Section 12-16-6.5-5 - Determination of eligibility for assistance and health care items or services; entitled to assistance(a) If the division receives an application that was filed on behalf of a person under IC 12-16-4.5, the division shall determine:(1) the eligibility of the person for assistance under the hospital care for the indigent program; and(2) if the health care items or services provided to the person and identified in a claim filed with the division under IC 12-16-4.5 were: (A) necessitated by at least one (1) medical condition listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3) or IC 12-16-3.5-2(a)(1) through IC 12-16-3.5-2(a)(3); or(B) the direct consequence of at least one (1) of the medical conditions listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3).(b) If: (1) the person, initially or upon appeal, is found eligible for assistance; and(2) at least one (1) of the items or services identified in the claim is determined initially or upon appeal: (A) to have been necessitated by one (1) or more of the medical conditions listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3) or IC 12-16-3.5-2(a)(1) through IC 12-16-3.5-2(a)(3); or(B) to be a direct consequence of one (1) or more of the medical conditions listed in IC 12-16-3.5-1(a)(1) through IC 12-16-3.5-1(a)(3); the person is entitled to assistance for those items and services.
As added by P.L. 120-2002, SEC.22. Amended by P.L. 255-2003, SEC.34; P.L. 145-2005, SEC.21.