-IR- Database Guide
-IR- Database: Indiana Register

TITLE 405 OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES

Notice of Intent to Readopt
LSA Document #19-487

Readopts rules in anticipation of IC 4-22-2.5-2, providing that an administrative rule adopted under IC 4-22-2 expires January 1 of the seventh year after the year in which the rule takes effect unless the rule contains an earlier expiration date. Effective 30 days after filing with the Publisher.

OVERVIEW: Rules to be readopted without changes are as follows:
  405 IAC 1-1-3.1  Providing services to members enrolled under the Medicaid spend-down provision 
  405 IAC 1-1-7  Nursing home rate setting; governing provisions 
  405 IAC 1-1-8  Level of care criteria for long-term care facilities; governing provisions 
  405 IAC 1-1-9  Nursing home admission; governing provisions 
  405 IAC 1-1-10  Intermediate care for the mentally retarded; governing provisions 
  405 IAC 1-1-11  Intermediate care of the mentally retarded; eligibility 
  405 IAC 1-1-12  Regular access authority to Medicaid division personal information system 
  405 IAC 1-1.6  Managed Care Provider Reimbursement Dispute Resolution 
  405 IAC 1-3  Criteria for Level of Care in Long Term Care Facilities 
  405 IAC 1-10.5-5  Health care-acquired conditions and other provider-preventable conditions 
  405 IAC 1-12-6  Active providers; rate review; annual request 
  405 IAC 1-12-8  Limitations or qualifications to Medicaid reimbursement; advertising; vehicle basis 
  405 IAC 1-12-10  Computation of rate; allowable costs; review of cost reasonableness 
  405 IAC 1-12-11  Allowable costs; services provided by parties related to provider 
  405 IAC 1-12-12  Allowable costs; capital return factor 
  405 IAC 1-12-13  Allowable costs; capital return factor; computation of use fee component; interest; allocation of loan to facilities and parties 
  405 IAC 1-12-14  Allowable costs; capital return factor; computation of return on equity component 
  405 IAC 1-12-16  Capital return factor; basis; historical cost; mandatory record keeping; valuation 
  405 IAC 1-12-17  Capital return factor; basis; sale or capital lease of facility; valuation; sale or lease among family members 
  405 IAC 1-12-18  Unallowable costs; cost adjustments; charity and courtesy allowances; discounts; rebates; refunds of expenses 
  405 IAC 1-12-20.5  Extensive support needs residences for adults; fair rental value allowance 
  405 IAC 1-14.6-8  Limitations or qualifications to Medicaid reimbursement; advertising; vehicle basis 
  405 IAC 1-14.6-13  Reporting of financing arrangements; working capital; interest; allocation of loans 
  405 IAC 1-14.6-14  Property; basis; historical cost; mandatory record keeping; valuation 
  405 IAC 1-14.6-15  Valuation; sale or lease among family members 
  405 IAC 1-14.6-17  Allowable costs; wages; costs of employment; record keeping; owner or related party compensation 
  405 IAC 1-17-3  Accounting records; retention schedule; audit trail; cash basis; segregation of accounts by nature of business and by location 
  405 IAC 1-17-5  New provider; initial financial report to office; criteria for establishing initial rates; supplemental report 
  405 IAC 1-17-6  Active providers; rate review; annual request; additional requests; requests due to change in law 
  405 IAC 1-17-8  Limitations or qualifications to Medicaid reimbursement; advertising 
  405 IAC 1-17-9  Criteria limiting rate adjustment granted by office 
  405 IAC 1-17-10  Computation of rate; allowable costs; review of cost reasonableness 
  405 IAC 1-17-11  Allowable costs; capital reimbursement; depreciable life 
  405 IAC 1-17-12  Capital reimbursement; basis; historical cost; mandatory record keeping; valuation 
  405 IAC 1-17-13  Unallowable costs; cost adjustments; charity and courtesy allowances; discounts; rebates; refunds of expenses 
  405 IAC 1-17-14  Allowable costs; wages; costs of employment; record keeping; owner or related party compensation 
  405 IAC 1-17-15  Allowable costs; calculation of allowable owner or related party compensation; wages; salaries; fees; fringe benefits 
  405 IAC 1-17-16  Allocation of costs 
  405 IAC 1-19-1  Information to be disclosed 
  405 IAC 1-20-3  Change of ownership types 
  405 IAC 1-20-5  Record retention 
  405 IAC 1.1  APPEAL PROCEDURES FOR APPLICANTS AND RECIPIENTS OF MEDICAID 
