1. (a) Except as provided in section 0.6 of this chapter, as used in this chapter, "clean claim" means a claim submitted by a provider for payment under the Medicaid program that can be processed without obtaining additional information from:

   1. (1) the provider of the service; or
   2. (2) a third party.

2. (b) The definition under subsection (a):

   1. (1) includes a claim with errors originating in the state's claims processing system; and

   2. (2) does not include a claim:

      1. (A) from a provider who is under investigation for fraud or abuse (as used in 42 CFR 447.45(b); or
      2. (B) under review for medical necessity.

As added by P.L.107-1996, SEC.2 and P.L.257-1996, SEC.2.