with a managed care organization described in subdivision (2).
(c) The office shall authorize Medicaid reimbursement for eligible Medicaid services provided by a student if:
(1) the student is currently enrolled in a graduate or postgraduate degree level:
(A) medical;
(B) nursing;
(C) mental health;
(D) behavioral health; or
(E) addiction treatment;
accredited college or university program;
(2) the student has been approved by the college or university to work as an intern or practicum student at a community mental health center under the direct supervision of a licensed professional who holds a master's degree or doctoral level degree related to the area of study; and
(3) the services being provided by the student are within the scope of practice of the supervising practitioner.
(d) Medicaid claims for eligible Medicaid services provided under this section must be submitted by the supervising practitioner. Only one (1) Medicaid claim may be submitted per episode of care.
(e) A community mental health center that allows intern and practicum students to provide services under this section shall have a policy and procedure for the intern and practicum students to receive supervision and a method for documenting the supervision provided.
As added by P.L.87-2016, SEC.5. Amended by P.L.85-2017, SEC.59.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 5. Services Provided › 12-15-5-16. Reimbursement for Clinical Addiction Counselors; Clinical Supervision Requirement

Sec. 16. (a) This section is effective upon approval by the federal government of the office's Medicaid state plan amendment to implement the requirements of this section. The office shall submit the Medicaid state plan amendment not later than December 1, 2016.
(b) As used in this section, "office" includes the following:
(1) The office of the secretary of family and social services.
(2) A managed care organization that has contracted with the office of Medicaid policy and planning under this article.
(3) A person that has contracted with a managed care organization described in subdivision (2).
(c) The office shall reimburse a clinical addiction counselor licensed under IC 25-23.6 for an eligible Medicaid behavioral health or addictions service that is within the counselor's scope of practice if the clinical addiction counselor is under the clinical supervision of a physician or health service provider in psychology.
As added by P.L.87-2016, SEC.6.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 5. Services Provided › 12-15-5-18. Emergency Medical Service Provider Agencies; Reimbursement; Federal Approval

Sec. 18. (a) This section applies to an emergency medical services provider agency that meets the following requirements:
(1) Is requesting reimbursement for services provided as part of a mobile integrated healthcare program that has been approved by the emergency medical services commission under IC 16-31-12.
(2) Is a Medicaid provider.
(b) The office of the secretary may reimburse an emergency medical services provider agency that is a Medicaid provider under this article for Medicaid covered services provided to a Medicaid recipient.
(c) The office of the secretary may apply to the United States Department of Health and Human Services for any amendment to the state Medicaid plan or for any Medicaid waiver necessary to implement this section.
As added by P.L.100-2019, SEC.1.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 5. Services Provided › 12-15-5-18.2. Mobile Integrated Healthcare Program; Authority to Apply for a Waiver and for Federal Funding

Sec. 18.2. The office of the secretary may apply to the United States Department of Health and Human Services for the following concerning the mobile integrated healthcare program:
(1) A waiver to implement the program.
(2) Federal funding through Section 9813 of the American Rescue Plan Act of 2021 (P.L. 117-2) for the programs set forth in IC 16-31-12.
However, if federal funding ceases to be available, then no additional state funding for the mobile integrated healthcare program shall be allocated to the program after that date.
As added by P.L.165-2021, SEC.139.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 5. Services Provided › 12-15-5-18.5. Reimbursement for Emergency Medical Services

Sec. 18.5. (a) This section applies to an emergency medical services provider organization that meets the following requirements:
(1) Is certified by the Indiana emergency medical services commission as an advanced life support provider organization under rules adopted under IC 16-31-3.
(2) Is a Medicaid provider.
(b) The office of the secretary shall provide reimbursement for Medicaid covered services provided to a Medicaid recipient that are:
(1) rendered by an emergency medical services provider organization that is a Medicaid provider;
(2) within the emergency medical services provider organization's scope of practice;
(3) performed or provided as advanced life support services; and
(4) performed or provided during a response initiated through the 911 system, regardless of whether the patient is transported.
(c) If multiple emergency medical services provider organizations qualify and submit a claim for reimbursement under this section, the office of the secretary:
(1) may reimburse under this section only for one (1) claim per patient encounter; and
(2) shall reimburse the claim submitted by the emergency medical services provider organization that performed or provided the majority of advanced life support services.
(d) The office of the secretary may apply to the United States Department of Health and Human Services for any amendment to the state Medicaid plan or for any Medicaid waiver necessary to implement this section.
As added by P.L.115-2020, SEC.3.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 5. Services Provided › 12-15-5-18.7. Reimbursement for Emergency Medical Services Provider Organizations; Waiver or State Plan Amendment

