Ind. Admin. Code tit. 405, r. 1-4.2-3
Authority: IC 12-15-5-11; IC 12-15-21
Affected: IC 12-15-13-2
Sec. 3. (a) Medicaid will reimburse HHAs for the following home health services:
The services in this subsection must be provided within the limitations set forth in 405 IAC 5-16.
(b) Except as provided in subsection (c), all home health services require prior authorization by submitting a properly completed written request to the office. Prior authorization procedures for home health care are set forth in 405 IAC 5-16-3 and 405 IAC 5-16- 3.1.
(c) Prior authorization may be obtained by telephone under the circumstances and subject to the limitations set forth in 405 IAC 5-3- 2(b)(3). Services ordered in writing by a physician prior to the patient's discharge from a hospital within the limitations set forth in 405 IAC 5-3-12(2) do not need prior authorization.
(Office of the Secretary of Family and Social Services; 405 IAC 1- 4.2-3; filed Jul 18, 1996, 3:00 p.m.: 19 IR 3376; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; filed Jun 18, 2007, 11:38 a.m.: 20070718-IR-405070031FRA; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFA; filed Sep 19, 2014, 3:22 p.m.: 20141015-IR-405140194FRA; filed Aug 1, 2016, 3:44 p.m.: 20160831-IR-405150418FRA; errata filed Oct 6, 2016, 2:59 p.m.: 20161019-IR- 405160452ACA; filed Dec 21, 2018, 3:11 p.m.: 20190116-IR-405180269FRA; readopted filed May 30, 2023, 11:54 a.m.: 20230628-IR-405230292RFA)