Indiana Code Title 12. Human Services § 12-15-4-1.5

(1) Performance standards for hospitals to use in making presumptive eligibility determinations.

(2) An appeals process for a hospital that disputes a determination that a presumptive eligibility standard was violated.

(1) Notify the office of the secretary of each presumptive eligibility determination not later than five (5) business days after the date of the determination.

(2) Assist individuals whom the hospital determines are presumptively eligible with completing and submitting a full Medicaid application.

(3) Notify the applicant in writing and on all relevant forms with plain language and large print that if the applicant:

(1) Determine whether each presumptive eligibility determination received from the hospital complied with the time requirement set forth in subsection (b)(1).

(2) Determine whether the office of the secretary received before the expiration of each presumptive eligibility period the full application from the individual determined by the hospital to be presumptively eligible.

(3) Determine whether each applicant who was determined by the hospital to be presumptively eligible was determined to be eligible for Medicaid after the full application was received.

(1) A description of the standard that was not met and an explanation of why the hospital did not meet the standard.

(2) Notice that a second finding on noncompliance with a standard will result in a requirement that the hospital's applicable staff participate in mandatory training on hospital presumptive eligibility rules and standards that is performed by the office of the secretary.

(3) A description of the available appeal procedures that the hospital may use to dispute the finding of a violation of presumptive eligibility standards.

(1) A description of the standard that was not met and an explanation of why the hospital did not meet the standard.

(2) Notice that the hospital's applicable staff must participate in mandatory training on hospital presumptive eligibility rules and standards that is performed by the office of the secretary, and information concerning the date, time, and location of the training by the office.

(3) A description of the available appeal procedures that the hospital may use to dispute the finding of a violation of presumptive eligibility standards.

(4) Notice that a third violation by the hospital of a presumptive eligibility standard within a twelve (12) month period from the second violation will result in the hospital no longer being qualified to make presumptive eligibility determinations.

(1) A description of the standard that was not met and an explanation of why the hospital did not meet the standard.

(2) A description of the available appeal procedures that the hospital may use to dispute the finding of a violation of presumptive eligibility standards.

(3) Notice that, effective immediately from receipt of the notice, the hospital is no longer qualified to make presumptive eligibility determinations for the Medicaid program.