Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Article 10 - HEALTHY INDIANA PLAN
Rule 7 - Benefits and Medical Policy
Section 7-11 - Self-referral services
Universal Citation: 405 IN Admin Code 7-11
Current through September 18, 2024
Authority: IC 12-15-44.5-9
Affected: IC 12-15-11; IC 12-15-44.5; IC 27-8-14.5-6
Sec. 11.
(a) A member may receive the following covered services without a referral from the member's primary medical provider or prior authorization or precertification from the member's managed care organization:
(1) Family planning services.
(2) Emergency services.
(b) A member may receive the following services without a referral from the member's primary medical provider, provided the service is a covered service under such member's benefits package and subject to any requirements established by the managed care organization regarding the use of in-network providers:
(1) Psychiatric services provided by a
provider licensed under IC 12-15-11.
(2) Behavioral health services.
(3) Immunization services.
(4) Diabetes self-management training
services, as set forth in IC
27-8-14.5-6.
(5) Chiropractic services.
(6) Eye care services, except for surgical
services on the eye.
(7) Podiatric
services.
(8) Urgent care
services.
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