Sec. 22. (a) The office shall visit a Medicaid provider's office, entity, or facility if:
(1) the provider is categorized as high risk to the Medicaid program under 42 U.S.C. 1395cc(j)(2)(B) and 42 CFR 455.450; and
(2) the provider's Medicaid claims have increased by at least fifty percent (50%) over a six (6) month period.
(b) The office shall adopt rules under IC 4-22-2 or issue a Medicaid provider bulletin setting forth procedures and standards for the visit required under this section.
As added by P.L.197-2013, SEC.9.
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