Authority: IC 12-15-44.5-9

Affected: IC 12-15-11; IC 12-15-44.5; IC 27-8-14.5-6

Sec. 11. (a) A member may receive the following covered services without a referral from the member's primary medical provider or prior authorization or precertification from the member's managed care organization:

1. (1) Family planning services.
2. (2) Emergency services.

(b) A member may receive the following services without a referral from the member's primary medical provider, provided the service is a covered service under such member's benefits package and subject to any requirements established by the managed care organization regarding the use of in-network providers:

1. (1) Psychiatric services provided by a provider licensed under IC 12-15-11.
2. (2) Behavioral health services.
3. (3) Immunization services.
4. (4) Diabetes self-management training services, as set forth in IC 27-8-14.5-6.
5. (5) Chiropractic services.
6. (6) Eye care services, except for surgical services on the eye.
7. (7) Podiatric services.
8. (8) Urgent care services.

(Office of the Secretary of Family and Social Services; 405 IAC 10-7-11; filed May 18, 2015, 12:34 p.m.: 20150617-IR-405140339FRA; filed Jan 19, 2018, 8:42 a.m.: 20180214-IR-405170484FRA; readopted filed Oct 16, 2024, 11:20 a.m.: 20241113-IR-405230817RFA)