IC 12-15-5-1 Services and supplies provided; exceptions
Sec. 1. Except as provided in IC 12-15-2-12, IC 12-15-6, and
IC 12-15-21, the following services and supplies are provided under
Medicaid:
(1) Inpatient hospital services.
(2) Nursing facility services.
(3) Physician's services, including services provided under
IC 25-10-1 and IC 25-22.5-1.
(4) Outpatient hospital or clinic services.
(5) Home health care services.
(6) Private duty nursing services.
(7) Physical therapy and related services.
(8) Dental services.
(9) Prescribed laboratory and x-ray services.
(10) Prescribed drugs and services.
(11) Eyeglasses and prosthetic devices.
(12) Optometric services.
(13) Diagnostic, screening, preventive, and rehabilitative
services.
(14) Podiatric medicine services.
(15) Hospice services.
(16) Services or supplies recognized under Indiana law and
specified under rules adopted by the office.
(17) Family planning services except the performance of
abortions.
(18) Nonmedical nursing care given in accordance with the
tenets and practices of a recognized church or religious
denomination to an individual qualified for Medicaid who
depends upon healing by prayer and spiritual means alone in
accordance with the tenets and practices of the individual's
church or religious denomination.
(19) Services provided to individuals described in IC 12-15-2-8
and IC 12-15-2-9.
(20) Services provided under IC 12-15-34 and IC 12-15-32.
(21) Case management services provided to individuals
described in IC 12-15-2-11 and IC 12-15-2-13.
(22) Any other type of remedial care recognized under Indiana
law and specified by the United States Secretary of Health and
Human Services.
(23) Examinations required under IC 16-41-17-2(a)(10). As added by P.L.2-1992, SEC.9. Amended by P.L.24-1997, SEC.48;
P.L.149-2001, SEC.1.
IC 12-15-5-2 Necessity of federal financial participation
Sec. 2. Medicaid does not include a service or supply for which
federal financial participation is not available. As added by P.L.2-1992, SEC.9.
IC 12-15-5-3
Repealed
(Repealed by P.L.161-2007, SEC.40.)
IC 12-15-5-4
Reserved
IC 12-15-5-5
Office may provide drug coverage; requirements for drug coverage in
managed care
Sec. 5. (a) The office may provide a prescription drug benefit to
a Medicaid recipient in the Medicaid risk based managed care
program.
(b) If the office provides a prescription drug benefit to a Medicaid
recipient in the Medicaid risk based managed care program:
(1) the office shall develop a procedure and provide the
recipient's risk based managed care provider with information
concerning the recipient's prescription drug utilization for the
risk based managed care provider's case management program;
and
(2) the provisions of IC 12-15-35.5 apply.
(c) If the office does not provide a prescription drug benefit to a
Medicaid recipient in the Medicaid risk based managed care
program, a Medicaid managed care organization shall provide
coverage and reimbursement for outpatient single source legend
drugs subject to IC 12-15-35-46, IC 12-15-35-47, and IC 12-15-35.5. As added by P.L.231-1999, SEC.1. Amended by P.L.101-2005,
SEC.1.
IC 12-15-5-6 Prohibiting limiting the number of brand name prescription drugs
a recipient may receive
Sec. 6. The office may not limit the number of brand name
prescription drugs a recipient may receive under the program. As added by P.L.107-2002, SEC.10.
IC 12-15-5-8 Maintenance drugs; prescriptions; Internet based pharmacies
Sec. 8. (a) As used in this section, "maintenance drug" means a
medication that is dispensed under a single prescription for a period
of not less than one hundred eighty (180) days, excluding authorized
refills, for the ongoing treatment of a chronic medical condition or
disease or congenital condition or disorder.
(b) The office may designate:
(1) a mail order pharmacy;
(2) an Internet based pharmacy (as defined in IC 25-26-18-1);
(3) a pharmacy that agrees to sell a maintenance drug at the
same price as a mail order or an Internet based pharmacy; or
(4) all the pharmacies listed in subdivisions (1) through (3);
through which a recipient may obtain a maintenance drug.
(c) If the office makes a designation under subsection (b), a
managed care organization that has a contract with the office under
IC 12-15-12 is not required to use a pharmacy that is designated
under subsection (b).
(d) If a Medicaid recipient's physician prescribes a maintenance
prescription drug, the Medicaid recipient may purchase the
maintenance prescription drug from a pharmacy that is designated
under subsection (b).
