460 IAC 14-11-4 - Conflicts of interest

Authority: IC 12-8-8.5-4; IC 12-9-2-3; IC 12-9-5-1; IC 12-9-5-3

Affected: IC 12-9-5; IC 12-12-1

Sec. 4.

(a) The same service provider is not permitted to prescribe or recommend and sell goods or services to the same eligible individual if the service provider would benefit financially from the sale of the goods and services prescribed or recommended, except when:

(1) it is a routine and professionally acceptable practice;

(2) the prescribing provider and the vending provider operate under the same entity, but neither benefits directly from the activities of the other;

(3) the prescriber is the sole source vendor for the goods or services, nothing comparable is available from other sources, and the sole source nature of the purchase is documented in the eligible individual's record of services; or

(4) the counselor has determined that goods or services are required on an emergency basis and can be provided most efficiently by a single source.

(b) Family members of an eligible individual shall not be service providers for the eligible individual, unless the service provider:

(1) is a licensed or certified provider for the applicable service;

(2) is not prohibited by any ethical or professional standards from providing the applicable service; and

(3) is the lowest cost provider for that service.

Notes

460 IAC 14-11-4

Division of Disability and Rehabilitative Services; 460 IAC 14-11-4; filed 7/13/2015, 4:09 p.m.: 20150812-IR-460140507FRA Readopted filed 8/18/2021, 10:01 a.m.: 20210915-IR-460210198RFA