Sec. 18.7. (a) This section applies to an emergency medical services provider organization that meets the following requirements:
(1) Is certified by the Indiana emergency medical services commission to provide emergency medical services.
(2) Is a Medicaid provider.
(b) Beginning July 1, 2023, the office of the secretary shall reimburse an emergency medical services provider organization for Medicaid covered services to a Medicaid recipient, including:
(1) advanced life support services;
(2) basic life support services; and
(3) nonemergency medical transportation services;
that are within the emergency medical services provider organization's scope of practice at a rate that is comparable to the federal Medicare reimbursement rate for the service provided by the emergency medical services provider organization. However, the reimbursement rate specified in this subsection may not be implemented by the office of the secretary before July 1, 2023.
(c) Before September 1, 2022, the office of the secretary shall apply to the United States Department of Health and Human Services for any state plan amendment or waiver necessary to implement this section and IC 12-15-12-18.5.
As added by P.L.142-2022, SEC.1.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 5. Services Provided › 12-15-5-19. Medicaid Rehabilitation Option Service; Review; Determination on Services; Report; Notification; Contract With Community Mental Health Center

Sec. 19. (a) Not later than one (1) year from the date the office receives approval for the state plan amendment described in IC 12-15-1.3-21 concerning Medicaid rehabilitation option services, the office shall do the following:
(1) Review the current services included in the Medicaid rehabilitation option services program in the school setting.
(2) Determine whether additional appropriate services, including:
(A) family engagement services; and
(B) additional comprehensive behavioral health services, including addiction services;
should be included as part of the program.
(3) Report the office's findings under this subsection to the general assembly in an electronic format under IC 5-14-6.
(b) Not later than three (3) months from the date the office receives approval for the state plan amendment described in IC 12-15-1.3-21 concerning Medicaid rehabilitation option services, the office shall notify each school corporation that the United States Department of Health and Human Services has approved the state plan amendment applied for under IC 12-15-1.3-21.
(c) Each school corporation shall, not later than one (1) year from the date the office receives approval for the state plan amendment described in IC 12-15-1.3-21 concerning Medicaid rehabilitation option services, contract with a community mental health center to provide Medicaid rehabilitation option services for:
(1) a student of the school corporation who is a Medicaid recipient; and
(2) the student's family.
As added by P.L.246-2019, SEC.3.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 5. Services Provided › 12-15-5-20. "Intensive Outpatient Treatment Program"

Sec. 20. (a) As used in this section, "intensive outpatient treatment program" means an organized treatment program that uses behavioral health professionals and clinicians in a group setting to provide multiple treatment service components for rehabilitation of alcohol and other substance use or dependency. The term includes services determined by the office and approved in the Medicaid state plan.
(b) If the office requires a supervisor for addiction based intensive outpatient treatment under this article, the following supervisors who either have at least two (2) years of experience in addiction treatment or hold an addiction credential, as determined by the division, are eligible supervisors:
(1) Licensed clinical social workers.
(2) Licensed mental health counselors.
(3) Licensed marriage and family therapists.
(4) Licensed clinical addiction counselors.
(c) The office may not require a direct service provider in an intensive outpatient treatment program to be a licensed addiction counselor or a licensed clinical addiction counselor. However, the direct service provider must, under the supervision of a clinician described in subsection (b), either:
(1) hold an addiction credential, as determined by the division; or
(2) have training and experience in addiction treatment, as determined by the division.
As added by P.L.127-2020, SEC.1.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 5. Services Provided › 12-15-5-21. Community Mental Health Centers; Governmental Units

Sec. 21. For purposes of required nonfederal share medical assistance payments under Title XIX of the Social Security Act, a community mental health center is defined as a governmental unit.
As added by P.L.127-2020, SEC.2.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 6. Individual Contributions › 12-15-6-1. Enrollment Fees, Premiums, or Other Charges as Condition of Eligibility

Sec. 1. Except as provided in IC 12-15-41, IC 12-15-44.5, and IC 12-17.6, an enrollment fee, a premium, a copayment, or a similar charge may not be imposed as a condition of an individual's eligibility for Medicaid.
[Pre-1992 Revision Citation: 12-1-7-16(c) part.]
As added by P.L.2-1992, SEC.9. Amended by P.L.287-2001, SEC.8; P.L.241-2023, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 6. Individual Contributions › 12-15-6-3. Repealed

[Pre-1992 Revision Citation: 12-1-7-16(c) part.]
As added by P.L.2-1992, SEC.9. Amended by P.L.114-1996, SEC.1. Repealed by P.L.241-2023, SEC.11.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 6. Individual Contributions › 12-15-6-4. Repealed

[Pre-1992 Revision Citation: 12-1-7-16(c) part.]
As added by P.L.2-1992, SEC.9. Amended by P.L.210-2015, SEC.48. Repealed by P.L.241-2023, SEC.12.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 6. Individual Contributions › 12-15-6-6. Repealed

[Pre-1992 Revision Citation: 12-1-7-16(c) part.]
As added by P.L.2-1992, SEC.9. Repealed by P.L.278-1993(ss), SEC.29.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 7. Personal Allowance › 12-15-7-1. Persons Entitled to Allowance; Receipt of Care in Hospital or Nursing Home; Amount of Allowance

Sec. 1. Subject to section 2 of this chapter, an individual eligible to receive Medicaid who is not living in the individual's own home but is receiving care in a:
(1) hospital; or
(2) nursing facility;
may retain from the individual's income a personal allowance in an amount to be established by the office.
[Pre-1992 Revision Citation: 12-1-7-21(b) part.]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 7. Personal Allowance › 12-15-7-2. Amount of Allowance; Permissible Range

Sec. 2. Fifty-two dollars ($52) monthly may be exempt from income eligibility consideration.
[Pre-1992 Revision Citation: 12-1-7-21(b) part.]
As added by P.L.2-1992, SEC.9. Amended by P.L.272-1999, SEC.40; P.L.294-2001, SEC.3.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 7. Personal Allowance › 12-15-7-3. Use of Allowance

Sec. 3. The money described in section 2 of this chapter may be exclusively used by the recipient for the recipient's personal needs.
[Pre-1992 Revision Citation: 12-1-7-21(b) part.]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 7. Personal Allowance › 12-15-7-4. Individuals Employed as Part of Habilitation Plan or Working in Sheltered Workshop or Day Activity Center; Amount of Allowance

Sec. 4. The personal allowance for one (1) month described in sections 1, 2, and 3 of this chapter for an individual whose employment is part of the recipient's individual habilitation plan or who is working in a sheltered workshop or day activity center is the amount that a person would be entitled to retain under sections 1, 2, and 3 of this chapter plus an amount equal to one-half (1/2) of the remainder of:
(1) gross earned income for the month; minus
(2) the sum of:
(A) sixteen dollars ($16);
(B) the amount withheld from the recipient's paycheck for that month for payment of state income tax, federal income tax, and the tax prescribed by the Federal Insurance Contribution Act (26 U.S.C. 3101 et seq.); and
(C) transportation expenses for the month.
[Pre-1992 Revision Citation: 12-1-7-21(c) part.]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 7. Personal Allowance › 12-15-7-5. Retention of Amount Equal to Individual's State and Local Income Tax Liability; Monthly Limitation; Exemption From Income Eligibility Consideration; Use of Amount Retained

Sec. 5. (a) In addition to the amount that may be retained as a personal allowance under this chapter, an individual is allowed to retain an amount equal to the individual's state and local income tax liability.
(b) The amount that may be retained during a month may not exceed one-third (1/3) of the individual's state and local income tax liability for the calendar quarter in which the month occurs. This amount is exempt from income eligibility consideration by the office.
(c) The amount retained under this section must be used by the individual to pay any state or local income taxes owed.
[Pre-1992 Revision Citation: 12-1-7-21(d).]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 7. Personal Allowance › 12-15-7-6. Payment Calculation for Federal Ssi Recipient; Exemption From Income Eligibility Consideration

Sec. 6. (a) If an individual described in section 1 of this chapter:
(1) is a recipient of assistance under the federal Supplemental Security Income (SSI) program; and
(2) receives an income that is less than the amount described in section 2 of this chapter;
the office shall pay to the individual an amount equal to the difference between the amount of the monthly allowance described in section 2 of this chapter and the amount of income, including assistance under the federal Supplemental Security Income (SSI) program received by the individual.
(b) Money paid to an individual under subsection (a) is exempt from income eligibility consideration.
As added by P.L.294-2001, SEC.4. Amended by P.L.26-2003, SEC.1.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8. Liens › 12-15-8-1. Recipient Asserting Claim Against Another Person for Injury or Illness Resulting From Negligence or Act of Other Person; Lien Against Other Person; Amount of Lien

