Sec. 6. (a) A health insurance plan that provides coverage for early intervention services shall reimburse the first steps program a monthly fee established by the division of disability and rehabilitative services. Except when the monthly fee is less than the product determined under IC 12-12.7-2-23(b), the monthly fee shall be provided instead of claims processing of individual claims.
(b) A health insurance plan may not require authorization for services specified in the covered individual's individualized family service plan, if those services are a covered benefit under the plan, once the individualized family service plan is signed by a physician, an advanced practice registered nurse, or a physician assistant.
(c) The department of insurance shall adopt rules under IC 4-22-2 to ensure compliance with this section.
As added by P.L.121-1999, SEC.13. Amended by P.L.229-2011, SEC.254; P.L.111-2020, SEC.13; P.L.133-2020, SEC.19; P.L.143-2022, SEC.75.
Structure Indiana Code
Article 8. Life, Accident, and Health
Chapter 27. Coverage for Services to Infants and Toddlers With Disabilities
27-8-27-1. "Early Intervention Services" Defined
27-8-27-2. "First Steps Child" Defined
27-8-27-3. "First Steps Program" Defined
27-8-27-4. "Health Insurance Plan"
27-8-27-6. Reimbursement of First Steps Program for Early Intervention Services Payments
27-8-27-8. Reimbursement Not to Be Applied to Lifetime Coverage Limit
27-8-27-9. Payment of Deductibles, Copayments, or Other Expenses