Section 405 IAC 10-7-11 - Self-referral servicesAuthority: 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) Family planning 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) Psychiatric services provided by a provider licensed under IC 12-15-11.(2) Behavioral health services.(3) Immunization services.(4) Diabetes self-management training services, as set forth in IC 27-8-14.5-6.(5) Chiropractic services.(6) Eye care services, except for surgical services on the eye.(8) Urgent care services.Filed 5/18/2015, 12:34 p.m.: 20150617-IR-405140339FRAFiled 1/19/2018, 8:42 a.m.: 20180214-IR-405170484FRA