  405 IAC 2  MEDICAID RECIPIENTS; ELIGIBILITY 
  405 IAC 5-2-1  Applicability 
  405 IAC 5-2-7  "CPT" defined 
  405 IAC 5-2-7.1  "Curative care services" defined 
  405 IAC 5-2-10  "EPSDT" defined 
  405 IAC 5-2-10.1  "Hospice" defined 
  405 IAC 5-2-10.2  "Hospice program" defined 
  405 IAC 5-2-13.1  "IEP" defined 
  405 IAC 5-2-13.3  "IEP transportation services" defined 
  405 IAC 5-2-26  "School corporation" defined 
  405 IAC 5-3-3  Prior authorization based on false information 
  405 IAC 5-8-1  Reimbursement 
  405 IAC 5-9-3  Office visits exceeding established parameters 
  405 IAC 5-10-2  "Anesthetist" defined 
  405 IAC 5-10-4  Anesthesia administered during labor/delivery 
  405 IAC 5-12-4  Laboratory services 
  405 IAC 5-12-5  Muscle testing services 
  405 IAC 5-12-7  Durable medical equipment 
  405 IAC 5-13-4  Services included in the per diem rate for large state ICFs/MR; exceptions 
  405 IAC 5-13-5  Prior authorization for services rendered outside the large state ICF/MR 
  405 IAC 5-14-8  Extractions 
  405 IAC 5-14-9  Space maintenance 
  405 IAC 5-14-11  Analgesia 
  405 IAC 5-14-12  Infection control 
  405 IAC 5-14-13  Emergency treatment of dental pain 
  405 IAC 5-14-14  Office visits 
  405 IAC 5-14-16  Periodontics; surgical 
  405 IAC 5-14-17  Oral surgery 
  405 IAC 5-15-5  Prior authorization 
  405 IAC 5-15-7  Screening referrals 
  405 IAC 5-15-8  EPSDT periodicity and screening schedule 
  405 IAC 5-16-4  Rehabilitation center services; limitations 
  405 IAC 5-17-3  Emergency; weekend inpatient admissions 
  405 IAC 5-18-1  Clinical diagnostic laboratory services; reimbursement 
  405 IAC 5-18-2  Reimbursement restrictions 
  405 IAC 5-19-10  Braces and orthopedic shoes 
  405 IAC 5-20-6  Emergency admissions 
  405 IAC 5-21.5-16  Diagnosis; individualized integrated care plan 
  405 IAC 5-21.6-1  General provisions 
  405 IAC 5-22-4  Certified nurse practitioner services 
  405 IAC 5-22-5  Audiology, occupational, and physical therapy and speech pathology; reimbursement 
  405 IAC 5-23-1  Reimbursement limitations 
  405 IAC 5-23-6  Prior authorization 
  405 IAC 5-24-10  Medical and nonmedical supply items for long term care facility residents 
  405 IAC 5-24-12  Risk-based managed care 
  405 IAC 5-25-3  Physician's written order, plan of treatment; when required 
  405 IAC 5-25-5  Inpatient services; reimbursement limitations 
  405 IAC 5-26-1  Scope 
  405 IAC 5-26-3  Routine foot care; restrictions 
  405 IAC 5-26-4  Laboratory or x-ray services 
  405 IAC 5-26-9  Surgical procedures; reimbursement 
  405 IAC 5-27  Radiology Services 
  405 IAC 5-28-2  Medical diagnostic procedures 
  405 IAC 5-28-3  Cardiac pacemaker 
  405 IAC 5-28-6  Monitoring of pacemakers 
  405 IAC 5-28-7  Abortion 
  405 IAC 5-28-11  Hyperbaric oxygen therapy 
  405 IAC 5-30-1.5  Reimbursement rates for transportation services 
  405 IAC 5-30-11  IEP transportation services 
  405 IAC 5-31-6  Personal care items 
  405 IAC 5-31-7  Limitations on nursing services 
  405 IAC 5-32  Rehabilitation Units 
  405 IAC 5-33  Acute Care Hospital Admission 
  405 IAC 5-35  Case Management Services for Infants and Toddlers with Disabilities 
  405 IAC 5-36-2  Requirements for the provision of DSMT 


Requests for any part of this readoption to be separate from this action must be made in writing within 30 days of this publication. Send written comments to the Small Business Regulatory Coordinator for this rule (see IC 4-22-2-28.1):
Chelsea Princell
Office of General Counsel
Indiana Family and Social Services Administration
Indiana Government Center South
402 West Washington Street, Room W451
Indianapolis, IN 46204
(317) 232-1161
chelsea.princell@fssa.in.gov

For purposes of IC 4-22-2-28.1, the Small Business Ombudsman designated by IC 5-28-17-6 is:
Katelyn Colclazier
Small Business Ombudsman
Indiana Economic Development Corporation
One North Capitol, Suite 700
Indianapolis, IN 46204
(317) 431-1560
kcolclazier@iedc.in.gov
Resources available to regulated entities through the small business ombudsman include the ombudsman's duties stated in IC 5-28-17-6, specifically IC 5-28-17-6(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.

Posted: 09/18/2019 by Legislative Services Agency

DIN: 20190918-IR-405190487RNA
Composed: Apr 23,2024 8:42:42PM EDT
A PDF version of this document.