-IR- Database Guide
-IR- Database: Indiana Register

TITLE 405 OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES

Readopted Final Rule
LSA Document #19-487(F)

DIGEST

Readopts rules in anticipation of IC 4-22-2.5-2, providing that an administrative rule adopted under IC 4-22-2 expires January 1 of the seventh year after the year in which the rule takes effect unless the rule contains an earlier expiration date. Effective 30 days after filing with the Publisher.

405 IAC 1-1-3.1; 405 IAC 1-1-7; 405 IAC 1-1-8; 405 IAC 1-1-9; 405 IAC 1-1-10; 405 IAC 1-1-11; 405 IAC 1-1-12; 405 IAC 1-1.6; 405 IAC 1-3; 405 IAC 1-10.5-5; 405 IAC 1-12-6; 405 IAC 1-12-8; 405 IAC 1-12-10; 405 IAC 1-12-11; 405 IAC 1-12-12; 405 IAC 1-12-13; 405 IAC 1-12-14; 405 IAC 1-12-16; 405 IAC 1-12-17; 405 IAC 1-12-18; 405 IAC 1-12-20.5; 405 IAC 1-14.6-8; 405 IAC 1-14.6-13; 405 IAC 1-14.6-14; 405 IAC 1-14.6-15; 405 IAC 1-14.6-17; 405 IAC 1-17-3; 405 IAC 1-17-5; 405 IAC 1-17-6; 405 IAC 1-17-8; 405 IAC 1-17-9; 405 IAC 1-17-10; 405 IAC 1-17-11; 405 IAC 1-17-12; 405 IAC 1-17-13; 405 IAC 1-17-14; 405 IAC 1-17-15; 405 IAC 1-17-16; 405 IAC 1-19-1; 405 IAC 1-20-3; 405 IAC 1-20-5; 405 IAC 1.1; 405 IAC 2; 405 IAC 5-2-1; 405 IAC 5-2-7; 405 IAC 5-2-7.1; 405 IAC 5-2-10; 405 IAC 5-2-10.1; 405 IAC 5-2-10.2; 405 IAC 5-2-13.1; 405 IAC 5-2-13.3; 405 IAC 5-2-26; 405 IAC 5-3-3; 405 IAC 5-8-1; 405 IAC 5-9-3; 405 IAC 5-10-2; 405 IAC 5-10-4; 405 IAC 5-12-4; 405 IAC 5-12-5; 405 IAC 5-12-7; 405 IAC 5-13-4; 405 IAC 5-13-5; 405 IAC 5-14-8; 405 IAC 5-14-9; 405 IAC 5-14-11; 405 IAC 5-14-12; 405 IAC 5-14-13; 405 IAC 5-14-14; 405 IAC 5-14-16; 405 IAC 5-14-17; 405 IAC 5-15-5; 405 IAC 5-15-7; 405 IAC 5-15-8; 405 IAC 5-16-4; 405 IAC 5-17-3; 405 IAC 5-18-1; 405 IAC 5-18-2; 405 IAC 5-19-10; 405 IAC 5-20-6; 405 IAC 5-21.5-16; 405 IAC 5-21.6-1; 405 IAC 5-22-4; 405 IAC 5-22-5; 405 IAC 5-23-1; 405 IAC 5-23-6; 405 IAC 5-24-10; 405 IAC 5-24-12; 405 IAC 5-25-3; 405 IAC 5-25-5; 405 IAC 5-26-1; 405 IAC 5-26-3; 405 IAC 5-26-4; 405 IAC 5-26-9; 405 IAC 5-27; 405 IAC 5-28-2; 405 IAC 5-28-3; 405 IAC 5-28-6; 405 IAC 5-28-7; 405 IAC 5-28-11; 405 IAC 5-30-1.5; 405 IAC 5-30-11; 405 IAC 5-31-6; 405 IAC 5-31-7; 405 IAC 5-32; 405 IAC 5-33; 405 IAC 5-35; 405 IAC 5-36-2

