Indiana Administrative Code
Title 410 - INDIANA DEPARTMENT OF HEALTH
Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS
Rule 2 - Application
Section 2-4 - Application process and enrollment in the Medicaid program

Universal Citation: 410 IN Admin Code 2-4

Current through March 20, 2024

Authority: IC 16-35-2-7

Affected: IC 16-35-2

Sec. 4.

(a) The state department of health shall not complete the processing of an application and enrollment for the CSHCN program until the applicant shows evidence that the child is enrolled in the Medicaid program or that the child has applied for the Medicaid program.

(b) All children currently enrolled in the CSHCN program shall also meet the conditions specified in subsection (a).

(c) Refusal to comply with the provisions in subsection (a) shall be sufficient cause for the state department of health to deny or cancel enrollment and participation in the CSHCN program.

(d) If a child is denied enrollment in the Medicaid program, the state department of health shall complete the processing of the child's application for the CSHCN program. If the state department of health determines that a child is financially and medically eligible for the CSHCN program, the effective date for payment of services provided by the CSHCN program shall be the date that the applicant submitted a written application form, for processing, for health care services through the CSHCN program.

(e) Children who are enrolled in the Medicaid program may apply for enrollment in the CSHCN program for the following purposes only:

(1) Care coordination services.

(2) Access to the CSHCN program's regional diagnostic and treatment centers.

(3) Access to other approved providers.

(f) Costs of all eligible services, including travel reimbursement, for children dually enrolled in the Medicaid program and the CSHCN program shall be charged to the Medicaid program. The CSHCN program shall not pay for services that are paid for by the Medicaid program.

(g) Dual enrollment in no way expands the range of services that the CSHCN program provides or pays for.

(h) Dual enrollment does not create a right for children enrolled in the CSHCN program to receive or to be provided by the CSHCN program the range of services available, provided, or paid for by the Medicaid program.

(i) Any person who contracts with the state department of health to provide services shall be limited to the compensation provided for under the terms of the contract.

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