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Indiana Code Title 12. Human Services § 12-10-11.5-4.5

Current as of January 02, 2024 | Updated by Findlaw Staff

Sec. 4.5. (a) As used in this section, “functional eligibility assessment” means a review of an individual's functional impairment level to determine whether an individual meets the eligibility requirements for the state's Medicaid aged and disabled waiver.

(b) As used in this section, “functional eligibility determination” means making a final decision concerning whether an individual meets the proper level of care requirements to receive services under the state's Medicaid aged and disabled waiver.

(c) Not later than June 30, 2025, the office shall provide at least one (1) statewide option other than the area agencies on aging for functional eligibility determinations for the state's Medicaid aged and disabled waiver.

(d) Not later than October 1, 2023, and every subsequent two (2) years, the office of the secretary, in consultation with home and community based health care providers that provide Medicaid services and the area agencies on aging, shall report the following information and analysis to the budget committee and the legislative council in an electronic format under IC 5-14-6:

(1) The average length of time taken by each area agency on aging to conduct functional eligibility assessments and make functional eligibility determinations for individuals seeking home and community based Medicaid services.

(2) The average length of time taken by each entity approved by the office of the secretary to conduct functional eligibility assessments and make functional eligibility determinations for individuals seeking home and community based Medicaid services under the state's Medicaid aged and disabled waiver.

(3) A plan for determining functional eligibility of individuals seeking home and community based Medicaid services not later than seventy-two (72) hours from the completion of an eligibility assessment, including a time frame for implementation of the plan and specific metrics and compliance measures that will be used to improve the time frame for functional eligibility assessments and functional eligibility determinations.

(e) The office of the secretary shall:

(1) publish the report described in subsection (d) on the office of the secretary's website;  and

(2) share the report with all home and community based providers that provide services for the Medicaid aged and disabled waiver.

(f) This section expires December 1, 2029.

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Cite this article: FindLaw.com - Indiana Code Title 12. Human Services § 12-10-11.5-4.5 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-12-human-services/in-code-sect-12-10-11-5-4-5/

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