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
12-16-6.5-5. Determination of eligibility for assistance and health care items or services; entitled to assistance
Sec. 5. (a) If the division receives an application that was filed on behalf of a person under IC 12-16-4.5, the division shall determine:
(1) the eligibility of the person for assistance under the hospital care for the indigent program; and
(2) if the health care items or services provided to the person and identified in a claim filed with the division under IC 12-16-4.5 were:
(A) necessitated by at least one (1) medical condition 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
(B) the direct consequence of at least one (1) of the medical conditions listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3).
(b) If:
(1) the person, initially or upon appeal, is found eligible for assistance; and
(2) at least one (1) of the items or services identified in the claim is determined initially or upon appeal:
(A) to have been 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
(B) to be 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);
the person is entitled to assistance for those items and services.
As added by P.L.120-2002, SEC.22. Amended by P.L.255-2003, SEC.34; P.L.145-2005, SEC.21.