Sec. 1. Whenever:
(1) the office pays medical expenses for or on behalf of a person who has been injured or has suffered an illness or a disease as a result of the negligence or act of another person; and
(2) the injured or diseased person asserts a claim against the other person for damages resulting from the injury, illness, or disease;
on any recovery under the claim, whether by judgment, compromise, or settlement, the office has a lien against the other person in the amount paid by the office to the extent of the other person's liability for the medical expenses.
[Pre-1992 Revision Citation: 12-1-7-24.6(a).]
As added by P.L.2-1992, SEC.9. Amended by P.L.245-1999, SEC.2.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8. Liens › 12-15-8-2. Recipient Asserting Claim Against Insurer; Lien for Medical Expenses Paid or for Medical Services Rendered; Amount

Sec. 2. Whenever:
(1) the office pays for medical expenses or renders medical services on behalf of a person who has been injured or has suffered an illness or a disease; and
(2) the person asserts a claim against an insurer as a result of that person's injury, illness, or disease;
the office has a lien against the insurer, to the extent of the amount paid by the office, on any recovery from the insurer.
[Pre-1992 Revision Citation: 12-1-7-24.6(b).]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8. Liens › 12-15-8-3. Perfection of Lien

Sec. 3. A lien under this chapter is not effective unless the office takes the following actions before the party alleged to be liable has concluded a final settlement with the injured, ill, or diseased person or the person's attorney or legal representative as compensation for the person's injury, illness, or disease:
(1) Filing in the Marion County circuit court a written notice stating the following:
(A) Notice of the eligibility of the injured, ill, or diseased person for Medicaid.
(B) The name and address of the injured, ill, or diseased person.
(C) The name of the person, firm, limited liability company, or corporation alleged to be liable to the injured, ill, or diseased person.
(2) Sending to the person, firm, limited liability company, or corporation alleged to be liable, by registered or certified mail, a copy of the notice required by subdivision (1), with a statement of the date of filing of the notice.
[Pre-1992 Revision Citation: 12-1-7-24.6(c).]
As added by P.L.2-1992, SEC.9. Amended by P.L.8-1993, SEC.182.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8. Liens › 12-15-8-4. Notice; Person for Whom Medical Expenses Paid, Insurance Carrier, and Attorney for Injured or Diseased Person

Sec. 4. In addition to the requirements of section 3 of this chapter, the office shall send a copy of the notice required by section 3(1) of this chapter to the following persons or entities if the appropriate names and addresses can be determined:
(1) The injured, ill, or diseased person for whom the office has paid medical expenses.
(2) An insurance carrier that may be ultimately liable.
(3) An attorney for the injured or diseased person.
[Pre-1992 Revision Citation: 12-1-7-24.6(d) part.]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8. Liens › 12-15-8-5. Itemized Statement of Medical Expenses Paid; Sending Statement to Person for Whom Expenses Paid and to Attorney for Injured or Diseased Person; Time

Sec. 5. Not more than twenty-one (21) days after the filing of the notice required under section 3(1) of this chapter, the office shall send to persons or entities listed in section 4(1) and 4(3) of this chapter an itemized statement of the medical expenses paid by the office for which the office seeks to perfect a lien.
[Pre-1992 Revision Citation: 12-1-7-24.6(d) part.]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8. Liens › 12-15-8-6. Actions on Behalf of Injured, Ill, or Diseased Person and to Perfect Lien; Conditions

Sec. 6. (a) The office may, on behalf of an injured, an ill, or a diseased person and to perfect a lien provided by this chapter, initiate and prosecute an action or a proceeding against a:
(1) person;
(2) firm;
(3) corporation; or
(4) limited liability company;
who may be liable to the injured, ill, or diseased person.
(b) The office may initiate an action or a proceeding under subsection (a) only if the following occurs:
(1) The injured, ill, or diseased person has not initiated legal proceedings against the person, firm, limited liability company, or corporation alleged to be liable.
(2) The time remaining under the statute of limitations for the action or proceeding is not more than six (6) months.
[Pre-1992 Revision Citation: 12-1-7-24.6(e).]
As added by P.L.2-1992, SEC.9. Amended by P.L.8-1993, SEC.183.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8. Liens › 12-15-8-7. Recovery Under Lien; Payment of Pro Rata Share of Costs and Expenses Incurred in Asserting Claim

Sec. 7. If the office recovers money under a lien established by this chapter and the recovery is the result of a claim asserted by an injured, an ill, or a diseased person, the office shall pay the office's pro rata share of all costs and reasonably necessary expenses incurred in asserting the claim, including the following:
(1) Deposition costs.
(2) Witness fees.
(3) Other costs and expenses.
[Pre-1992 Revision Citation: 12-1-7-24.6(f).]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8. Liens › 12-15-8-8. Attorney's Fees

