Authority: IC 12-13-5-3

Affected: IC 5-11-10-1; IC 12-14-17

Sec. 1. (a) In order to receive payment for funeral and cemetery expenses under IC 12-14-17, a provider must submit a claim as required in this section.

(b) A person or entity becomes a provider under this section when the person or entity is duly licensed, registered, or certified by the appropriate professional regulatory agency to provide funeral or cemetery services under state or federal law.

(c) To be eligible for payment, a provider must complete the following:

1. (1) Inform the division of family resources (DFR) of changes to its contact information through any of the following methods:

   1. (A) Telephone.
   2. (B) Facsimile.
   3. (C) Email.
2. (2) Have a W-9 form on file with the family and social services administration (FSSA) accounts payable department.
3. (3) Ensure that a subsidiary or other entity or person used to provide funeral or cemetery services abides by all provisions of this rule.
4. (4) Comply with all applicable federal and state laws and regulations.

5. (5) Submit a claim which is:

   1. (A) submitted on a completed state form 35937 titled "Claim to Defray Funeral and Cemetery Expenses" which is available on the DFR website at https://www.in.gov/fssa/dfr/2689.htm;
   2. (B) fully completed and accurate;
   3. (C) submitted within ninety (90) days of the date of death of the decedent;
   4. (D) signed by the provider;
   5. (E) dated; and
   6. (F) certified under IC 5-11-10-1(e).

(d) A provider may be paid for both funeral and cemetery expenses provided that:

1. (1) only one (1) claim for funeral expenses will be paid per decedent; and
2. (2) only one (1) claim for cemetery expenses will be paid per decedent.

(e) A provider must report to FSSA accounts payable, at claimsInfo@fssa.in.gov, additional monies received that were not reported on the previously submitted claim within ninety (90) days of receipt of the additional monies.

(Division of Family Resources; 470 IAC 15-1-1; filed Apr 24, 2023, 10:50 a.m.: 20230524-IR-470220142FRA)