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 7-4 - HIP State Plan
Universal Citation: 405 IN Admin Code 7-4
Current through September 18, 2024
Authority: IC 12-15-44.5
Affected: IC 12-15-44.5
Sec. 4.
(a) This section outlines services available to a member enrolled in HIP State Plan. All covered services under HIP State Plan are subject to the coverage criteria, limitations, and procedures specified in this article as well as those services specified in the Centers for Medicare and Medicaid Services approved Medicaid State Plan.
(b) HIP State Plan shall include covered services in the following categories that are equivalent to the Medicaid State Plan:
(1) Ambulatory
patient services.
(2) Emergency
services.
(3)
Hospitalization.
(4) Maternity
services.
(5) Mental health and
substance abuse services.
(6)
Prescription drugs.
(7)
Rehabilitative and habilitative services and devices.
(8) Laboratory services.
(9) Preventive care services.
(10) Vision services.
(11) Dental services.
(12) Early and periodic screening,
diagnostic, and treatment services for members nineteen (19) and twenty (20)
years of age.
(c) The following services shall not be covered under HIP State Plan:
(1) Services that are not medically
necessary.
(2) Any other services
not covered by the Centers for Medicare and Medicaid Services approved Medicaid
State Plan.
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