Sec. 8. (a) This section does not apply to a lien on a Medicaid recipient's real property under IC 12-15-8.5.
(b) This section applies only to a lien on a recovery under section 1 or section 2 of this chapter.
(c) The office shall pay attorney's fees in the amount of one (1) of the following:
(1) Twenty-five percent (25%) of the office's recovery under the lien if the claim was collected without initiating legal proceedings.
(2) Thirty-three and one-third percent (33 1/3%) of the office's recovery under the lien if the claim was collected by initiating legal proceedings.
[Pre-1992 Revision Citation: 12-1-7-24.6(g).]
As added by P.L.2-1992, SEC.9. Amended by P.L.224-2003, SEC.81; P.L.236-2007, SEC.1.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8. Liens › 12-15-8-9. Waiver of Right to Lien

Sec. 9. (a) The office may waive the office's right to assert a lien under this chapter.
(b) If the office does waive the right to a lien, the office is not liable for a pro rata share of costs under section 7 of this chapter.
[Pre-1992 Revision Citation: 12-1-7-24.6(h).]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8.5. Liens on Real Property of Medicaid Recipients › 12-15-8.5-1. "Medical Institution"

Sec. 1. As used in this chapter, "medical institution" means any of the following:
(1) A hospital.
(2) A nursing facility.
(3) An intermediate care facility for individuals with intellectual disabilities.
As added by P.L.178-2002, SEC.81. Amended by P.L.35-2016, SEC.37.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8.5. Liens on Real Property of Medicaid Recipients › 12-15-8.5-2. Lien for Medicaid Expenditures

Sec. 2. (a) When the office, in accordance with 42 U.S.C. 1396p, determines that a Medicaid recipient who resides in a medical institution cannot reasonably be expected to be discharged from a medical institution and return home, the office may obtain a lien on the Medicaid recipient's real property for the cost of all Medicaid expenditures made on behalf of the recipient.
(b) The office shall conduct a look back (as described in 42 U.S.C. 1396p(c)) of a Medicaid recipient's property of at least three (3) years.
(c) A lien obtained under this chapter is subordinate to the security interest of a financial institution that loans money to be used as operating capital for the operation of a farm, a business, or income producing real property.
As added by P.L.178-2002, SEC.81. Amended by P.L.224-2003, SEC.71; P.L.1-2007, SEC.122.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8.5. Liens on Real Property of Medicaid Recipients › 12-15-8.5-3. Limitations on Lien

Sec. 3. The office may not obtain a lien under this chapter if any of the following persons lawfully reside in the home of the Medicaid recipient who resides in the medical institution:
(1) The Medicaid recipient's spouse.
(2) The Medicaid recipient's child who is:
(A) less than twenty-one (21) years of age; or
(B) disabled as defined by the federal Supplemental Security Income program.
(3) The Medicaid recipient's sibling who has an ownership interest in the home and who has lived in the home continuously beginning at least twelve (12) months before the recipient was admitted to the medical institution.
(4) The Medicaid recipient's parent.
As added by P.L.178-2002, SEC.81. Amended by P.L.224-2003, SEC.72.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8.5. Liens on Real Property of Medicaid Recipients › 12-15-8.5-4. Notice Required Before Lien Obtained

Sec. 4. Before obtaining a lien on a Medicaid recipient's interest in real property under this chapter, the office shall notify in writing the Medicaid recipient and the Medicaid recipient's authorized representative, if applicable, of the following:
(1) The office's determination that the Medicaid recipient cannot reasonably be expected to be discharged from the medical institution.
(2) The office's intent to impose a lien on the Medicaid recipient's home.
(3) The Medicaid recipient's right to a hearing under IC 12-15-28 upon the Medicaid recipient's request regarding whether the requirements for the imposition of a lien are satisfied. A lien may not be filed for at least thirty (30) days after the notice is given and until the hearing process is completed if a hearing is requested.
As added by P.L.178-2002, SEC.81.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8.5. Liens on Real Property of Medicaid Recipients › 12-15-8.5-5. Notice Required to Obtain Lien; Filing and Distribution of Notice

