Sec. 18.5. (a) Except as provided in subsection (b), this section applies to an emergency medical services provider organization that meets the following requirements:
(1) Is certified by the Indiana emergency medical services commission to provide emergency medical services.
(2) Is a Medicaid provider.
(b) This section does not apply to an emergency medical services provider organization that has contracted with the recipient's managed care organization to provide emergency medical services described in this section at a negotiated rate that is different than the Medicare rate described in this section.
(c) Beginning July 1, 2023, a managed care organization shall reimburse an emergency medical services provider organization for Medicaid covered services provided to a Medicaid recipient, including:
(1) advanced life support services;
(2) basic life support services; and
(3) nonemergency medical transportation services;
that are within the emergency medical services provider organization's scope of practice at a rate that is comparable to the federal Medicare reimbursement rate for the service provided by the emergency medical services provider organization. However, the reimbursement rate specified in this subsection may not be implemented by the office of the secretary before July 1, 2023.
As added by P.L.142-2022, SEC.2.
Structure Indiana Code
12-15-12-0.3. "Emergency Medical Condition"
12-15-12-0.5. "Emergency Services"
12-15-12-0.7. "Post-Stabilization Care Services"
12-15-12-0.9. Applicability; Medicaid Law Controlling Over Conflicting Insurance Law
12-15-12-2. Providers From Whom Recipients May Receive Physician Services; Exceptions
12-15-12-3. List of Managed Care Providers Furnished Recipient; Providers Included; Exception
12-15-12-4.5. Managed Care Prescription Drug Program Requirements
12-15-12-7. Providers From Whom Recipients May Obtain Eye Care Services Other Than Surgical Services
12-15-12-8. Providers From Whom Recipients May Obtain Foot Care Services
12-15-12-9. Providers From Whom Recipients May Obtain Psychiatric Services
12-15-12-10. Selection or Assignment of Managed Care Provider; Selection of New Provider; Exception
12-15-12-11. Waiver From Department of Health and Human Services; Implementation of Chapter
12-15-12-12. Payments to Providers
12-15-12-15. Coverage for Emergency Services
12-15-12-17. Coverage for Post-Stabilization Care Services
12-15-12-18. Payment for Emergency Services
12-15-12-18.5. Reimbursement for Emergency Medical Services Provider Organizations; Implementation
12-15-12-20. Child Lead Poisoning Screening
12-15-12-22. Accepting, Receiving, and Processing Electronic Claims
12-15-12-23. Psychiatrist Practicing in Community Mental Health Center