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2017 Indiana Code
TITLE 12. Human Services
ARTICLE 16. PAYMENT FOR HEALTH SERVICES OTHER THAN MEDICAID
CHAPTER 6.5. Hospital Care for the Indigent; Denial of Eligibility; Appeals; Judicial Review
12-16-6.5-1.7. Item or service eligibility determination
Universal Citation: IN Code § 12-16-6.5-1.7 (2017)
IC 12-16-6.5-1.7 Item or service eligibility determination
Sec. 1.7. Subject to IC 12-16-5.5-3.2(c), if the division fails to complete an investigation and determination of one (1) or more health care items or services identified in a claim within forty-five (45) days after receipt of the claim filed under IC 12-16-4.5, the item or service is considered to have been:
(1) necessitated by one (1) or more of the medical conditions listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3) or IC 12-16-3.5-2(a)(1) through IC 12-16-3.5-2(a)(3); or
(2) a direct consequence of one (1) or more of the medical conditions listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3).
As added by P.L.145-2005, SEC.20.
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