Sec. 5. (a) The office shall obtain a lien under this chapter by filing a notice of lien with the recorder of the county in which the real property subject to the lien is located. The notice shall be filed prior to the recipient's death and shall include the following:
(1) The name and place of residence of the individual against whose property the lien is asserted.
(2) A legal description of the real property subject to the lien.
(b) Upon the office's request, the county auditor or assessor of a county shall furnish the office with the legal description of any property in the county registered to the recipient.
(c) The office shall file one (1) copy of the notice of lien with the division of family resources in the county in which the real property is located. The division of family resources shall retain a copy of the notice with the records of the division of family resources.
(d) The office shall provide one (1) copy of the notice of lien to the recipient or the Medicaid recipient's authorized representative, if applicable, whose real property is affected.
As added by P.L.178-2002, SEC.81. Amended by P.L.128-2012, SEC.13.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8.5. Liens on Real Property of Medicaid Recipients › 12-15-8.5-6. Effect of Notice of Lien; Duration of Lien

Sec. 6. (a) Beginning on the date on which a notice of lien is recorded in the office of the county recorder under section 5 of this chapter, the notice of lien:
(1) constitutes due notice of a lien against the Medicaid recipient's real property for any amount then recoverable and any amount that becomes recoverable under this article; and
(2) gives a specific lien in favor of the office on the Medicaid recipient's interest in the real property.
(b) The lien continues from the date of filing the lien until the lien:
(1) is satisfied; or
(2) is released.
As added by P.L.178-2002, SEC.81. Amended by P.L.224-2003, SEC.73.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8.5. Liens on Real Property of Medicaid Recipients › 12-15-8.5-7. Lien Foreclosure; Automatic Expiration of Lien

Sec. 7. The office may bring proceedings in foreclosure on a lien arising under this chapter:
(1) during the lifetime of the Medicaid recipient if the Medicaid recipient or a person acting on behalf of the Medicaid recipient sells the property; or
(2) upon the death of the Medicaid recipient.
The lien automatically expires unless the office commences a foreclosure action not later than two (2) years after the Medicaid recipient's death.
As added by P.L.178-2002, SEC.81. Amended by P.L.224-2003, SEC.74.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8.5. Liens on Real Property of Medicaid Recipients › 12-15-8.5-8. Limitations on Enforcement of Lien

Sec. 8. The office may not enforce a lien against a Medicaid recipient's home under this chapter as long as any of the following individuals reside in the home:
(1) The recipient's child of any age if the child:
(A) resided in the home for at least twenty-four (24) months before the Medicaid recipient was admitted to the medical institution;
(B) provided care to the Medicaid recipient that delayed the Medicaid recipient's admission to the medical institution; and
(C) has resided in the home on a continuous basis since the date of the individual's admission to the medical institution.
(2) The Medicaid recipient's sibling who has an ownership interest in the home and who has lived in the home continuously beginning at least twelve (12) months before the Medicaid recipient was admitted to the medical institution.
As added by P.L.178-2002, SEC.81. Amended by P.L.224-2003, SEC.75.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8.5. Liens on Real Property of Medicaid Recipients › 12-15-8.5-9. Release of Lien; Waiver of Filing Fee

Sec. 9. (a) The office shall release a lien imposed under this chapter within ten (10) business days after the division of family resources receives notice that the Medicaid recipient:
(1) is no longer living in the medical institution; and
(2) has returned home to live.
(b) The county recorder shall waive the filing fee for the filing of a release made under this section.
(c) If the property subject to the lien is sold, the office shall release its lien at the closing, and the lien shall attach to the net proceeds of the sale.
As added by P.L.178-2002, SEC.81. Amended by P.L.224-2003, SEC.76; P.L.128-2012, SEC.14.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8.5. Liens on Real Property of Medicaid Recipients › 12-15-8.5-12. Conditions Under Which Lien Is Void

Sec. 12. (a) This section applies:
(1) after the death of a Medicaid recipient whose property; or
(2) upon the sale of property that;
is subject to a lien under this chapter.
(b) A lien under this chapter is void if both of the following occur:
(1) The owner of property subject to a lien under this chapter or any person or corporation having an interest in the property, including a mortgagee or a lienholder, provides written notice to the office to file an action to foreclose the lien.
(2) The office fails to file an action to foreclose the lien in the county where the property is located not later than sixty (60) days after receiving the notice.
However, this section does not prevent the claim from being collected as other claims are collected by law.
(c) A person who gives notice under subsection (b)(1) by registered or certified mail to the office at the address given in the recorded statement and notice of intention to hold a lien may file an affidavit of service of the notice to file an action to foreclose the lien with the recorder of the county in which the property is located. The affidavit must state the following:
(1) The facts of the notice.
(2) That more than sixty (60) days have passed since the notice was received by the office.
(3) That no action for foreclosure of the lien is pending.
(4) That no unsatisfied judgment has been rendered on the lien.
(d) The recorder shall:
(1) record the affidavit of service in the miscellaneous record book of the recorder's office; and
(2) certify on the face of the record any lien that is fully released.
When the recorder records the affidavit and certifies the record under this subsection, the real estate described in the lien is released from the lien.
As added by P.L.224-2003, SEC.77. Amended by P.L.246-2005, SEC.106.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 8.5. Liens on Real Property of Medicaid Recipients › 12-15-8.5-13. Contracting With Attorney; Attorney's Fees

