IC 12-15-2.3
Chapter 2.3. Presumptive Eligibility for Women With Breast or
Cervical Cancer
IC 12-15-2.3-1 Applicability of chapter
Sec. 1. This chapter applies to a woman who is eligible for
Medicaid under IC 12-15-2-13.5. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-2 "Qualified entity" defined
Sec. 2. As used in this chapter, "qualified entity" means an entity
that:
(1) is eligible to receive payments and provide items and
services under this article;
(2) provides outpatient hospital services, rural health clinic
services, and any other ambulatory services offered by a rural
health clinic, or clinic services furnished by or under the
direction of a licensed physician; and
(3) meets all other requirements set forth in 42 U.S.C. 1920B. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-3 Qualified entities to establish eligibility
Sec. 3. A qualified entity may establish the presumptive eligibility
of a woman described in section 1 of this chapter. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-4 Identity of qualified entities
Sec. 4. The office shall consider the following to be qualified
entities:
(1) A disproportionate share provider under IC 12-15-16-1(a) or
IC 12-15-16-1(b).
(2) A federally qualified health clinic.
(3) A rural health clinic. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-5 Qualified entities provided with application forms and information
Sec. 5. The office shall provide each qualified entity with the
following:
(1) Application forms for Medicaid.
(2) Information on how to assist a woman described in section
1 of this chapter in completing and filing the application forms. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-6 Period during which services provided
Sec. 6. The office shall provide Medicaid services to a woman
described in section 1 of this chapter during a period that:
(1) begins on the date on which a qualified entity determines on
the basis of preliminary information that the woman is eligible
for Medicaid under IC 12-15-2-13.5; and
(2) ends on the earlier of the following:
(A) The date on which a determination is made by a
representative of the county office with respect to the
eligibility of the woman under IC 12-15-2-13.5.
(B) The last day of the month following the month in which
the qualified entity makes the determination described in
subdivision (1). As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-7 Woman's eligibility determined by qualified entity
Sec. 7. A woman described in section 1 of this chapter may only
have a presumptive eligibility determination made by an entity
described in section 2 of this chapter. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-8 Actions taken after establishment of eligibility
Sec. 8. A qualified entity that determines that a woman described
in section 1 of this chapter is presumptively eligible for Medicaid
shall do the following:
(1) Notify the office of the determination within five (5)
working days after the date on which the determination is made.
(2) Inform the woman at the time a determination is made that
an application for Medicaid is required to be made at the county
office in the county where the woman resides or an enrollment
center (as provided in IC 12-15-4-1) not later than the last day
of the month following the month during which the
determination is made. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-9 Completion of application
Sec. 9. If a woman described in section 1 of this chapter is
determined to be presumptively eligible for Medicaid under this
chapter, the woman must complete an application for Medicaid as
provided in IC 12-15-4 not later than the last day of the month
following the month during which the determination is made. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-10 Face-to-face interview
Sec. 10. If a woman described in section 1 of this chapter:
(1) is determined to be presumptively eligible for Medicaid
under this chapter; and
(2) appoints, in writing, an agent of a qualified entity under
section 4 of this chapter as the woman's authorized
representative for purposes of completing all aspects of the
Medicaid application process;
the county office shall conduct any face-to-face interview that is
necessary to determine the woman's eligibility for Medicaid with the
woman's authorized representative. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-11 Reimbursement for care during presumptive eligibility
Sec. 11. If a woman described in section 1 of this chapter is:
(1) determined to be presumptively eligible for Medicaid under
this chapter; and
(2) subsequently determined not to be eligible for Medicaid;
a qualified entity under section 4(1) or 4(2) of this chapter that
determined that the woman was presumptively eligible for Medicaid
shall reimburse the office for all funds expended by the office in
paying for care for the woman during the woman's period of
presumptive eligibility. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-12 Rules
Sec. 12. The office shall adopt rules under IC 4-22-2 to implement
this chapter, including rules that may impose additional requirements
for qualified entities that are consistent with federal regulations. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-13 Annual appropriation to provide services
Sec. 13. There is annually appropriated to the office of the
secretary of family and social services from the state general fund an
amount sufficient to provide services to those individuals eligible for
Medicaid under IC 12-15-2-13.5 and this chapter. As added by P.L.16-2009, SEC.18.
