Section 11-10-3-7 - Determination on coverage of insurance for medical care expenses; department as Medicaid authorized representative; memorandum of understanding; reimbursement for medical care(a) If the department or a county incurs medical care expenses in providing medical care to an inmate who is committed to the department and the medical care expenses are not reimbursed, the department or the county shall attempt to determine the amount, if any, of the medical care expenses that may be paid: (1) by a policy of insurance that is maintained by the inmate and that covers medical care, dental care, eye care, or any other health care related service; or(b) For an inmate who: (1) is committed to the department and resides in a department facility or jail;(2) incurs or will incur medical care expenses that are not otherwise reimbursable;(3) is unwilling or unable to pay for the inmate's own health care services; and(4) is potentially eligible for Medicaid (IC 12-15); the department is the inmate's Medicaid authorized representative and may apply for Medicaid on behalf of the inmate.
(c) The department and the office of the secretary of family and social services shall enter into a written memorandum of understanding providing that the department shall reimburse the office of the secretary for administrative costs and the state share of the Medicaid costs incurred for an inmate.(d) Reimbursement under this section for reimbursable health care services provided by a health care provider, including a hospital, to an inmate as an inpatient in a hospital must be as follows: (1) For inmates eligible and participating in the healthy Indiana plan (IC 12-15-44.5), the reimbursement rates described in IC 12-15-44.5-5.(2) For inmates other than those described in subdivision (1) who are eligible under the Medicaid program, the reimbursement rates provided under the Medicaid program, except that reimbursement for inpatient hospital services shall be reimbursed at rates equal to the fee-for-service rates described in IC 16-21-10-8(a)(1). Hospital assessment fee funds collected under IC 16-21-10 or the healthy Indiana plan trust fund (IC 12-15-44.2-17) may not be used as the state share of Medicaid costs for the reimbursement of health care services provided to the inmate as an inpatient in the hospital.
Amended by P.L. 30-2016, SEC. 1, eff. 7/1/2016.Amended by P.L. 185-2015, SEC. 2, eff. 7/1/2015.Added by P.L. 205-2013, SEC. 170, eff. 7/1/2013.