Indiana Code Title 12. Human Services § 12-15-5-13

Sec. 13 . (a) The office shall provide coverage for treatment of opioid or alcohol dependence that includes the following:

(1) Counseling services that address the psychological and behavioral aspects of addiction.

(2) When medically indicated, drug treatment involving agents approved by the federal Food and Drug Administration for the:

(A) treatment of opioid or alcohol dependence;  or

(B) prevention of relapse to opioids or alcohol after detoxification.

(3) Inpatient detoxification:

(A) in accordance with:

(i) the most current edition of the American Society of Addiction Medicine Patient Placement Criteria;  or

(ii) other clinical criteria that are determined by the office and are evidence based and peer reviewed;  and

(B) when determined by the treatment plan to be medically necessary.

(b) The office shall:

(1) develop quality measures to ensure;  and

(2) require a managed care organization to report;

compliance with the coverage required under subsection (a).

(c) The office may implement quality capitation withholding of reimbursement to ensure that a managed care organization has provided the coverage required under subsection (a).

(d) The office shall report the clinical use of the medications covered under this section to the mental health Medicaid quality advisory committee established by IC 12-15-35-51 .  The mental health Medicaid quality advisory committee may make recommendations to the office concerning this section.


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