Section 12-16-1-3 - Rules; adoption; requisites(a) The division shall, with the advice of the division's medical staff, representatives of affected agencies, and other individuals selected by the director of the division, adopt rules under IC 4-22-2 to do the following: (1) Provide for prior review and approval of covered medical services, including special review and approval procedures for emergency covered medical services.(2) Establish limitations consistent with medical necessity on the duration of services to be provided.(3) Specify the amount of and method for reimbursement for services.(4) Specify the conditions under which payments will be denied and improper payments will be recovered.(b) To the extent possible, rules adopted under this section must be consistent with Title XIX of the federal Social Security Act and with IC 12-15-21-2 and IC 12-15-21-3.Pre-1992 Revision Citation: 12-5-7-4.
As added by P.L. 2-1992, SEC.10.