TITLE 405 OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES

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 1-10.5-1, 405 IAC 1-10.5-2, 405 IAC 1-10.5-3, 405 IAC 5-1-5, 405 IAC 5-2-13, 405 IAC 5-3-5, and 405 IAC 5-3-6 to modify the Medicaid reimbursement rule for covered inpatient hospital services due to the implementation of the International Classification of Diseases 10th Revision (ICD-10) diagnosis and procedure codes, the adoption of a new diagnosis related group (DRG) classification and payment system, and the rebasing of inpatient hospital rates, and to make technical changes. Amends 405 IAC 1-1-1 to update and modify definitions to provide uniformity in terminology used throughout the articles and to reflect current terms used in practice. Amends 405 IAC 1-1-2, 405 IAC 1-1-3, 405 IAC 1-1-13, 405 IAC 1-1-15, 405 IAC 1-1-16, 405 IAC 1-1.6-1, 405 IAC 1-3-2, 405 IAC 1-4.2-1, 405 IAC 1-4.2-2, 405 IAC 1-4.2-3, 405 IAC 1-4.2-3.1, 405 IAC 1-4.2-4, 405 IAC 1-4.2-6, 405 IAC 1-4.3-1, 405 IAC 1-8-2, 405 IAC 1-8-3, 405 IAC 1-8-4, 405 IAC 1-10.5-4, 405 IAC 1-11.5-1, 405 IAC 1-11.5-2, 405 IAC 1- 11.5-3, 405 IAC 1-12-1, 405 IAC 1-12-2, 405 IAC 1-12-3, 405 IAC 1-12-4, 405 IAC 1-12-5, 405 IAC 1-12-7, 405 IAC 1-12-9, 405 IAC 1-12-15, 405 IAC 1-12-19, 405 IAC 1-12-21, 405 IAC 1-12-22, 405 IAC 1-12-23, 405 IAC 1-12-24, 405 IAC 1-12-25, 405 IAC 1-12-26, 405 IAC 1-12-27, 405 IAC 1-13-1, 405 IAC 1-13-2, 405 IAC 1-14.6-1, 405 IAC 1-14.6-2, 405 IAC 1-14.6-3, 405 IAC 1-14.6-4, 405 IAC 1-14.6-5, 405 IAC 1-14.6-6, 405 IAC 1-14.6-7, 405 IAC 1-14.6-9, 405 IAC 1-14.6-10, 405 IAC 1-14.6-16, 405 IAC 1-14.6-19, 405 IAC 1-14.6-20, 405 IAC 1-14.6-22, 405 IAC 1-14.6-24, 405 IAC 1-15-1, 405 IAC 1-15-2, 405 IAC 1-15-3, 405 IAC 1-15-5, 405 IAC 1-16-1, 405 IAC 1-16-2, 405 IAC 1-16-3, 405 IAC 1-16-4, 405 IAC 1-16-5, 405 IAC 1-17-1, 405 IAC 1-17-2, 405 IAC 1-17-4, 405 IAC 1-17-7, 405 IAC 1-17-17, 405 IAC 1-17- 18, 405 IAC 1-18-2, 405 IAC 1-20-1, 405 IAC 1-20-2, 405 IAC 1-20-4, 405 IAC 1-21-1, 405 IAC 1-21-3, and 405 IAC 1-21-4 to reflect the definitions updates. Amends 405 IAC 5-2-3, 405 IAC 5-2-6, 405 IAC 5-2-9, 405 IAC 5-2-12, 405 IAC 5-2-13.2, 405 IAC 5-2-15, 405 IAC 5-2-16, 405 IAC 5-2-17, 405 IAC 5-2-18, 405 IAC 5-2-19, 405 IAC 5-2-20, 405 IAC 5-2-21, 405 IAC 5-2-22, and 405 IAC 5-2-24 and adds 405 IAC 5-2-10.5, 405 IAC 5-2-11.5, 405 IAC 5-2-15.5, 405 IAC 5-2-17.5, and 405 IAC 5-2-29 to update and modify definitions to provide uniformity in terminology used throughout the articles and to reflect current terms used in practice. Amends 