(e) The office shall apply to amend the state Medicaid plan if the
office determines that an amendment is necessary to carry out this
section.
(f) The office may require a recipient to pay the maximum
copayment allowable under federal law if the recipient obtains a
maintenance drug from a pharmacy other than a pharmacy described
in subsection (b). As added by P.L.246-2005, SEC.105.
IC 12-15-5-9 Provision of self-directed care options
Sec. 9. The office shall have self-directed care options and
services available for an eligible individual who:
(1) is a Medicaid waiver recipient; and
(2) chooses self-directed care services. As added by P.L.47-2009, SEC.3.
IC 12-15-5-9.2 Coverage for care related to cancer clinical trials
Sec. 9.2. (a) As used in this section, "care method" means the use
of a particular drug or device in a particular manner.
(b) As used in this section, "clinical trial" means a Phase I, II, III,
or IV research study:
(1) that is conducted:
(A) using a particular care method to prevent, diagnose, or
treat a cancer for which:
(i) there is no clearly superior, noninvestigational
alternative care method; and
(ii) available clinical or preclinical data provides a
reasonable basis from which to believe that the care
method used in the research study is at least as effective as
any noninvestigational alternative care method;
(B) in a facility where personnel providing the care method
to be followed in the research study have:
(i) received training in providing the care method;
(ii) expertise in providing the type of care required for the
research study; and
(iii) experience providing the type of care required for the
research study to a sufficient volume of patients to
maintain expertise; and
(C) to scientifically determine the best care method to
prevent, diagnose, or treat the cancer; and
(2) that is approved or funded by one (1) of the following:
(A) A National Institutes of Health institute.
(B) A cooperative group of research facilities that has an
established peer review program that is approved by a
National Institutes of Health institute or center.
(C) The federal Food and Drug Administration.
(D) The United States Department of Veterans Affairs.
(E) The United States Department of Defense.
(F) The institutional review board of an institution located
in Indiana that has a multiple project assurance contract
approved by the National Institutes of Health Office for
Protection from Research Risks as provided in 45 CFR
46.103.
(G) A research entity that meets eligibility criteria for a
support grant from a National Institutes of Health center.
(c) As used in this section, "routine care cost" means the cost of
medically necessary services related to the care method that is under
evaluation in a clinical trial. The term does not include the following:
(1) The drug or device that is under evaluation in a clinical trial.
(2) Items or services that are:
(A) provided solely for data collection and analysis and not
in the direct clinical management of an individual enrolled
in a clinical trial;
(B) customarily provided at no cost by a research sponsor to
an individual enrolled in a clinical trial; or
(C) provided solely to determine eligibility of an individual
for participation in a clinical trial.
(d) The Medicaid program must provide coverage for routine care
costs that are incurred in the course of a clinical trial if the Medicaid
program would provide coverage for the same routine care costs not
incurred in a clinical trial.
(e) The coverage that must be provided under this section is
subject to the terms, conditions, restrictions, exclusions, and
limitations that apply generally under the Medicaid program,
including terms, conditions, restrictions, exclusions, or limitations
that apply to health care services rendered by participating providers
and nonparticipating providers.
(f) This section does not do any of the following:
(1) Require the Medicaid program to provide coverage for
clinical trial services rendered by a participating provider.
(2) Prohibit the Medicaid program from providing coverage for
clinical trial services rendered by a participating provider.
(3) Require reimbursement for services that are rendered in a
clinical trial by a nonparticipating provider at the same rate of
reimbursement that would apply to the same services rendered
by a participating provider. As added by P.L.109-2009, SEC.2. IC 12-15-5-10 Care available for individuals receiving Medicaid waiver services;
eligibility not affected by receipt of services
Sec. 10. (a) An individual who receives Medicaid services
through a Medicaid waiver shall receive the following:
(1) The development of a care plan addressing the individual's
needs.
(2) Advocacy on behalf of the individual's interests.
(3) The monitoring of the quality of community and home care
services provided to the individual.
(4) Information and referral services concerning community and
home care services if the individual is eligible for these
services.
(b) The use by or on behalf of an individual receiving Medicaid
waiver services of any of the following services or devices does not
make the individual ineligible for services under a Medicaid waiver:
(1) Skilled nursing assistance.
(2) Supervised community and home care services, including
skilled nursing supervision.
(3) Adaptive medical equipment and devices.
(4) Adaptive nonmedical equipment and devices. As added by P.L.47-2009, SEC.4.
