405 IAC 5-34-11
405 IAC 5-34-11 Prior authorization for nonhospice services
Cite as Ind. Admin. Code tit. 405, r. 5-34-11
Sec. 11. (a) Except as provided in subsection (b), prior authorization is required for any Medicaid-covered service not related to the hospice
member's terminal condition if prior authorization is otherwise required under this article.
(b) Notwithstanding any other provision of this article, prior authorization is not required for the following services when provided to
hospice patients:
(1) Pharmacy services, for conditions not related to the patient's terminal condition. Pharmacy services related to the patient's terminal
condition do not require prior authorization because they are included in the hospice per diem.
(2) Dental services.
(3) Vision care services.