405 IAC 5-1-1, 405 IAC 5-1-2, 405 IAC 5-1-3, 405 IAC 5-1-4, 405 IAC 5-1-6, 405 IAC 5-3-1, 405 IAC 5-3-2, 405 IAC 5-3-7, 405 IAC 5-3-8, 405 IAC 5-3-9, 405 IAC 5-3-11, 405 IAC 5-3-12, 405 IAC 5-3-13, 405 IAC 5-3-14, 405 IAC 5-5-2, 405 IAC 5-5- 3, 405 IAC 5-6-1, 405 IAC 5-6-2, 405 IAC 5-7-1, 405 IAC 5-7-2, 405 IAC 5-7-3, 405 IAC 5-8-2, 405 IAC 5-8-3, 405 IAC 5-8-4, 405 IAC 5-9-1, 405 IAC 5-9-2, 405 IAC 5-10-1, 405 IAC 5-10-3, 405 IAC 5-12-1, 405 IAC 5-12-2, 405 IAC 5-12-3, 405 IAC 5-13-1, 405 IAC 5-13-2, 405 IAC 5-13-3, 405 IAC 5-13-6, 405 IAC 5-13-7, 405 IAC 5-13-8, 405 IAC 5-13-10, 405 IAC 5-14-1, 405 IAC 5-14-2, 405 IAC 5-14-3, 405 IAC 5-14-4, 405 IAC 5-14-5, 405 IAC 5-14-6, 405 IAC 5-14-7, 405 IAC 5-14-15, 405 IAC 5-14-18, 405 IAC 5-14-19, 405 IAC 5-14-20, 405 IAC 5-14-21, 405 IAC 5-15-1, 405 IAC 5-15-2, 405 IAC 5-15-3, 405 IAC 5-15-4, 405 IAC 5-15-6, 405 IAC 5-16-1, 405 IAC 5-16-3, 405 IAC 5-16-3.1, 405 IAC 5-16-5, 405 IAC 5-16-6, 405 IAC 5-16.5-1, 405 IAC 5-16.5-2, 405 IAC 5-16.5-3, 405 IAC 5-16.5-4, 405 IAC 5-17-1, 405 IAC 5-17-2, 405 IAC 5-17-4, 405 IAC 5-17-5, 405 IAC 5-18-4, 405 IAC 5-19-1, 405 IAC 5-19-2, 405 IAC 5-19-3, 405 IAC 5-19-4, 405 IAC 5-19-5, 405 IAC 5-19-6, 405 IAC 5-19-7, 405 IAC 5-19-8, 405 IAC 5-19-9, 405 IAC 5-19-12, 405 IAC 5-19-13, 405 IAC 5-19-14, 405 IAC 5-19-15, 405 IAC 5-19-16, 405 IAC 5-19-17, 405 IAC 5-19-18, 405 IAC 5-20-1, 405 IAC 5-20-2, 405 IAC 5-20-3, 405 IAC 5-20-4, 405 IAC 5-20-5, 405 IAC 5-20-8, 405 IAC 5-21.5-1, 405 IAC 5-21.5-2, 405 IAC 5-21.5-3, 405 IAC 5-21.5-4, 405 IAC 5-21.5-5, 405 IAC 5-21.5-6, 405 IAC 5-21.5-7, 405 IAC 5-21.5-8, 405 IAC 5-21.5-9, 405 IAC 5-21.5-10, 405 IAC 5-21.5-11, 405 IAC 5-21.5-12, 405 IAC 5-21.5-13, 405 IAC 5-21.5-14, 405 IAC 5-21.5-15, 405 IAC 5-21.5-17, 405 IAC 5-21.6-2, 405 IAC 5-21.6-3, 405 IAC 5-21.6-4, 405 IAC 5-21.6-5, 405 IAC 5- 21.6-6, 405 IAC 5-21.6-7, 405 IAC 5-21.6-8, 405 IAC 5-21.6-9, 405 IAC 5-21.6-10, 405 IAC 5-21.6-11, 405 IAC 5-21.6-12, 405 IAC 5-21.6-13, 405 IAC 5-21.6-14, 405 IAC 5-21.6-15, 405 IAC 5-21.6-16, 405 IAC 5-21.6-17, 405 IAC 5-21.6-18, 405 IAC 5-21.6-19, 405 IAC 5-21.7-1, 405 IAC 5-21.7-2, 405 IAC 5-21.7-3, 405 IAC 5-21.7-4, 405 IAC 5-21.7-5, 405 IAC 5-21.7-6, 405 IAC 5-21.7-7, 405 IAC 5-21.7-8, 405 IAC 5-21.7-9, 405 IAC 5-21.7-10, 405 IAC 5-21.7-11, 405 IAC 5-21.7-12, 405 IAC 5-21.7-13, 405 IAC 5-21.7-14, 405 IAC 5-21.7-15, 405 IAC 5-21.7-16, 405 IAC 5-21.7-17, 405 IAC 5-21.7-18, 405 IAC 5-21.7-19, 405 IAC 5-21.7-20, 405 IAC 5-21.7-21, 405 IAC 5-21.8-2, 405 IAC 5-21.8-3, 405 IAC 5-21.8-4, 405 IAC 5-21.8-5, 