IC 12-15-5-1 Services and supplies provided; exceptions
Sec. 1. Except as provided in IC 12-15-2-12, IC 12-15-6, and
IC 12-15-21, the following services and supplies are provided under
Medicaid:
(1) Inpatient hospital services.
(2) Nursing facility services.
(3) Physician's services, including services provided under
IC 25-10-1 and IC 25-22.5-1.
(4) Outpatient hospital or clinic services.
(5) Home health care services.
(6) Private duty nursing services.
(7) Physical therapy and related services.
(8) Dental services.
(9) Prescribed laboratory and x-ray services.
(10) Prescribed drugs and services.
(11) Eyeglasses and prosthetic devices.
(12) Optometric services.
(13) Diagnostic, screening, preventive, and rehabilitative
services.
(14) Podiatric medicine services.
(15) Hospice services.
(16) Services or supplies recognized under Indiana law and
specified under rules adopted by the office.
(17) Family planning services except the performance of
abortions.
(18) Nonmedical nursing care given in accordance with the
tenets and practices of a recognized church or religious
denomination to an individual qualified for Medicaid who
depends upon healing by prayer and spiritual means alone in
accordance with the tenets and practices of the individual's
church or religious denomination.
(19) Services provided to individuals described in IC 12-15-2-8
and IC 12-15-2-9.
(20) Services provided under IC 12-15-34 and IC 12-15-32.
(21) Case management services provided to individuals
described in IC 12-15-2-11 and IC 12-15-2-13.
(22) Any other type of remedial care recognized under Indiana
law and specified by the United States Secretary of Health and
Human Services.
(23) Examinations required under IC 16-41-17-2(a)(10). As added by P.L.2-1992, SEC.9. Amended by P.L.24-1997, SEC.48;
P.L.149-2001, SEC.1.
IC 12-15-5-2 Necessity of federal financial participation
Sec. 2. Medicaid does not include a service or supply for which
federal financial participation is not available. As added by P.L.2-1992, SEC.9.
IC 12-15-5-3
Repealed
(Repealed by P.L.161-2007, SEC.40.)
IC 12-15-5-4
Reserved
IC 12-15-5-5
Office may provide drug coverage; requirements for drug coverage in
managed care
Sec. 5. (a) The office may provide a prescription drug benefit to
a Medicaid recipient in the Medicaid risk based managed care
program.
(b) If the office provides a prescription drug benefit to a Medicaid
recipient in the Medicaid risk based managed care program:
(1) the office shall develop a procedure and provide the
recipient's risk based managed care provider with information
concerning the recipient's prescription drug utilization for the
risk based managed care provider's case management program;
and
(2) the provisions of IC 12-15-35.5 apply.
(c) If the office does not provide a prescription drug benefit to a
Medicaid recipient in the Medicaid risk based managed care
program, a Medicaid managed care organization shall provide
coverage and reimbursement for outpatient single source legend
drugs subject to IC 12-15-35-46, IC 12-15-35-47, and IC 12-15-35.5. As added by P.L.231-1999, SEC.1. Amended by P.L.101-2005,
SEC.1.
IC 12-15-5-6 Prohibiting limiting the number of brand name prescription drugs
a recipient may receive
Sec. 6. The office may not limit the number of brand name
prescription drugs a recipient may receive under the program. As added by P.L.107-2002, SEC.10.
IC 12-15-5-8 Maintenance drugs; prescriptions; Internet based pharmacies
Sec. 8. (a) As used in this section, "maintenance drug" means a
medication that is dispensed under a single prescription for a period
of not less than one hundred eighty (180) days, excluding authorized
refills, for the ongoing treatment of a chronic medical condition or
disease or congenital condition or disorder.
(b) The office may designate:
(1) a mail order pharmacy;
(2) an Internet based pharmacy (as defined in IC 25-26-18-1);
(3) a pharmacy that agrees to sell a maintenance drug at the
same price as a mail order or an Internet based pharmacy; or
(4) all the pharmacies listed in subdivisions (1) through (3);
through which a recipient may obtain a maintenance drug.
(c) If the office makes a designation under subsection (b), a
managed care organization that has a contract with the office under
IC 12-15-12 is not required to use a pharmacy that is designated
under subsection (b).
(d) If a Medicaid recipient's physician prescribes a maintenance
prescription drug, the Medicaid recipient may purchase the
maintenance prescription drug from a pharmacy that is designated
under subsection (b).
