Indiana § 12-15-5-18.5 - Reimbursement for emergency medical services

§ 12-15-5-18.5. Reimbursement for emergency medical services

Sec. 18.5. (a) This section applies to an emergency medical services provider organization that meets the following requirements:

(1) Is certified by the Indiana emergency medical services commission as an advanced life support provider organization under rules adopted under IC 16-31-3.

(2) Is a Medicaid provider.

(b) The office of the secretary shall provide reimbursement for Medicaid covered services provided to a Medicaid recipient that are:

(1) rendered by an emergency medical services provider organization that is a Medicaid provider;

(2) within the emergency medical services provider organization's scope of practice;

(3) performed or provided as advanced life support services; and

(4) performed or provided during a response initiated through the 911 system, regardless of whether the patient is transported.

(c) If multiple emergency medical services provider organizations qualify and submit a claim for reimbursement under this section, the office of the secretary:

(1) may reimburse under this section only for one (1) claim per patient encounter; and

(2) shall reimburse the claim submitted by the emergency medical services provider organization that performed or provided the majority of advanced life support services.

(d) The office of the secretary may apply to the United States Department of Health and Human Services for any amendment to the state Medicaid plan or for any Medicaid waiver necessary to implement this section.

As added by P.L.115-2020, SEC.3.