IC 12-15-2.3
Chapter 2.3. Presumptive Eligibility for Women With Breast or
Cervical Cancer
IC 12-15-2.3-1 Applicability of chapter
Sec. 1. This chapter applies to a woman who is eligible for
Medicaid under IC 12-15-2-13.5. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-2 "Qualified entity" defined
Sec. 2. As used in this chapter, "qualified entity" means an entity
that:
(1) is eligible to receive payments and provide items and
services under this article;
(2) provides outpatient hospital services, rural health clinic
services, and any other ambulatory services offered by a rural
health clinic, or clinic services furnished by or under the
direction of a licensed physician; and
(3) meets all other requirements set forth in 42 U.S.C. 1920B. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-3 Qualified entities to establish eligibility
Sec. 3. A qualified entity may establish the presumptive eligibility
of a woman described in section 1 of this chapter. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-4 Identity of qualified entities
Sec. 4. The office shall consider the following to be qualified
entities:
(1) A disproportionate share provider under IC 12-15-16-1(a) or
IC 12-15-16-1(b).
(2) A federally qualified health clinic.
(3) A rural health clinic. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-5 Qualified entities provided with application forms and information
Sec. 5. The office shall provide each qualified entity with the
following:
(1) Application forms for Medicaid.
(2) Information on how to assist a woman described in section
1 of this chapter in completing and filing the application forms. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-6 Period during which services provided
Sec. 6. The office shall provide Medicaid services to a woman
described in section 1 of this chapter during a period that:
(1) begins on the date on which a qualified entity determines on
the basis of preliminary information that the woman is eligible
for Medicaid under IC 12-15-2-13.5; and
(2) ends on the earlier of the following:
(A) The date on which a determination is made by a
representative of the county office with respect to the
eligibility of the woman under IC 12-15-2-13.5.
(B) The last day of the month following the month in which
the qualified entity makes the determination described in
subdivision (1). As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-7 Woman's eligibility determined by qualified entity
Sec. 7. A woman described in section 1 of this chapter may only
have a presumptive eligibility determination made by an entity
described in section 2 of this chapter. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-8 Actions taken after establishment of eligibility
Sec. 8. A qualified entity that determines that a woman described
in section 1 of this chapter is presumptively eligible for Medicaid
shall do the following:
(1) Notify the office of the determination within five (5)
working days after the date on which the determination is made.
(2) Inform the woman at the time a determination is made that
an application for Medicaid is required to be made at the county
office in the county where the woman resides or an enrollment
center (as provided in IC 12-15-4-1) not later than the last day
of the month following the month during which the
determination is made. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-9 Completion of application
Sec. 9. If a woman described in section 1 of this chapter is
determined to be presumptively eligible for Medicaid under this
chapter, the woman must complete an application for Medicaid as
provided in IC 12-15-4 not later than the last day of the month
following the month during which the determination is made. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-10 Face-to-face interview
Sec. 10. If a woman described in section 1 of this chapter:
(1) is determined to be presumptively eligible for Medicaid
under this chapter; and
(2) appoints, in writing, an agent of a qualified entity under
section 4 of this chapter as the woman's authorized
representative for purposes of completing all aspects of the
Medicaid application process;
the county office shall conduct any face-to-face interview that is
necessary to determine the woman's eligibility for Medicaid with the
woman's authorized representative. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-11 Reimbursement for care during presumptive eligibility
Sec. 11. If a woman described in section 1 of this chapter is:
(1) determined to be presumptively eligible for Medicaid under
this chapter; and
(2) subsequently determined not to be eligible for Medicaid;
a qualified entity under section 4(1) or 4(2) of this chapter that
determined that the woman was presumptively eligible for Medicaid
shall reimburse the office for all funds expended by the office in
paying for care for the woman during the woman's period of
presumptive eligibility. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-12 Rules
Sec. 12. The office shall adopt rules under IC 4-22-2 to implement
this chapter, including rules that may impose additional requirements
for qualified entities that are consistent with federal regulations. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-13 Annual appropriation to provide services
Sec. 13. There is annually appropriated to the office of the
secretary of family and social services from the state general fund an
amount sufficient to provide services to those individuals eligible for
Medicaid under IC 12-15-2-13.5 and this chapter. As added by P.L.16-2009, SEC.18.
