Indiana Code 12-12.7-2-17. Cost participation schedule; cost participation plan
(b) A family shall participate in the cost of programs and services provided under this chapter to the extent allowed by federal law according to a cost participation schedule established by the division. The cost participation schedule must be based on the federal income poverty level and set forth a copayment per unit of treatment and a maximum monthly cost share amount.
Terms Used In Indiana Code 12-12.7-2-17
- early intervention services: means developmental services that meet the following conditions:
Indiana Code 12-12.7-2-3
- Month: means a calendar month, unless otherwise expressed. See Indiana Code 1-1-4-5
- Year: means a calendar year, unless otherwise expressed. See Indiana Code 1-1-4-5
(1) must:
(A) be based on income and ability to pay;
(B) provide for a review of a family’s cost participation amount:
(i) annually; and
(ii) within thirty (30) days after the family reports a reduction in income; and
(C) allow the division to waive a required copayment if other medical expenses or personal care needs expenses for any member of the family reduce the level of income the family has available to pay copayments under this section;
(2) may allow a family to voluntarily contribute payments that exceed the family’s required cost participation amount;
(3) must require the family to allow the division access to all health care coverage information that the family has concerning the infant or toddler who is to receive services;
(4) must require families to consent to the division billing third party payors for early intervention services provided;
(5) may allow the division to waive the billing to third party payors if the family is able to demonstrate financial or personal hardship on the part of the family member; and
(6) must require the division to waive the family’s monthly copayments in any month for those services for which it receives payment from the family’s health insurance coverage.
(d) Funds received through a cost participation plan under this section must be used to fund programs described in section 18 of this chapter.
(e) Before the division may make a change to the cost participation schedule, the division must do the following:
(1) Release the proposed changes to the cost participation schedule for public comment no later than September 1 in the year before the change will be effective.
(2) Allow a sixty (60) day public comment period on the proposed changes to the cost participation schedule.
(3) Implement any change to the cost participation schedule no earlier than July 1 of the year following the release of the proposed change under subdivision (1).
As added by P.L.93-2006, SEC.11. Amended by P.L.229-2011, SEC.120; P.L.108-2019, SEC.192; P.L.111-2020, SEC.8.