Sec. 13. (a) The office may contract with an attorney to obtain or enforce a lien under this chapter.
(b) If the office contracts with an attorney under this section, the attorney's fees may not exceed:
(1) seven and five-tenths percent (7.5%) of the office's recovery under the lien if the proceeding to obtain and enforce the lien is not contested; or
(2) ten percent (10%) of the office's recovery under the lien if the proceeding to obtain and enforce the lien is contested.
As added by P.L.236-2007, SEC.2.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 9. Death and Funeral Expenses; Claims Against an Estate › 12-15-9-0.5. "Estate" and "Nonprobate Transfer"

Sec. 0.5. (a) As used in this chapter, "estate" includes:
(1) all real and personal property and other assets included within an individual's probate estate;
(2) any interest in real property owned by the individual at the time of death that was conveyed to the individual's survivor through joint tenancy with right of survivorship, if the joint tenancy was created after June 30, 2002;
(3) any real or personal property conveyed through a nonprobate transfer; and
(4) any sum due after June 30, 2005, to a person after the death of a Medicaid recipient that is under the terms of an annuity contract purchased after May 1, 2005, with the assets of the Medicaid recipient.
(b) As used in this chapter, "nonprobate transfer" has the meaning set forth in IC 32-17-13-1.
As added by P.L.152-1995, SEC.5. Amended by P.L.178-2002, SEC.82; P.L.224-2003, SEC.78; P.L.246-2005, SEC.107; P.L.149-2012, SEC.3; P.L.163-2018, SEC.1.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 9. Death and Funeral Expenses; Claims Against an Estate › 12-15-9-0.6. Claim Against Assets Transferred by Nonprobate Transfer; Time Limit

Sec. 0.6. (a) This section applies to the enforcement of claims against assets transferred by a nonprobate transfer involving a deceased transferor who dies before, on, or after July 1, 2018.
(b) The office's claim against assets transferred by a nonprobate transfer may be enforced as set out in IC 32-17-13.
(c) Except as provided in subsection (d), enforcement of a claim against assets transferred by a nonprobate transfer must be commenced within the time limits provided in IC 32-17-13.
(d) The time limits provided in subsection (c) do not apply to any assets that were not reported to the county office of the division of family resources.
As added by P.L.178-2002, SEC.83. Amended by P.L.1-2003, SEC.54; P.L.145-2006, SEC.87; P.L.44-2009, SEC.12; P.L.163-2018, SEC.2; P.L.231-2019, SEC.4.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 9. Death and Funeral Expenses; Claims Against an Estate › 12-15-9-0.7. Repealed

As added by P.L.178-2002, SEC.84. Amended by P.L.224-2003, SEC.79. Repealed by P.L.246-2005, SEC.230.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 9. Death and Funeral Expenses; Claims Against an Estate › 12-15-9-0.8. Limitation on Definition of Estate

Sec. 0.8. Any nonprobate assets:
(1) that the office determined were exempt or unavailable assets; or
(2) that were transferred out of the probate estate;
before May 1, 2002, may not be included in the definition of estate under this chapter.
As added by P.L.178-2002, SEC.85.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 9. Death and Funeral Expenses; Claims Against an Estate › 12-15-9-1. Amount of Claim; Preference

Sec. 1. Upon the death of a Medicaid recipient, the total amount of Medicaid paid on behalf of the recipient after the recipient became fifty-five (55) years of age must be allowed as a preferred claim against the estate of the recipient in favor of the state. The affidavit of a person designated by the secretary to administer this section is evidence of the amount of the claim and is payable after the payment of the following in accordance with IC 29-1-14-9:
(1) Funeral expenses for the recipient, not to exceed three hundred fifty dollars ($350).
(2) The expenses of the last illness of the recipient that are authorized or paid by the office.
(3) The expenses of administering the estate, including the attorney's fees approved by the court.
[Pre-1992 Revision Citation: 12-1-7-25(a).]
As added by P.L.2-1992, SEC.9. Amended by P.L.152-1995, SEC.6; P.L.246-2005, SEC.108; P.L.149-2012, SEC.4.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 9. Death and Funeral Expenses; Claims Against an Estate › 12-15-9-2. Property Exempt From Enforcement

