TITLE 405 OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES

Notice of Intent to Adopt a Rule

LSA Document #08-664

Under IC 4-22-2-23, the Office of the Secretary of Family and Social Services intends to adopt a rule concerning the following:

OVERVIEW: Amends 405 IAC 5-3-9 to provide for prior authorization of a nursing facility admission after services have begun in certain situations. Amends 405 IAC 5-3-10 to add nursing facilities to the list of providers who may submit prior authorization requests. Amends 405 IAC 5-3-13 to add nursing facility admissions and continued stays to the list of Medicaid services requiring prior authorization. Amends 405 IAC 5-31-1 to specify that prior authorization of a nursing facility admission or continued stay is required for Medicaid reimbursement. Adds 405 IAC 5-31-8.1 to define continued stay and to establish the prior authorization process for admission to a nursing facility or a continued stay. Repeals 405 IAC 1-1-7 and 405 IAC 1-4.1. Statutory authority: IC 12-8-6-5; IC 12-15-1-10; IC 12-15-21-3.

For purposes of IC 4-22-2-28.1, the Small Business Regulatory Coordinator for this rule is:

Natalie Angel

Manager, Agency Coordination and Integration

Office of Medicaid Policy and Planning

Indiana Government Center South

402 West Washington Street, Room W374, MS 07

Indianapolis, IN 46204

(317) 234-5547

natalie.angel@fssa.in.gov

DIN: 20080820-IR-405080664NIA

Composed: May 03,2024 12:44:03PM EDT

A PDF version of this document.