SECTION 1. UNDER IC 4-22-2.5-4, THE FOLLOWING ARE READOPTED:
  405 IAC 1-1-3.1  Providing services to members enrolled under the Medicaid spend-down provision 
  405 IAC 1-1-7  Nursing home rate setting; governing provisions 
  405 IAC 1-1-8  Level of care criteria for long-term care facilities; governing provisions 
  405 IAC 1-1-9  Nursing home admission; governing provisions 
  405 IAC 1-1-10  Intermediate care for the mentally retarded; governing provisions 
  405 IAC 1-1-11  Intermediate care of the mentally retarded; eligibility 
  405 IAC 1-1-12  Regular access authority to medicaid division personal information system 
  405 IAC 1-1.6  Managed Care Provider Reimbursement Dispute Resolution 
  405 IAC 1-3  Criteria for Level of Care in Long Term Care Facilities 
  405 IAC 1-10.5-5  Health care-acquired conditions and other provider-preventable conditions 
  405 IAC 1-12-6  Active providers; rate review; annual request 
  405 IAC 1-12-8  Limitations or qualifications to Medicaid reimbursement; advertising; vehicle basis 
  405 IAC 1-12-10  Computation of rate; allowable costs; review of cost reasonableness 
  405 IAC 1-12-11  Allowable costs; services provided by parties related to provider 
  405 IAC 1-12-12  Allowable costs; capital return factor 
  405 IAC 1-12-13  Allowable costs; capital return factor; computation of use fee component; interest; allocation of loan to facilities and parties 
  405 IAC 1-12-14  Allowable costs; capital return factor; computation of return on equity component 
  405 IAC 1-12-16  Capital return factor; basis; historical cost; mandatory record keeping; valuation 
  405 IAC 1-12-17  Capital return factor; basis; sale or capital lease of facility; valuation; sale or lease among family members 
  405 IAC 1-12-18  Unallowable costs; cost adjustments; charity and courtesy allowances; discounts; rebates; refunds of expenses 
  405 IAC 1-12-20.5  Extensive support needs residences for adults; fair rental value allowance 
  405 IAC 1-14.6-8  Limitations or qualifications to Medicaid reimbursement; advertising; vehicle basis 
  405 IAC 1-14.6-13  Reporting of financing arrangements; working capital; interest; allocation of loans 
  405 IAC 1-14.6-14  Property; basis; historical cost; mandatory record keeping; valuation 
  405 IAC 1-14.6-15  Valuation; sale or lease among family members 
  405 IAC 1-14.6-17  Allowable costs; wages; costs of employment; record keeping; owner or related party compensation 
  405 IAC 1-17-3  Accounting records; retention schedule; audit trail; cash basis; segregation of accounts by nature of business and by location 
  405 IAC 1-17-5  New provider; initial financial report to office; criteria for establishing initial rates; supplemental report 
  405 IAC 1-17-6  Active providers; rate review; annual request; additional requests; requests due to change in law 
  405 IAC 1-17-8  Limitations or qualifications to Medicaid reimbursement; advertising 
  405 IAC 1-17-9  Criteria limiting rate adjustment granted by office 
  405 IAC 1-17-10  Computation of rate; allowable costs; review of cost reasonableness 
  405 IAC 1-17-11  Allowable costs; capital reimbursement; depreciable life 
  405 IAC 1-17-12  Capital reimbursement; basis; historical cost; mandatory record keeping; valuation 
  405 IAC 1-17-13  Unallowable costs; cost adjustments; charity and courtesy allowances; discounts; rebates; refunds of expenses 
  405 IAC 1-17-14  Allowable costs; wages; costs of employment; record keeping; owner or related party compensation 
  405 IAC 1-17-15  Allowable costs; calculation of allowable owner or related party compensation; wages; salaries; fees; fringe benefits 
  405 IAC 1-17-16  Allocation of costs 
