Indiana Code
Chapter 44.5. Healthy Indiana Plan 2.0
12-15-44.5-5.7. Nonemergency Services Received in an Emergency Room; Copayment

Sec. 5.7. Subject to appeal to the office, an individual may be held responsible under the plan for receiving nonemergency services in an emergency room setting, including prohibiting the individual from using funds in the individual's health care account to pay for the nonemergency services and paying a copayment for the services of at least eight dollars ($8) for the nonemergency use of a hospital emergency department. However, an individual may not be prohibited from using funds in the individual's health care account to pay for nonemergency services provided in an emergency room setting for a medical condition that arises suddenly and unexpectedly and manifests itself by acute symptoms of such severity, including severe pain, that the absence of immediate medical attention could reasonably be expected by a prudent layperson who possesses an average knowledge of health and medicine to:
(1) place an individual's health in serious jeopardy;
(2) result in serious impairment to the individual's bodily functions; or
(3) result in serious dysfunction of a bodily organ or part of the individual.
As added by P.L.30-2016, SEC.34. Amended by P.L.114-2018, SEC.7.

Structure Indiana Code

Indiana Code

Title 12. Human Services

Article 15. Medicaid

Chapter 44.5. Healthy Indiana Plan 2.0

12-15-44.5-1. "Phase Out Period"

12-15-44.5-2. "Plan"

12-15-44.5-2.3. "Preventative Care Services"

12-15-44.5-3. Plan Established; Eligibility; Oversight of Marketing; Promotion of Plan; Ensure Enrollment Distribution; Consumer Protection; Provider Participation; Exemptions

12-15-44.5-3.5. Coverage; Vision and Dental; Preventative Care Services

12-15-44.5-4. Scope of the Plan; Termination of Plan; Obligation of State; Report to Budget Committee

12-15-44.5-4.5. Required Health Care Account; Payments

12-15-44.5-4.7. Application; Pregnant Woman Exemption; Payments; Failure to Make Payments; State Contribution; Change in Health Plan

12-15-44.5-4.9. Eligibility Period; Renewal; Unused Share of Health Care Account Distribution

12-15-44.5-5. Managed Care Organization Responsibilities; Reimbursement; Cultural Competency Standards

12-15-44.5-5.5. Workforce Training and Job Search Program Referral

12-15-44.5-5.7. Nonemergency Services Received in an Emergency Room; Copayment

12-15-44.5-6. Phase Out Funds Deposited From Incremental Hospital Assessment Fees; Notice and Phase Out if Plan Is Terminated

12-15-44.5-7. Phase Out Trust Fund Established; Purpose of the Fund; Uses; Administration; Fund Is Considered a Trust Fund

12-15-44.5-8. Requirements for Use of Money Appropriated to the Fund; Requirements for Use of the Incremental Hospital Assessment Fee; Payment for Health Care Services; Administrative Costs; Profit

12-15-44.5-9. Rules

12-15-44.5-10. Benefits for Adult Group; Negotiation of Plan Limitations