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Chapter 1. Definitions
12-17.6-1-1. Applicability of Definitions - Sec. 1. The definitions in this chapter apply throughout this...
12-17.6-1-2. "Crowd Out" - Sec. 2. "Crowd out" means the extent to which: (1)...
12-17.6-1-2.6. "Emergency" - Sec. 2.6. "Emergency" means a medical condition that manifests itself...
12-17.6-1-3. "Fund" - Sec. 3. "Fund" refers to the children's health insurance program...
12-17.6-1-4. "Office" - Sec. 4. "Office" refers to the office of Medicaid policy...
12-17.6-1-5. "Program" - Sec. 5. "Program" refers to the children's health insurance program...
12-17.6-1-6. "Provider" - Sec. 6. "Provider" has the meaning set forth in IC...
Chapter 2. Program Administration
12-17.6-2-1. Administration of Program - Sec. 1. The secretary shall administer the children's health insurance...
12-17.6-2-2. Design and Administration of Health Benefits Coverage System - Sec. 2. The secretary, through the office, shall design and...
12-17.6-2-3. Use of Same Factors as Medicaid Managed Care Program for Children - Sec. 3. To the greatest extent possible, the office shall...
12-17.6-2-4. Feasibility Studies - Sec. 4. The office shall evaluate the feasibility of the...
12-17.6-2-5. Program Review Requirements - Sec. 5. Reviews of the program shall: (1) be conducted...
12-17.6-2-6. Performance Criteria and Monitoring - Sec. 6. The office shall do the following: (1) Establish...
12-17.6-2-7. Evaluation of Program - Sec. 7. (a) The office shall contract with an independent...
12-17.6-2-8. Contracts With Community Entities - Sec. 8. The office may, in administering the program, contract...
12-17.6-2-9. Creative Methods Reflective of Community Level Objectives - Sec. 9. (a) The office shall incorporate creative methods, reflective...
12-17.6-2-10. Program to Subsidize Employer Sponsored Coverage - Sec. 10. (a) The office may establish a program to...
12-17.6-2-11. Rules; Emergency Rules; Transfer of Rules - Sec. 11. (a) The secretary shall adopt rules under IC...
12-17.6-2-12. Annual Report - Sec. 12. Not later than April 1, the office shall...
Chapter 3. Eligibility, Outreach, and Enrollment
12-17.6-3-1. Applicability of Chapter - Sec. 1. This chapter does not apply until January 1,...
12-17.6-3-2. Eligibility Requirements - Sec. 2. (a) To be eligible to enroll in the...
12-17.6-3-2.5. 529 Education Savings Plan - Sec. 2.5. Except as otherwise provided under federal law, the...
12-17.6-3-3. Termination of Eligibility; Continuous Eligibility Until Three Years of Age - Sec. 3. (a) Subject to subsections (b) and (c), a...
12-17.6-3-4. Outreach Strategies - Sec. 4. The office shall implement outreach strategies that build...
12-17.6-3-5. Enrollment - Sec. 5. A child may, in any manner determined by...
Chapter 4. Benefits, Crowd Out, and Cost Sharing
12-17.6-4-1. Applicability of Chapter - Sec. 1. This chapter does not apply until January 1,...
12-17.6-4-2. Services Covered; Prohibition on Treatment Limitations or Financial Requirements; Mental Health Services - Sec. 2. (a) The benefit package provided under the program...
12-17.6-4-2.5. Prescription Drug Requirements - Sec. 2.5. Prescription drugs provided under the program are subject...
12-17.6-4-3. Limits on Premium and Cost Sharing Amounts - Sec. 3. Premium and cost sharing amounts established by the...
12-17.6-4-4. Powers of Office; Cost Sharing and Crowd Out - Sec. 4. The office may do the following: (1) Determine...
12-17.6-4-5. Prohibited Referrals; Mechanisms to Minimize Incentive for Employer to Eliminate or Reduce Coverage - Sec. 5. (a) It is a violation of IC 27-4-1-4...
12-17.6-4-6. Community Health Centers - Sec. 6. Community health centers shall be used to provide...
12-17.6-4-7. Selection of Primary Dental Provider Encouraged - Sec. 7. The office shall encourage the parent of a...
12-17.6-4-8. Use of Generic Drugs and Preferred Drug List Required - Sec. 8. (a) The office shall require the use of...