  405 IAC 1-19-1  Information to be disclosed 
  405 IAC 1-20-3  Change of ownership types 
  405 IAC 1-20-5  Record retention 
  405 IAC 1.1  APPEAL PROCEDURES FOR APPLICANTS AND RECIPIENTS OF MEDICAID 
  405 IAC 2  MEDICAID RECIPIENTS; ELIGIBILITY 
  405 IAC 5-2-1  Applicability 
  405 IAC 5-2-7  "CPT" defined 
  405 IAC 5-2-7.1  "Curative care services" defined 
  405 IAC 5-2-10  "EPSDT" defined 
  405 IAC 5-2-10.1  "Hospice" defined 
  405 IAC 5-2-10.2  "Hospice program" defined 
  405 IAC 5-2-13.1  "IEP" defined 
  405 IAC 5-2-13.3  "IEP transportation services" defined 
  405 IAC 5-2-26  "School corporation" defined 
  405 IAC 5-3-3  Prior authorization based on false information 
  405 IAC 5-8-1  Reimbursement 
  405 IAC 5-9-3  Office visits exceeding established parameters 
  405 IAC 5-10-2  "Anesthetist" defined 
  405 IAC 5-10-4  Anesthesia administered during labor/delivery 
  405 IAC 5-12-4  Laboratory services 
  405 IAC 5-12-5  Muscle testing services 
  405 IAC 5-12-7  Durable medical equipment 
  405 IAC 5-13-4  Services included in the per diem rate for large state ICFs/MR; exceptions 
  405 IAC 5-13-5  Prior authorization for services rendered outside the large state ICF/MR 
  405 IAC 5-14-8  Extractions 
  405 IAC 5-14-9  Space maintenance 
  405 IAC 5-14-11  Analgesia 
  405 IAC 5-14-12  Infection control 
  405 IAC 5-14-13  Emergency treatment of dental pain 
  405 IAC 5-14-14  Office visits 
  405 IAC 5-14-16  Periodontics; surgical 
  405 IAC 5-14-17  Oral surgery 
  405 IAC 5-15-5  Prior authorization 
  405 IAC 5-15-7  Screening referrals 
  405 IAC 5-15-8  EPSDT periodicity and screening schedule 
  405 IAC 5-16-4  Rehabilitation center services; limitations 
  405 IAC 5-17-3  Emergency; weekend inpatient admissions 
  405 IAC 5-18-1  Clinical diagnostic laboratory services; reimbursement 
  405 IAC 5-18-2  Reimbursement restrictions 
  405 IAC 5-19-10  Braces and orthopedic shoes 
  405 IAC 5-20-6  Emergency admissions 
  405 IAC 5-21.5-16  Diagnosis; individualized integrated care plan 
  405 IAC 5-21.6-1  General provisions 
  405 IAC 5-22-4  Certified nurse practitioner services 
  405 IAC 5-22-5  Audiology, occupational, and physical therapy and speech pathology; reimbursement 
  405 IAC 5-23-1  Reimbursement limitations 
  405 IAC 5-23-6  Prior authorization 
  405 IAC 5-24-10  Medical and nonmedical supply items for long term care facility residents 
  405 IAC 5-24-12  Risk-based managed care 
  405 IAC 5-25-3  Physician's written order, plan of treatment; when required 
  405 IAC 5-25-5  Inpatient services; reimbursement limitations 
  405 IAC 5-26-1  Scope 
  405 IAC 5-26-3  Routine foot care; restrictions 
  405 IAC 5-26-4  Laboratory or x-ray services 
  405 IAC 5-26-9  Surgical procedures; reimbursement 
  405 IAC 5-27  Radiology Services 
  405 IAC 5-28-2  Medical diagnostic procedures 
  405 IAC 5-28-3  Cardiac pacemaker 
  405 IAC 5-28-6  Monitoring of pacemakers 
  405 IAC 5-28-7  Abortion 
  405 IAC 5-28-11  Hyperbaric oxygen therapy 
  405 IAC 5-30-1.5  Reimbursement rates for transportation services 
  405 IAC 5-30-11  IEP transportation services 
  405 IAC 5-31-6  Personal care items 
  405 IAC 5-31-7  Limitations on nursing services 
  405 IAC 5-32  Rehabilitation Units 
  405 IAC 5-33  Acute Care Hospital Admission 
  405 IAC 5-35  Case Management Services for Infants and Toddlers with Disabilities 
  405 IAC 5-36-2  Requirements for the provision of DSMT 

LSA Document #19-487(F)
Intent to Readopt Rules: 20190918-IR-405190487RNA
Filed with Publisher: November 13, 2019, 11:54 a.m.

Posted: 12/11/2019 by Legislative Services Agency

DIN: 20191211-IR-405190487RFA
Composed: Feb 04,2023 4:33:14AM EST
A PDF version of this document.