Bill Text: IN HB1171 | 2011 | Regular Session | Introduced
Bill Title: Medicaid verification and claims.
Spectrum: Bipartisan Bill
Status: (Passed) 2011-05-16 - Effective 07/01/2011 [HB1171 Detail]
Download: Indiana-2011-HB1171-Introduced.html
Citations Affected: IC 12-15-13.
Synopsis: Diagnostic codes and forms for Medicaid claims. Updates
claims processing forms under the Medicaid program. Requires the
office of Medicaid policy and planning to use the most current forms
for claims that the office processes within 90 days after the effective
date of the new form.
Effective: July 1, 2011.
January 10, 2011, read first time and referred to Committee on Public Health.
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in
Additions: Whenever a new statutory provision is being enacted (or a new constitutional provision adopted), the text of the new provision will appear in this style type. Also, the word NEW will appear in that style type in the introductory clause of each SECTION that adds a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or
A BILL FOR AN ACT to amend the Indiana Code concerning
Medicaid.
(1) CMS-1500 or its subsequent form.
(2) CMS-1450 (UB04) or its subsequent form.
(3) American Dental Association (ADA) claim form.
(4) Pharmacy and compound drug form.
(b) The office and an entity with which the office contracts for the payment of claims:
(1) may designate as acceptable claim forms other than a form listed in subsection (a); and
(2) may not mandate the use of a crossover claim form.
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 7.2. (a) As used in this
section, "provider" has the meaning set forth in IC 27-8-11-1.
(b) Not more than ninety (90) days after the effective date of a
diagnostic or procedure code described in this subsection:
(1) the office shall for all purposes begin using the most current
version of the:
(A) current procedural terminology (CPT);
(B) international classification of diseases (ICD);
(C) American Psychiatric Association's Diagnostic and
Statistical Manual of Mental Disorders (DSM);
(D) current dental terminology (CDT);
(E) Healthcare common procedure coding system (HCPCS);
and
(F) third party administrator (TPA);
codes under which the office pays processes claims for services
provided under the Medicaid program; and
(2) a provider shall begin using the most current version of the:
(A) current procedural terminology (CPT);
(B) international classification of diseases (ICD);
(C) American Psychiatric Association's Diagnostic and
Statistical Manual of Mental Disorders (DSM);
(D) current dental terminology (CDT);
(E) Healthcare common procedure coding system (HCPCS);
and
(F) third party administrator (TPA);
codes under which the provider submits claims for payment for
services provided under the Medicaid program.
(c) If a provider provides services that are covered under the
Medicaid program:
(1) after the effective date of the most current version of a
diagnostic or procedure code described in subsection (b); and
(2) before the office begins using the most current version of the
diagnostic or procedure code;
the office shall reimburse the provider under the version of the
diagnostic or procedure code that was in effect on the date that the
services were provided.