Sec. 2. A claim may not be enforced against the following:
(1) Real estate of a recipient while it is necessary for the support, maintenance, or comfort of the surviving spouse, a dependent child less than twenty-one (21) years of age, or a dependent who is nonsupporting because of blindness or other disability.
(2) Personal property necessary for the support, maintenance, or comfort of the surviving spouse, a dependent child less than twenty-one (21) years of age, or a dependent who is nonsupporting because of blindness or other disability.
(3) Personal effects, ornaments, or keepsakes of the deceased.
[Pre-1992 Revision Citation: 12-1-7-25(b).]
As added by P.L.2-1992, SEC.9. Amended by P.L.152-1995, SEC.7.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 9. Death and Funeral Expenses; Claims Against an Estate › 12-15-9-5. Claims Against the Estate of a Recipient's Spouse Prohibited

Sec. 5. The office may not file a claim against the estate of a recipient's surviving spouse.
As added by P.L.152-1995, SEC.8. Amended by P.L.246-2005, SEC.109; P.L.149-2012, SEC.5.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 9. Death and Funeral Expenses; Claims Against an Estate › 12-15-9-6. Waiver in Cases of Undue Hardship; Rules

Sec. 6. Notwithstanding sections 2 and 5 of this chapter, the office may waive the application of this chapter in cases of undue hardship. The office of the secretary shall adopt rules under IC 4-22-2 establishing criteria for hardship waivers that are consistent with guidelines of the Secretary of the United States Department of Health and Human Services.
As added by P.L.152-1995, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 9. Death and Funeral Expenses; Claims Against an Estate › 12-15-9-7. Reimbursement; Proceeds of Annuity Contracts

Sec. 7. A person receiving beneficiary payments from an annuity contract of a deceased Medicaid recipient is liable to the state for reimbursement of Medicaid benefits:
(1) paid to; or
(2) on behalf of;
the deceased Medicaid recipient to the extent of any payments that are received by the person under a annuity contract purchased after May 1, 2005.
As added by P.L.246-2005, SEC.110.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 10. Selection of Provider › 12-15-10-1. Repealed

[Pre-1992 Revision Citation: 12-1-7-14.8 part.]
As added by P.L.2-1992, SEC.9. Amended by P.L.278-1993(ss), SEC.26. Repealed by P.L.1-2001, SEC.51.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 10. Selection of Provider › 12-15-10-2. Licensed or Otherwise Qualified Providers; Participation in Medicaid Program

Sec. 2. If a provider is required to be licensed or otherwise qualified under Indiana law or the law of another state, the assistance must be obtained from a provider who is licensed or otherwise qualified and is enrolled to participate in the Medicaid program.
[Pre-1992 Revision Citation: 12-1-7-14.8 part.]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 10. Selection of Provider › 12-15-10-3. Individuals Required to Furnish Providers With Medicaid Information; Rules

Sec. 3. The office may by rule require the individual to furnish providers with information regarding Medicaid provided to the individual.
[Pre-1992 Revision Citation: 12-1-7-14.8 part.]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 10. Selection of Provider › 12-15-10-4. Furnishing Providers With Information; Forms

Sec. 4. The office shall provide forms for providing information under section 3 of this chapter.
[Pre-1992 Revision Citation: 12-1-7-14.8 part.]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 10. Selection of Provider › 12-15-10-5. Documentation of Medicaid Provided; Rules

Sec. 5. The office may by rule require a provider to make available to the office information necessary to document Medicaid provided under this chapter.
[Pre-1992 Revision Citation: 12-1-7-14.8 part.]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 10. Selection of Provider › 12-15-10-6. Selection of Primary Dental Provider Encouraged

Sec. 6. The office shall encourage the parent of a child who is a recipient of Medicaid to select a primary dental provider for the child before the child is eighteen (18) months of age.
As added by P.L.169-2001, SEC.2.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 11. Provider Agreements and Competitive Bidding › 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.
[Pre-1992 Revision Citation: 12-1-7-15.1(a).]
As added by P.L.2-1992, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 15. Medicaid › Chapter 11. Provider Agreements and Competitive Bidding › 12-15-11-2. Provider Agreement; Filing

Sec. 2. A provider desiring to participate in the Medicaid program by providing to individuals eligible for Medicaid services shall file a provider agreement with the office on forms provided by the office.
[Pre-1992 Revision Citation: 12-1-7-15.1(b) part.]
As added by P.L.2-1992, SEC.9. Amended by P.L.195-2018, SEC.3.