12-17.6-4-10. Repealed - As added by P.L.107-2002, SEC.27. Repealed by P.L.229-2011, SEC.272.
Chapter 5. Provider Contracts
12-17.6-5-1. Applicability of Chapter - Sec. 1. This chapter does not apply until January 1,...
12-17.6-5-2. Required Information - Sec. 2. A provider agreement must include information that the...
12-17.6-5-3. Compliance With Enrollment Requirements - Sec. 3. A provider who participates in the program, including...
12-17.6-5-4. Direct Access of Enrollee to Provider - Sec. 4. (a) A provider that participates in the Medicaid...
Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes
12-17.6-6-1. Applicability of Chapter - Sec. 1. This chapter does not apply until January 1,...
12-17.6-6-2. Provider Sanctions - Sec. 2. If after investigation the office finds that a...
12-17.6-6-3. Ineligibility to Participate in Program - Sec. 3. In addition to any sanction imposed on a...
12-17.6-6-4. Administrative Review - Sec. 4. A provider may appeal a sanction imposed under...
12-17.6-6-5. Judicial Review - Sec. 5. After exhausting all administrative remedies, a provider may...
12-17.6-6-6. Provider to Notify Recipients of Services for Which Office Will Not Pay - Sec. 6. A final directive made by the office that:...
12-17.6-6-7. Duration of Final Directive - Sec. 7. Subject to section 8 of this chapter, a...
12-17.6-6-8. Conditions for Reinstatement of Provider Under Sanction - Sec. 8. Except as provided in section 10 of this...
12-17.6-6-9. Provider Filing Agreements Under Sanction - Sec. 9. Except as provided in section 10 of this...
12-17.6-6-10. Ineligibility of Provider Under Sanction to Submit Claims - Sec. 10. A provider who has been: (1) convicted of...
12-17.6-6-11. Prima Facie Evidence of Intent to Deprive State of Value - Sec. 11. Evidence that a person or provider received money...
12-17.6-6-12. Violations - Sec. 12. A person who furnishes items or services to...
Chapter 7. Funding
12-17.6-7-1. Children's Health Insurance Program Fund Established - Sec. 1. The children's health insurance program fund is established...
12-17.6-7-2. Administration of Fund - Sec. 2. The secretary, through the office, shall administer the...
12-17.6-7-3. Contents of Fund - Sec. 3. The fund consists of the following: (1) Amounts...
12-17.6-7-4. Investments - Sec. 4. The treasurer of state shall invest the money...
12-17.6-7-5. Reversion of Money - Sec. 5. Money in the fund at the end of...
Chapter 8. Appeals and Hearings
12-17.6-8-1. Applicability of Chapter - Sec. 1. This chapter does not apply until January 1,...
12-17.6-8-2. Right to Appeal - Sec. 2. An applicant for or a recipient of services...
12-17.6-8-3. Applicability of Ic 4-21.5 - Sec. 3. The secretary shall conduct hearings and appeals concerning...
12-17.6-8-4. Setting Matter for Hearing - Sec. 4. The office shall, upon receipt of notice of...
12-17.6-8-5. Hearing Procedure - Sec. 5. (a) At a hearing held under section 4...
12-17.6-8-6. Powers and Duties - Sec. 6. The secretary, through the office: (1) may make...
Chapter 9. Confidentiality and Release of Information
12-17.6-9-1. Applicability of Chapter - Sec. 1. This chapter does not apply until January 1,...
12-17.6-9-2. Confidentiality of Information in General - Sec. 2. The following concerning a program applicant or recipient...
12-17.6-9-3. Disclosure of Information Authorized - Sec. 3. The use and the disclosure of the information...
12-17.6-9-4. Disclosure of Information of General Nature - Sec. 4. (a) The release and use of information of...
12-17.6-9-5. Information Available to Providers - Sec. 5. The office shall make available the following to...
12-17.6-9-6. Limits on Information Available to Providers - Sec. 6. Information released under section 5 of this chapter...
12-17.6-9-7. Confidentiality of Information Obtained by Providers - Sec. 7. Information obtained by a provider under this chapter...
12-17.6-9-8. Limitation of Provisions to Ensure Eligibility for Federal Financial Participation - Sec. 8. If it is established that a provision of...