405 IAC 5-34-3 - Out-of-state providers
Authority: IC 12-15-1-10; IC 12-15-21-2; IC 12-15-40
Affected: IC 12-15
Sec. 3.
(a) Subject
to the conditions in this section and section 2 of this rule, and any
applicable state or federal licensing laws or regulations, an Indiana resident
may receive hospice services from an out-of-state hospice provider if the
provider is:
(1) located in a designated
out-of-state area pursuant to
405 IAC 5-5-1; and
(2) enrolled in Medicaid.
(b) Prior authorization may be
granted for an Indiana resident to receive hospice services from an
out-of-state hospice provider not located in a designated out-of-state city if
any one (1) of the criteria listed at
405 IAC 5-5-2(c)
is met.
(c) Routine home care and continuous home
care hospice services may be provided by out-of-state hospice providers to
Indiana residents in their own home or in a nursing facility located in
Indiana.
(d) Inpatient respite care
and general inpatient care hospice services may be provided in an out-of-state
hospice provider's facility.
(e)
Routine home care and continuous home care hospice services cannot be provided
to an Indiana resident in a nursing facility outside of Indiana.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
Authority: IC 12-15-1-10; IC 12-15-21-2; IC 12-15-40
Affected: IC 12-15
Sec. 3.
(a) Subject to the conditions in this section and section 2 of this rule, and any applicable state or federal licensing laws or regulations, an Indiana resident may receive hospice services from an out-of-state hospice provider if the provider is:
(1) located in a designated out-of-state area pursuant to 405 IAC 5-5-1; and
(2) enrolled in Medicaid.
(b) Prior authorization may be granted for an Indiana resident to receive hospice services from an out-of-state hospice provider not located in a designated out-of-state city if any one (1) of the criteria listed at 405 IAC 5-5-2(c) is met.
(c) Routine home care and continuous home care hospice services may be provided by out-of-state hospice providers to Indiana residents in their own home or in a nursing facility located in Indiana.
(d) Inpatient respite care and general inpatient care hospice services may be provided in an out-of-state hospice provider's facility.
(e) Routine home care and continuous home care hospice services cannot be provided to an Indiana resident in a nursing facility outside of Indiana.