(e) The office shall apply to amend the state Medicaid plan if the
office determines that an amendment is necessary to carry out this
section.
(f) The office may require a recipient to pay the maximum
copayment allowable under federal law if the recipient obtains a
maintenance drug from a pharmacy other than a pharmacy described
in subsection (b). As added by P.L.246-2005, SEC.105.
IC 12-15-5-9 Provision of self-directed care options
Sec. 9. The office shall have self-directed care options and
services available for an eligible individual who:
(1) is a Medicaid waiver recipient; and
(2) chooses self-directed care services. As added by P.L.47-2009, SEC.3.
IC 12-15-5-9.2 Coverage for care related to cancer clinical trials
Sec. 9.2. (a) As used in this section, "care method" means the use
of a particular drug or device in a particular manner.
(b) As used in this section, "clinical trial" means a Phase I, II, III,
or IV research study:
(1) that is conducted:
(A) using a particular care method to prevent, diagnose, or
treat a cancer for which:
(i) there is no clearly superior, noninvestigational
alternative care method; and
(ii) available clinical or preclinical data provides a
reasonable basis from which to believe that the care
method used in the research study is at least as effective as
any noninvestigational alternative care method;
(B) in a facility where personnel providing the care method
to be followed in the research study have:
(i) received training in providing the care method;
(ii) expertise in providing the type of care required for the
research study; and
(iii) experience providing the type of care required for the
research study to a sufficient volume of patients to
maintain expertise; and
(C) to scientifically determine the best care method to
prevent, diagnose, or treat the cancer; and
(2) that is approved or funded by one (1) of the following:
(A) A National Institutes of Health institute.
(B) A cooperative group of research facilities that has an
established peer review program that is approved by a
National Institutes of Health institute or center.
(C) The federal Food and Drug Administration.
(D) The United States Department of Veterans Affairs.
(E) The United States Department of Defense.
(F) The institutional review board of an institution located
in Indiana that has a multiple project assurance contract
approved by the National Institutes of Health Office for
Protection from Research Risks as provided in 45 CFR
46.103.
(G) A research entity that meets eligibility criteria for a
support grant from a National Institutes of Health center.
(c) As used in this section, "routine care cost" means the cost of
medically necessary services related to the care method that is under
evaluation in a clinical trial. The term does not include the following:
(1) The drug or device that is under evaluation in a clinical trial.
(2) Items or services that are:
(A) provided solely for data collection and analysis and not
in the direct clinical management of an individual enrolled
in a clinical trial;
(B) customarily provided at no cost by a research sponsor to
an individual enrolled in a clinical trial; or
(C) provided solely to determine eligibility of an individual
for participation in a clinical trial.
(d) The Medicaid program must provide coverage for routine care
costs that are incurred in the course of a clinical trial if the Medicaid
program would provide coverage for the same routine care costs not
incurred in a clinical trial.
(e) The coverage that must be provided under this section is
subject to the terms, conditions, restrictions, exclusions, and
limitations that apply generally under the Medicaid program,
including terms, conditions, restrictions, exclusions, or limitations
that apply to health care services rendered by participating providers
and nonparticipating providers.
(f) This section does not do any of the following:
(1) Require the Medicaid program to provide coverage for
clinical trial services rendered by a participating provider.
(2) Prohibit the Medicaid program from providing coverage for
clinical trial services rendered by a participating provider.
(3) Require reimbursement for services that are rendered in a
clinical trial by a nonparticipating provider at the same rate of
reimbursement that would apply to the same services rendered
by a participating provider. As added by P.L.109-2009, SEC.2. IC 12-15-5-10 Care available for individuals receiving Medicaid waiver services;
eligibility not affected by receipt of services
Sec. 10. (a) An individual who receives Medicaid services
through a Medicaid waiver shall receive the following:
(1) The development of a care plan addressing the individual's
needs.
(2) Advocacy on behalf of the individual's interests.
(3) The monitoring of the quality of community and home care
services provided to the individual.
(4) Information and referral services concerning community and
home care services if the individual is eligible for these
services.
(b) The use by or on behalf of an individual receiving Medicaid
waiver services of any of the following services or devices does not
make the individual ineligible for services under a Medicaid waiver:
(1) Skilled nursing assistance.
(2) Supervised community and home care services, including
skilled nursing supervision.
(3) Adaptive medical equipment and devices.
(4) Adaptive nonmedical equipment and devices. As added by P.L.47-2009, SEC.4.