405 IAC 5-21.8-6, 405 IAC 5-21.8-7, 405 IAC 5-21.8-8, 405 IAC 5-21.8-9, 405 IAC 5-21.8-10, 405 IAC 5-21.8-11, 405 IAC 5-22- 1, 405 IAC 5-22-2, 405 IAC 5-22-6, 405 IAC 5-22-7, 405 IAC 5-22-8, 405 IAC 5-22-9, 405 IAC 5-22-10, 405 IAC 5-22-11, 405 IAC 5-23-2, 405 IAC 5-23-3, 405 IAC 5-23-4, 405 IAC 5-24-1, 405 IAC 5-24-3, 405 IAC 5-24-4, 405 IAC 5-24-6, 405 IAC 5-24-7, 405 IAC 5-24-9, 405 IAC 5-24-13, 405 IAC 5-25-1, 405 IAC 5-25-2, 405 IAC 5-25-4, 405 IAC 5-26-5, 405 IAC 5-26-6, 405 IAC 5-26-7, 405 IAC 5-26-10, 405 IAC 5-27-1, 405 IAC 5-28-1, 405 IAC 5-28-4, 405 IAC 5-28-5, 405 IAC 5-28-8, 405 IAC 5-28-9, 405 IAC 5-29-1, 405 IAC 5-30-1, 405 IAC 5-30-2, 405 IAC 5-30-3, 405 IAC 5-30-4, 405 IAC 5-30-5, 405 IAC 5-30-6, 405 IAC 5-30-7, 405 IAC 5-30-8, 405 IAC 5-30-9, 405 IAC 5-30-10, 405 IAC 5-31-1, 405 IAC 5-31-1.1, 405 IAC 5-31-4, 405 IAC 5-31-4.5, 405 IAC 5-31-5, 405 IAC 5-31-9, 405 IAC 5-34-1, 405 IAC 5-34-2, 405 IAC 5-34-3, 405 IAC 5-34-4, 405 IAC 5-34-4.1, 405 IAC 5-34-4.2, 405 IAC 5-34-5, 405 IAC 5-34-6, 405 IAC 5-34-7, 405 IAC 5-34-8, 405 IAC 5-34-9, 405 IAC 5-34-10, 405 IAC 5-34-11, 405 IAC 5-34-12, 405 IAC 5-36-1, 405 IAC 5-36-3, 405 IAC 5-37-1, 405 IAC 5-37-3, and 405 IAC 5-38-4 to reflect the definitions updates. Repeals 405 IAC 5-2-2, 405 IAC 5-2-4, 405 IAC 5-2-5, 405 IAC 5-2-8, 405 IAC 5-2-11, 405 IAC 5-2-14, 405 IAC 5-2-23, and 405 IAC 5-2-25. Effective 30 days after filing with the Publisher. Statutory authority: IC 12-15-1-10; IC 12-15-1-15; IC 12-15-13-7.2; IC 12-15-21-2; IC 12-15-21-3.

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

Chris Fletcher

Indiana Family and Social Services Administration

Office of Medicaid Policy and Planning

Indiana Government Center South

402 West Washington Street, Room W374

Indianapolis, IN 46204

(317) 234-4753

chris.fletcher@fssa.in.gov

For purposes of IC 4-22-2-28.1, the Small Business Ombudsman designated by IC 4-4-35-8 is:

Erik Scheub

Office of Small Business and Entrepreneurship

One North Capitol, Suite 600

Indianapolis, IN 46204

(317) 232-5679

ombudsman@osbe.in.gov

Resources available to regulated entities through the small business ombudsman include the ombudsman's duties stated in IC 4-4-35-8, specifically IC 4-4-35-8(9), investigating and attempting to resolve any matter regarding compliance by a small business with a law, rule, or policy administered by a state agency, either as a party to a proceeding or as a mediator.

DIN: 20151125-IR-405150418NIA

Composed: May 03,2024 11:28:34PM EDT

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