Statutes, codes, and regulations
Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICESArticle 10 - HEALTHY INDIANA PLAN
Rule 405 IAC 10-7 - Benefits and Medical Policy
Section 405 IAC 10-7-11 - Self-referral services

405 Ind. Admin. Code 10-7-11

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Current through December 25, 2024
Section 405 IAC 10-7-11 - Self-referral services

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) Family planning services.
(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) 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.
(7) Podiatric services.
(8) Urgent care services.

405 IAC 10-7-11

Filed 5/18/2015, 12:34 p.m.: 20150617-IR-405140339FRA
Filed 1/19/2018, 8:42 a.m.: 20180214-IR-405170484FRA