IC 12-15-5-1 Services and supplies provided; exceptions
Sec. 1. Except as provided in IC 12-15-2-12, IC 12-15-6, and
IC 12-15-21, the following services and supplies are provided under
Medicaid:
(1) Inpatient hospital services.
(2) Nursing facility services.
(3) Physician's services, including services provided under
IC 25-10-1 and IC 25-22.5-1.
(4) Outpatient hospital or clinic services.
(5) Home health care services.
(6) Private duty nursing services.
(7) Physical therapy and related services.
(8) Dental services.
(9) Prescribed laboratory and x-ray services.
(10) Prescribed drugs and services.
(11) Eyeglasses and prosthetic devices.
(12) Optometric services.
(13) Diagnostic, screening, preventive, and rehabilitative
services.
(14) Podiatric medicine services.
(15) Hospice services.
(16) Services or supplies recognized under Indiana law and
specified under rules adopted by the office.
(17) Family planning services except the performance of
abortions.
(18) Nonmedical nursing care given in accordance with the
tenets and practices of a recognized church or religious
denomination to an individual qualified for Medicaid who
depends upon healing by prayer and spiritual means alone in
accordance with the tenets and practices of the individual's
church or religious denomination.
(19) Services provided to individuals described in IC 12-15-2-8
and IC 12-15-2-9.
(20) Services provided under IC 12-15-34 and IC 12-15-32.
(21) Case management services provided to individuals
described in IC 12-15-2-11 and IC 12-15-2-13.
(22) Any other type of remedial care recognized under Indiana
law and specified by the United States Secretary of Health and
Human Services.
(23) Examinations required under IC 16-41-17-2(a)(10). As added by P.L.2-1992, SEC.9. Amended by P.L.24-1997, SEC.48;
P.L.149-2001, SEC.1.
IC 12-15-5-2 Necessity of federal financial participation
Sec. 2. Medicaid does not include a service or supply for which
federal financial participation is not available. As added by P.L.2-1992, SEC.9.
IC 12-15-5-3
Repealed
(Repealed by P.L.161-2007, SEC.40.)
IC 12-15-5-4
Reserved
IC 12-15-5-5
Office may provide drug coverage; requirements for drug coverage in
managed care
Sec. 5. (a) The office may provide a prescription drug benefit to
a Medicaid recipient in the Medicaid risk based managed care
program.
(b) If the office provides a prescription drug benefit to a Medicaid
recipient in the Medicaid risk based managed care program:
(1) the office shall develop a procedure and provide the
recipient's risk based managed care provider with information
concerning the recipient's prescription drug utilization for the
risk based managed care provider's case management program;
and
(2) the provisions of IC 12-15-35.5 apply.
(c) If the office does not provide a prescription drug benefit to a
Medicaid recipient in the Medicaid risk based managed care
program, a Medicaid managed care organization shall provide
coverage and reimbursement for outpatient single source legend
drugs subject to IC 12-15-35-46, IC 12-15-35-47, and IC 12-15-35.5. As added by P.L.231-1999, SEC.1. Amended by P.L.101-2005,
SEC.1.
IC 12-15-5-6 Prohibiting limiting the number of brand name prescription drugs
a recipient may receive
Sec. 6. The office may not limit the number of brand name
prescription drugs a recipient may receive under the program. As added by P.L.107-2002, SEC.10.
IC 12-15-5-8 Maintenance drugs; prescriptions; Internet based pharmacies
Sec. 8. (a) As used in this section, "maintenance drug" means a
medication that is dispensed under a single prescription for a period
of not less than one hundred eighty (180) days, excluding authorized
refills, for the ongoing treatment of a chronic medical condition or
disease or congenital condition or disorder.
(b) The office may designate:
(1) a mail order pharmacy;
(2) an Internet based pharmacy (as defined in IC 25-26-18-1);
(3) a pharmacy that agrees to sell a maintenance drug at the
same price as a mail order or an Internet based pharmacy; or
(4) all the pharmacies listed in subdivisions (1) through (3);
through which a recipient may obtain a maintenance drug.
(c) If the office makes a designation under subsection (b), a
managed care organization that has a contract with the office under
IC 12-15-12 is not required to use a pharmacy that is designated
under subsection (b).
(d) If a Medicaid recipient's physician prescribes a maintenance
prescription drug, the Medicaid recipient may purchase the
maintenance prescription drug from a pharmacy that is designated
under subsection (b).
