Sec. 16. (a) Each:
(1) school corporation; or
(2) school corporation's employed, licensed, or qualified provider;
must enroll in a program to use federal funds under the Medicaid program (IC 12-15-1 et seq.) with the intent to share the costs of services that are reimbursable under the Medicaid program and that are provided to eligible children by the school corporation. However, a school corporation or a school corporation's employed, licensed, or qualified provider is not required to file any claims or participate in the program developed under this section.
(b) The secretary and the department of education may develop policies and adopt rules to administer the program developed under this section.
(c) The federal reimbursement for services provided under this section must be distributed to the school corporation. The state shall retain the nonfederal share of the reimbursement for Medicaid services provided under this section.
(d) The office of Medicaid policy and planning, with the approval of the budget agency and after consultation with the department of education, shall establish procedures for the timely distribution of federal reimbursement due to the school corporations. The distribution procedures may provide for offsetting reductions to distributions of state tuition support or other state funds to school corporations in the amount of the nonfederal reimbursements required to be retained by the state under subsection (c).
(e) The office may apply to the United States Department of Health and Human Services for a state plan amendment to allow school corporations to seek Medicaid reimbursement for medically necessary, school based Medicaid covered services that are provided under federal or state mandates. If the state plan amendment is approved and implemented, services may be provided by a qualified provider in a school setting to Medicaid enrolled students. Subject to subsection (f), the services may be pursuant to any of the following:
(1) An individualized education program (as defined in IC 20-18-2-9).
(2) A plan developed under Section 504 of the federal Rehabilitation Act, 29 U.S.C. 794.
(3) A behavioral intervention plan (as defined in IC 20-20-40-1).
(4) A service plan developed under 511 IAC 7-34.
(5) An individualized health care plan.
The office may, in consultation with the department of education, develop any necessary state plan amendment under this subsection. The office may apply for any state plan amendment necessary to implement this subsection.
(f) Services under subsection (e) may not include the following:
(1) An abortion.
(2) Counseling for abortion procedures.
(3) Referrals for abortion services.
(4) Abortifacients.
(5) Contraceptives.
(g) If the state plan amendment described in subsection (e) is approved and implemented, the medically necessary, school based Medicaid covered services described in subsection (e):
(1) may only be performed by a qualified provider;
(2) must be within the qualified provider's scope of practice; and
(3) must be provided in accordance with this article and administrative rules concerning the Medicaid program.
As added by P.L.80-1994, SEC.1. Amended by P.L.224-2003, SEC.64; P.L.35-2016, SEC.35; P.L.108-2019, SEC.193; P.L.196-2021, SEC.1; P.L.35-2022, SEC.3.
Structure Indiana Code
12-15-1-1. Administration of Medicaid Program
12-15-1-2. Agents of the Division of Family Resources
12-15-1-3. Supervision of County Offices
12-15-1-4. Written Protocols; Contracts Implementing State Program
12-15-1-8. Receipt of Assistance in Adult Category Before January 1, 1974; Automatic Coverage
12-15-1-9. Application to County Offices
12-15-1-10. Administrative Actions and Directions; Adoption of Procedures and Rules
12-15-1-13. Annual Effectiveness Evaluation
12-15-1-14. Effectiveness Evaluation; Annual Report to Legislative Council
12-15-1-17. Reimbursement From Parent for Health Services Provided to Child
12-15-1-18. Use of Funds to Encourage Application and Enrollment of Minors
12-15-1-19. Contracts With Community Entities
12-15-1-20.2. Computer System for Disproportionate Share Hospital Payment Program; Hci; Upl
12-15-1-20.4. Suspension of Medicaid for Delinquent Child or Incarcerated Individual
12-15-1-21. Single Electronic Medicaid Eligibility Verification System
12-15-1-21.7. Life Insurance Policy Treatment
12-15-1-22. Visit to Medicaid Provider Offices, Entities, or Facilities; Rules