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Complete Plan (29.7 MB)
Table of Contents
Section 1 - Single State Agency Organization
1.1 - Designation and Authority
1.2 - Organization for Administration
1.3 - Statewide Operation
1.4 - State Medical Care Advisory Committee
1.5 - Pediatric Immunization Program
Section 2 - Coverage and Eligibility
2.1 - Application, Determination of Eligibility and Furnishing Medicaid
2.2 - Coverage and Conditions of Eligibility
2.3 - Residence
2.4 - Blindness
2.5 - Disability
2.6 - Financial Eligibility
2.7 - Medicaid Furnished Out of State
Section 3 - Services: General Provisions
3.1, Page 19(a1) - Amount, Duration, and Scope of Services
3.1, Page 20(a2) - Amount, Duration, and Scope of Services
3.1, Page 21(a3-a5) - Amount, Duration, and Scope of Services
3.1, Pages 21-22(a6-a10) - Amount, Duration, and Scope of Services
3.1, Page 23(b) - Amount, Duration, and Scope of Services
3.1, Pages 24-26(c-e) - Amount, Duration, and Scope of Services
3.1, Page 27(f-h) - Amount, Duration, and Scope of Services
3.2 - Coordination of Medicaid with Medicare Part B
3.3 - Medicaid for Individuals Age 65 or Over in Institutions for Mental Diseases
3.4 - Special Requirements Applicable to Sterilization Procedures
3.5 - Families Receiving Extended Medicaid Benefits
Section 4 - General Program Administration
4.1 - Methods of Administration
4.2 - Hearings for Applicants and Recipients
4.3 - Safeguarding Information on Applicants and Recipients
4.4 - Medicaid Quality Control
4.5 - Medicaid Agency Fraud Detection and Investigation Program
4.6 - Reports
4.7 - Maintenance of Records
4.8 - Availability of Agency Program Manuals
4.9 - Reporting Provider Payments to the Internal Revenue Service
4.10 - Free Choice of Providers
4.11 - Relations with Standard-Setting and Survey Agencies
4.12 - Consultation to Medical Facilities
4.13 - Required Provider Agreement
4.14 - Utilization Control
4.15 - Inspections of Care in Skilled Nursing and Intermediate Care Facilities and Institutions for Mental Diseases
4.16 - Relations with State Health and Vocational Rehabilitation Agencies and Title V Grantees
4.17 - Liens and Recoveries
4.18 - Cost Sharing and Similar Charges
4.19 - Payment for Services
4.20 - Direct Payments to certain Recipients for Physicians' or Dentists' Services
4.21 - Prohibition Against Reassignment of Provider Claims
4.22 - Third Party Liability
4.23 - Use of Contracts
4.24 - Standards for Payments for Skilled Nursing and Intermediate Care Facility Services
4.25 - Program for Licensing Administrators of Nursing Homes
4.26 - Drug Utilization Review Program
4.27 - Disclosure of Survey information and Provider or Contractor Evaluation
4.28 - Appeals Process for Skilled Nursing and Intermediate Care Facilities
4.29 - Conflict of Interest Provisions
4.30 - Exclusion of Providers and Suspension of Practitioners Convicted and Other Individuals
4.31 - Disclosure of Information by Providers and Fiscal Agents
4.32 - Income and Eligibility Verification System
4.33 - Medicaid Eligibility Cards for Homeless Individuals
4.34 - Systematic Alien Verification for Entitlements
4.35 - Remedies for Skilled Nursing and Intermediate Care Facilities that Do Not Meet Requirements of Participation
4.36 - Required Coordination Between the Medicaid and WIC Programs
4.38 - Nurse Aide Training and Competency Evaluation for Nursing Facilities
4.39 - Preadmission Screening and Annual Resident Review in Nursing Facilities
4.40 - Survey and Certification Process
4.41 - Resident Assessment for Nursing Facilities
4.42 - Employee Education About False Claim Recoveries
4.43 - Cooperation with Medicaid Integrity Program Efforts
Section 5 - Personnel Administration
5.1 - Standards of Personnel Administration
5.2 - For Future Use
5.3 - Training Programs; Subprofessional and Volunteer Programs
Section 6 - Financial Administration
6.1 - Fiscal Policies and Accountability
6.2 - Cost Allocation
6.3 - State Financial Participation
Section 7 - General Provisions
7.1 - Plan Amendments
7.2 - Nondiscrimination
7.3 - Maintenance of AFDC Effort
7.4 - State Governor's Review
Attachments
1.1-A - Attorney General's Certification
1.2-A - Organization and Function of State Agency
1.2-B - Organization and Function of Medical Assistance Unit
1.2-C - Professional Medical and Supporting Staff
1.2-D - Description of Staff Making Eligibility Determination
2.2-A, Pages 1-5 - Groups Covered and Agencies Responsible for Eligibility
2.2-A, Pages 6-8 - Groups Covered and Agencies Responsible for Eligibility
2.2-A, Pages 9-11 - Groups Covered and Agencies Responsible for Eligibility
2.2-A, Pages 12-17 - Groups Covered and Agencies Responsible for Eligibility
2.2-A, Pages 18-23e - Groups Covered and Agencies Responsible for Eligibility
2.2-A, Pages 24-27 - Groups Covered and Agencies Responsible for Eligibility
Supplement 1 - Reasonable Classifications of Individuals under the Age of 21, 20, 19 and 18
Supplement 3 - Method of Determining Cost Effectiveness of Caring for Certain Disabled Children at Home
2.6-A, Pages 1-4c - Eligibility Conditions and Requirements
2.6-A, Pages 5-10 - Eligibility Conditions and Requirements
2.6-A, Pages 11-15a - Eligibility Conditions and Requirements
2.6-A, Pages 16-20a - Eligibility Conditions and Requirements
2.6-A, Pages 21-26a - Eligibility Conditions and Requirements
Supplement 1 - Income Eligibility Levels
Supplement 2 - Resource Levels
Supplement 3 - Reasonable Limits on Amounts for Necessary Medical or Remedial Care Not Covered Under Medicaid
Supplement 4 - Section_1902(f) Methodologies for Treatment of Income that Differ from those of the SSI Program
Supplement 5 - More Restrictive Methods of Treatment Resources than those of the SSI Program
Supplement 5a - Methods for Treatment of Resources for Individuals with Incomes Related to the Federal Poverty Level
Supplement 6 - Standards for Optional State Supplementary Payments
Supplement 7 - Income Levels for 1902(f) States - Categorically Needy Who Are Covered Under Requirements More Restrictive than SSI
Supplement 8 - Resource Standards for 1902(f) States - Categorically Needy
Supplement 8a - More Liberal Methods of Treating Income Under Section 1902(r)(2) of the Act
Supplement 8b - More Liberal Methods of Treating Resources Under Section 1902(r)(2) of the Act
Supplement 9 - Transfer of Assets
Supplement 9a - Supplement 9a to Attachment A
Supplement 10 - Consideration of Medicaid Qualifying Trusts - Undue Hardship
Supplement 11 - Cost-Effective Methods for COBRA Groups (States and Territories)
Supplement 12 - Variations from the Basic Personal Needs Allowance; Section 1931 Eligibility
Supplement 13 - Section_1924 Provisions
Supplement 14 - Income and Resource Requirements for TB-infected Individuals
Supplement 15 - Eligibility Under Section 1931 of the Act
3.1-A, Pages 1-10 - Amount, Duration and Scope of Medical Services Provided to the Categorically Needy
3.1-A, Addendum Pages 1-13 - Description of Limitations
Supplement 1, Page 1-8 - Case Management Services
Supplement 1, Page 9-16 - Case Management Services
Supplement 1, Page 17-19 - Case Management Services
3.1-C - Standards and Methods of Assuring High Quality Care
3.1-D - Methods of Providing Transportation
3.1-E - Standards for the Coverage of Organ Transplant Procedures
4.11-A - Standards for Institutions
4.16-A, Pages 1a-7a - Cooperative Arrangement: Indiana State Department of Health
4.16-A, Pages 1b-4b - Cooperative Arrangement: Division of Disability, Aging and Rehabilitation
4.16-A, Pages 1c-7c - Cooperative Arrangement: Indiana State Department of Health
4.16-A, Pages 1d-1e - Cooperative Arrangement: Reserved for Future Use
4.16-A, Pages 1f-7f - Cooperative Arrangement: Division of Mental Health and Addiction, and Division of Disabilty, Aging and Rehabilitation
4.16-A, Pages 1g-6g - Cooperative Arrangement: Head Start Program
4.16-A, Pages 1h-4h - Cooperative Arrangement: Office of Attorney General
4.16-A, Pages 1i-4i - Cooperative Arrangement: Division of Mental Health and Addiction
