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 10-7-4 - HIP State Plan

405 Ind. Admin. Code 10-7-4

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Current through January 8, 2025
Section 405 IAC 10-7-4 - HIP State Plan

Authority: IC 12-15-44.5

Affected: IC 12-15-44.5

Sec. 4.

(a) This section outlines services available to a member enrolled in HIP State Plan. All covered services under HIP State Plan are subject to the coverage criteria, limitations, and procedures specified in this article as well as those services specified in the Centers for Medicare and Medicaid Services approved Medicaid State Plan.
(b) HIP State Plan shall include covered services in the following categories that are equivalent to the Medicaid State Plan:
(1) Ambulatory patient services.
(2) Emergency services.
(3) Hospitalization.
(4) Maternity services.
(5) Mental health and substance abuse services.
(6) Prescription drugs.
(7) Rehabilitative and habilitative services and devices.
(8) Laboratory services.
(9) Preventive care services.
(10) Vision services.
(11) Dental services.
(12) Early and periodic screening, diagnostic, and treatment services for members nineteen (19) and twenty (20) years of age.
(c) The following services shall not be covered under HIP State Plan:
(1) Services that are not medically necessary.
(2) Any other services not covered by the Centers for Medicare and Medicaid Services approved Medicaid State Plan.

405 IAC 10-7-4

Filed 5/18/2015, 12:34 p.m.: 20150617-IR-405140339FRA
Readopted filed 8/18/2021, 9:55 a.m.: 20210915-IR-405210197RFA