IC 12-15-2.3
Chapter 2.3. Presumptive Eligibility for Women With Breast or
Cervical Cancer
IC 12-15-2.3-1 Applicability of chapter
Sec. 1. This chapter applies to a woman who is eligible for
Medicaid under IC 12-15-2-13.5. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-2 "Qualified entity" defined
Sec. 2. As used in this chapter, "qualified entity" means an entity
that:
(1) is eligible to receive payments and provide items and
services under this article;
(2) provides outpatient hospital services, rural health clinic
services, and any other ambulatory services offered by a rural
health clinic, or clinic services furnished by or under the
direction of a licensed physician; and
(3) meets all other requirements set forth in 42 U.S.C. 1920B. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-3 Qualified entities to establish eligibility
Sec. 3. A qualified entity may establish the presumptive eligibility
of a woman described in section 1 of this chapter. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-4 Identity of qualified entities
Sec. 4. The office shall consider the following to be qualified
entities:
(1) A disproportionate share provider under IC 12-15-16-1(a) or
IC 12-15-16-1(b).
(2) A federally qualified health clinic.
(3) A rural health clinic. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-5 Qualified entities provided with application forms and information
Sec. 5. The office shall provide each qualified entity with the
following:
(1) Application forms for Medicaid.
(2) Information on how to assist a woman described in section
1 of this chapter in completing and filing the application forms. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-6 Period during which services provided
Sec. 6. The office shall provide Medicaid services to a woman
described in section 1 of this chapter during a period that:
(1) begins on the date on which a qualified entity determines on
the basis of preliminary information that the woman is eligible
for Medicaid under IC 12-15-2-13.5; and
(2) ends on the earlier of the following:
(A) The date on which a determination is made by a
representative of the county office with respect to the
eligibility of the woman under IC 12-15-2-13.5.
(B) The last day of the month following the month in which
the qualified entity makes the determination described in
subdivision (1). As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-7 Woman's eligibility determined by qualified entity
Sec. 7. A woman described in section 1 of this chapter may only
have a presumptive eligibility determination made by an entity
described in section 2 of this chapter. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-8 Actions taken after establishment of eligibility
Sec. 8. A qualified entity that determines that a woman described
in section 1 of this chapter is presumptively eligible for Medicaid
shall do the following:
(1) Notify the office of the determination within five (5)
working days after the date on which the determination is made.
(2) Inform the woman at the time a determination is made that
an application for Medicaid is required to be made at the county
office in the county where the woman resides or an enrollment
center (as provided in IC 12-15-4-1) not later than the last day
of the month following the month during which the
determination is made. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-9 Completion of application
Sec. 9. If a woman described in section 1 of this chapter is
determined to be presumptively eligible for Medicaid under this
chapter, the woman must complete an application for Medicaid as
provided in IC 12-15-4 not later than the last day of the month
following the month during which the determination is made. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-10 Face-to-face interview
Sec. 10. If a woman described in section 1 of this chapter:
(1) is determined to be presumptively eligible for Medicaid
under this chapter; and
(2) appoints, in writing, an agent of a qualified entity under
section 4 of this chapter as the woman's authorized
representative for purposes of completing all aspects of the
Medicaid application process;
the county office shall conduct any face-to-face interview that is
necessary to determine the woman's eligibility for Medicaid with the
woman's authorized representative. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-11 Reimbursement for care during presumptive eligibility
Sec. 11. If a woman described in section 1 of this chapter is:
(1) determined to be presumptively eligible for Medicaid under
this chapter; and
(2) subsequently determined not to be eligible for Medicaid;
a qualified entity under section 4(1) or 4(2) of this chapter that
determined that the woman was presumptively eligible for Medicaid
shall reimburse the office for all funds expended by the office in
paying for care for the woman during the woman's period of
presumptive eligibility. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-12 Rules
Sec. 12. The office shall adopt rules under IC 4-22-2 to implement
this chapter, including rules that may impose additional requirements
for qualified entities that are consistent with federal regulations. As added by P.L.152-2001, SEC.3.
IC 12-15-2.3-13 Annual appropriation to provide services
Sec. 13. There is annually appropriated to the office of the
secretary of family and social services from the state general fund an
amount sufficient to provide services to those individuals eligible for
Medicaid under IC 12-15-2-13.5 and this chapter. As added by P.L.16-2009, SEC.18.
