Statutes, codes, and regulations
Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICESArticle 5 - MEDICAID SERVICES
Rule 405 IAC 5-3 - Prior Authorization
Section 405 IAC 5-3-4 - Audit

405 Ind. Admin. Code 5-3-4

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Current through January 8, 2025
Section 405 IAC 5-3-4 - Audit

Authority: IC 12-15-1-10; IC 12-15-21-2; IC 12-15-21-3

Affected: IC 12-15-30-1

Sec. 4.

Retrospective audit shall include postpayment review of the medical record to determine whether the service was medically necessary as defined in this article.

405 IAC 5-3-4

Office of the Secretary of Family and Social Services; 405 IAC 5-3-4; filed Jul 25, 1997, 4:00 p.m.: 20 IR 3303; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; filed Oct 3, 2001, 9:47 a.m.: 25 IR 378; readopted filed Sep 19, 2007, 12:16p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFA
Errata filed 11/1/2016, 9:36 a.m.: 20161109-IR-405160493ACA
Readopted filed 7/28/2022, 2:21 p.m.: 20220824-IR-405220205RFA
Readopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA