Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Article 1 - MEDICAID PROVIDERS AND SERVICES
Rule 1 - General Provisions
Section 1-11 - Intermediate care for the mentally retarded; eligibility
Current through March 20, 2024
Authority: IC 12-15-1-10; IC 12-15-1-15; IC 12-15-21-2
Affected: IC 12-13-7-3; IC 12-15
Sec. 11.
Intermediate Care for the Mentally Retarded (ICF/MR) is to be provided for persons in an institution which meets the Federal certification standards to participate as an eligible Medicaid provider. Intermediate care services are designed for persons who are mentally retarded or with certain other conditions as specified herein. The services and/or treatment programs are delivered on an in-patient basis and under the direction and supervision of the required professional staff. Admissions to Intermediate Care Facilities for the Mentally Retarded must be based upon a determination of the need for such care by an interdisciplinary professional team. Approval by the State Department of Public Welfare-Medicaid Division, must be received by the ICF/MR institution prior to admission, or in cases of those individuals who make application while in the institution, prior to payment for that service. Intermediate Care for the Mentally Retarded (ICF/MR) will be provided by the Medicaid program, for eligible persons who must meet these two conditions:
(1) Patient or resident has a diagnosis of mental retardation or related conditions of epilepsy, cerebral palsy, or other developmental disability found to be closely related to mental retardation or to require treatment similar to that required for mentally retarded individuals.
(2) Patient or resident must have a comprehensive evaluation covering physical, emotional, social and cognitive factors conducted by an interdisciplinary professional team.
In addition to the above required conditions, eligible persons may require any of the following professional services:
Transferred from the Division of Family and Children (470 IAC 5-1-9) to the Office of the Secretary of Family and Social Services (405 IAC 1-1-11) by P.L. 9-1991, SECTION 131, effective January 1, 1992.