Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Article 2 - MEDICAID MEMBERS; ELIGIBILITY
Rule 9 - Medicaid for Employees with Disabilities
Section 9-7 - Medically improved disability
Current through March 20, 2024
Authority: IC 12-15
Affected: IC 12-14-15-1; IC 12-15-2-6.5; IC 12-15-41
Sec. 7.
(a) In order to qualify for the Medicaid for employees with disabilities program after improvement of a medical condition, a member must meet the requirements in this section.
(b) The person must be a member of Medicaid under the Medicaid for employees with disabilities group described in section 6 of this rule who no longer qualifies for coverage under that category due to a medical improvement in his or her condition. The improvement of the condition must be verifiable by acceptable clinical standards; however, the disease, illness, or process must be of a type that, due to the nature and course of the illness, will continue to be a disabling impairment. A condition that has been resolved or a person who is completely recovered does not medically qualify for this program.
(c) The determination of whether a member meets the medical eligibility requirements for this category will be made either: