12-15-23.5-1. “Covered Entity”

Sec. 1. As used in this chapter, “covered entity” has the meaning set forth in 45 CFR 160.103. As added by P.L.187-2007, SEC.3.

12-15-23.5-2. Examination and Recovery of Medicaid Claims

Sec. 2. (a) Before January 1, 2008, the office shall: (1) examine all Medicaid claims paid after January 1, 2001, and before July 1, 2007; (2) determine which claims examined under subdivision (1) were eligible for payment by a third party other than Medicaid; and (3) recover the claims that were determined under subdivision (2) […]

12-15-23.5-3. Coordination of Benefits Procedures

Sec. 3. If at least one percent (1%) of the claims were determined under section 2 of this chapter to be eligible for payment by a third party other than Medicaid, the office shall develop and implement a procedure to improve the coordination of benefits between: (1) the Medicaid program; and (2) any other third […]

12-15-23.5-4. Procedure Requirements

Sec. 4. If a procedure is developed and implemented under section 3 of this chapter, the procedure: (1) must be automated; and (2) must provide a system for determining whether a Medicaid claim is eligible for payment by another third party before the claim is paid under the Medicaid program. As added by P.L.187-2007, SEC.3.