OVERVIEW: Amends
405 IAC 1-4.2-4 to extend through June 30, 2017, the three percent rate reduction for covered home health agency (HHA) services that is currently set to expire on June 30, 2015, and clarify the time limits for submission of requested documentation. Amends
405 IAC 1-8-3 to extend through June 30, 2017, the three percent rate reduction for covered outpatient hospital services that is currently set to expire on June 30, 2015. Amends
405 IAC 1-10.5-6 to extend through June 30, 2017, the three percent rate reduction for covered inpatient hospital services that is currently set to expire on June 30, 2015. Amends
405 IAC 1-11.5-2 to update the list of procedure codes exempt from the physician global surgery policy. Amends
405 IAC 1-12-21 to modify the Medicaid reimbursement rule for covered services provided by privately (nonstate) owned intermediate care facilities for the mentally retarded (ICFs/MR) licensed as a comprehensive rehabilitative management needs facility (CRMNF). Amends
405 IAC 1-12-27 to extend through June 30, 2017, the one percent rate reduction for covered services provided by privately (nonstate) owned intermediate care facilities for the mentally retarded (ICFs/MR) and community residential facilities for the developmentally disabled (CRFs/DD) that is currently set to
expire on June 30, 2015. Amends
405 IAC 1-14.6-2 to update and add definitions. Amends
405 IAC 1-14.6-5 to add a penalty for untimely filing of the Checklist of Management Representations. Amends
405 IAC 1-14.6-7 to amend the case mix indices, inflation adjustment, and effective dates. Amends
405 IAC 1-14.6-9 to modify effective dates, substitute the language "total quality score" for "report card score", and modify the newly defined total quality score. Amends
405 IAC 1-14.6-18 to update beginning and end dates for allowable costs. Amends
405 IAC 1-14.6-24 to extend until June 30, 2017, the nursing facility quality assessment fee enhanced reimbursements and change the quality assessment provisions and to conform with applicable statutory provisions and the federal waiver. Amends
405 IAC 1-14.6-26 to modify the rate reduction for reimbursed nursing facilities. Amends
405 IAC 1-19-2 to revise the time period providers are required to notify the office of a change in ownership. Amends
405 IAC 1-20-2 to change mandatory language to permissive. Amends
405 IAC 5-24-6 to extend through June 30, 2017, the Medicaid dispensing fee maximum of three dollars and ninety cents that is currently set to expire on June 30, 2015. Amends
405 IAC 5-24-13 to revise and clarify the
criteria for determining when legend and nonlegend water products are to be included in the nursing facility per diem rate and when they are to be reimbursed through the pharmacy benefit. Adds
405 IAC 5-24-14 to add criteria for determining when skin protectants, sealants, moisturizers, and ointments are to be included in the nursing facility per diem rate and when they are to be reimbursed through the pharmacy benefit. Amends
405 IAC 5-31-4 to revise the criteria for determining when legend and nonlegend water products are included in the nursing facility per diem rate and add criteria for determining when skin protectants, sealants, moisturizers, and ointments are to be included in the nursing facility per diem rate. Effective 30 days after filing with the Publisher. Statutory authority:
IC 12-15-1-10;
IC 12-15-21-1;
IC 12-15-21-2;
IC 12-15-21-3.