2011 Indiana Code
TITLE 12. HUMAN SERVICES
ARTICLE 15. MEDICAID
CHAPTER 23.5. COORDINATION OF BENEFITS STUDY

IC 12-15-23.5
Chapter 23.5. Coordination of Benefits Study

IC 12-15-23.5-1
"Covered entity"
Sec. 1. As used in this chapter, "covered entity" has the meaning set forth in 45 CFR 160.103.
As added by P.L.187-2007, SEC.3.

IC 12-15-23.5-2
Examination and recovery of Medicaid claims
Sec. 2. (a) Before January 1, 2008, the office shall:
(1) examine all Medicaid claims paid after January 1, 2001, and before July 1, 2007;
(2) determine which claims examined under subdivision (1) were eligible for payment by a third party other than Medicaid; and
(3) recover the claims that were determined under subdivision (2) to be eligible for payment by a third party other than Medicaid.
(b) The office shall require through an eligibility and benefit request, and a covered entity shall provide, any information necessary for the office to complete the examination required by this section. The office, after notice and hearing, may impose a fine not to exceed one thousand dollars ($1,000) for each refusal by a covered entity to provide information concerning an eligibility and benefit request for a Medicaid recipient requested by the office under this section.
As added by P.L.187-2007, SEC.3.

IC 12-15-23.5-3
Coordination of benefits procedures
Sec. 3. If at least one percent (1%) of the claims were determined under section 2 of this chapter to be eligible for payment by a third party other than Medicaid, the office shall develop and implement a procedure to improve the coordination of benefits between:
(1) the Medicaid program; and
(2) any other third party source of health care coverage provided to a recipient.
As added by P.L.187-2007, SEC.3.

IC 12-15-23.5-4
Procedure requirements
Sec. 4. If a procedure is developed and implemented under section 3 of this chapter, the procedure:
(1) must be automated; and
(2) must provide a system for determining whether a Medicaid claim is eligible for payment by another third party before the claim is paid under the Medicaid program.
As added by P.L.187-2007, SEC.3.