(e) The office shall apply to amend the state Medicaid plan if the
office determines that an amendment is necessary to carry out this
section.
(f) The office may require a recipient to pay the maximum
copayment allowable under federal law if the recipient obtains a
maintenance drug from a pharmacy other than a pharmacy described
in subsection (b). As added by P.L.246-2005, SEC.105.
IC 12-15-5-9 Provision of self-directed care options
Sec. 9. The office shall have self-directed care options and
services available for an eligible individual who:
(1) is a Medicaid waiver recipient; and
(2) chooses self-directed care services. As added by P.L.47-2009, SEC.3.
IC 12-15-5-9.2 Coverage for care related to cancer clinical trials
Sec. 9.2. (a) As used in this section, "care method" means the use
of a particular drug or device in a particular manner.
(b) As used in this section, "clinical trial" means a Phase I, II, III,
or IV research study:
(1) that is conducted:
(A) using a particular care method to prevent, diagnose, or
treat a cancer for which:
(i) there is no clearly superior, noninvestigational
alternative care method; and
(ii) available clinical or preclinical data provides a
reasonable basis from which to believe that the care
method used in the research study is at least as effective as
any noninvestigational alternative care method;
(B) in a facility where personnel providing the care method
to be followed in the research study have:
(i) received training in providing the care method;
(ii) expertise in providing the type of care required for the
research study; and
(iii) experience providing the type of care required for the
research study to a sufficient volume of patients to
maintain expertise; and
(C) to scientifically determine the best care method to
prevent, diagnose, or treat the cancer; and
(2) that is approved or funded by one (1) of the following:
(A) A National Institutes of Health institute.
(B) A cooperative group of research facilities that has an
established peer review program that is approved by a
National Institutes of Health institute or center.
(C) The federal Food and Drug Administration.
(D) The United States Department of Veterans Affairs.
(E) The United States Department of Defense.
(F) The institutional review board of an institution located
in Indiana that has a multiple project assurance contract
approved by the National Institutes of Health Office for
Protection from Research Risks as provided in 45 CFR
46.103.
(G) A research entity that meets eligibility criteria for a
support grant from a National Institutes of Health center.
(c) As used in this section, "routine care cost" means the cost of
medically necessary services related to the care method that is under
evaluation in a clinical trial. The term does not include the following:
(1) The drug or device that is under evaluation in a clinical trial.
(2) Items or services that are:
(A) provided solely for data collection and analysis and not
in the direct clinical management of an individual enrolled
in a clinical trial;
(B) customarily provided at no cost by a research sponsor to
an individual enrolled in a clinical trial; or
(C) provided solely to determine eligibility of an individual
for participation in a clinical trial.
(d) The Medicaid program must provide coverage for routine care
costs that are incurred in the course of a clinical trial if the Medicaid
program would provide coverage for the same routine care costs not
incurred in a clinical trial.
(e) The coverage that must be provided under this section is
subject to the terms, conditions, restrictions, exclusions, and
limitations that apply generally under the Medicaid program,
including terms, conditions, restrictions, exclusions, or limitations
that apply to health care services rendered by participating providers
and nonparticipating providers.
(f) This section does not do any of the following:
(1) Require the Medicaid program to provide coverage for
clinical trial services rendered by a participating provider.
(2) Prohibit the Medicaid program from providing coverage for
clinical trial services rendered by a participating provider.
(3) Require reimbursement for services that are rendered in a
clinical trial by a nonparticipating provider at the same rate of
reimbursement that would apply to the same services rendered
by a participating provider. As added by P.L.109-2009, SEC.2. IC 12-15-5-10 Care available for individuals receiving Medicaid waiver services;
eligibility not affected by receipt of services
Sec. 10. (a) An individual who receives Medicaid services
through a Medicaid waiver shall receive the following:
(1) The development of a care plan addressing the individual's
needs.
(2) Advocacy on behalf of the individual's interests.
(3) The monitoring of the quality of community and home care
services provided to the individual.
(4) Information and referral services concerning community and
home care services if the individual is eligible for these
services.
(b) The use by or on behalf of an individual receiving Medicaid
waiver services of any of the following services or devices does not
make the individual ineligible for services under a Medicaid waiver:
(1) Skilled nursing assistance.
(2) Supervised community and home care services, including
skilled nursing supervision.
(3) Adaptive medical equipment and devices.
(4) Adaptive nonmedical equipment and devices. As added by P.L.47-2009, SEC.4.