4.17-A - Liens and Adjustments or Recoveries
4.18-A - Charges Imposed on Categorically Needy
4.18-C - Charges Imposed on Medically Needy and Other Optional Groups
4.18-D - Premiums Imposed on Low-Income Pregnant Women and Infants
4.18-E - Premiums Imposed on Qualified Disabled and Working Individuals
4.19-A, Pages i-1H - Methods and Standards for Establishing Payment Rates - Inpatient Hospital Care
4.19-A, Pages 1I-1M - Methods and Standards for Establishing Payment Rates - Inpatient Hospital Care
4.19-A, Pages 1N.1-1N.10 - Methods and Standards for Establishing Payment Rates - Inpatient Hospital Care
4.19-A, Pages 2-19 - Methods and Standards for Establishing Payment Rates - Inpatient Hospital Care
4.19-B, Pages 1-1e - Methods and Standards for Establishing Payment Rates - Other Types of Care
4.19-B, Pages 2-2d - Methods and Standards for Establishing Payment Rates - Other Types of Care
4.19-B, Pages 3-3e - Methods and Standards for Establishing Payment Rates - Other Types of Care
4.19-B, Pages 4-7 - Methods and Standards for Establishing Payment Rates - Other Types of Care
Supplement 1 - Methods and Standards for Establishing Payment Rates for Title XVIII Deductible/Coinsurance
4.19-C - Payments for Reserved Beds
4.19-D, Pages i-9 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-D, Pages 10-15 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facilities
4.19-D, Pages 16-25 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facilities
4.19-D, Pages 26-35a - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-D, Pages 36-45 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-D, Pages 46-54 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-D, Pages 55-64 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-D, Pages 65-68D - Methods and Standards for Establishing Payment Rates - Inpatient Hospital Care
4.19-D, Pages 69-77 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-D, Pages 78-86 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-D, Pages 87-95 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-D, Pages 96-105 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-D, Pages 106-112 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-D, Pages 113-123 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-D, Pages 124-137 - Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-E - Timely Claims Payment
4.22-A - Requirements for Third Party Liability - Identifying Liable Resources
4.22-B - Requirements for Third Party Liability - Payment of Claims
4.22-C - State Methodology on Cost Effectiveness of Employer-Based Group Health Plans
4.30 - Sanctions for Psychiatric Hospitals
4.32-A - Income and Eligibility Verification System Procedures: Requests to Other State Agencies
4.33-A - Method for Issuance of Medicaid Eligibility Cards to Homeless Individuals
4.34-A - Advanced Directives
4.35-A - Enforcement of Compliance for Nursing Facilities
4.35-B - Enforcement of Compliance for Nursing Facilities
4.35-C - Enforcement of Compliance for Nursing Facilities
4.35- D - Enforcement of Compliance for Nursing Facilities
4.35- E - Enforcement of Compliance for Nursing Facilities
4.35-F - Enforcement of Compliance for Nursing Facilities
4.35-G - Enforcement of Compliance for Nursing Facilities
4.35-H - Enforcement of Compliance for Nursing Facilities
4.38 - Disclosure of Additional Registry Information
4.38-A - Collection of Additional Registry Information
4.39 - Definition of Specialized Services
4.39-A - Categorical Determinations
4.40-A - Survey and Certification Education Program
4.40-B - Process for Investigation of Allegations of Resident Neglect, Abuse and Misappropriation of Resident Property
4.40-C - Procedures for Scheduling and Conduct of Standard Surveys
4.40-D - Programs to Measure and Reduce Inconsistency
4.40-E - Process for Investigations of Complaints and Monitoring
4.42 - Employee Education About False Claim Recoveries
7.2-A - Methods of Administration - Civil Rights Act (Title VI)
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