Sec. 6. (a) Subject to subsection (b), a recovery audit shall not require documentation, at the time of service, for services provided by a community mental health center (as defined in IC 12-7-2-38 ) when the documentation is part of an ongoing plan of treatment or a documentation of specific treatment methods. (b) The direct service provider shall complete documentation described in subsection (a) within a reasonable time frame, but not later than thirty (30) days from the date of service, prior to Medicaid billing. (c) Any supervising provider in a community mental health center is eligible to review documentation in order to certify a plan of treatment or review specific treatment methods at intervals not greater than ninety (90) days. (d) A supervising provider described in subsection (c) may review the documentation described in subsection (c) regardless of: (1) whether the supervising provider is providing direct supervision; and (2) the location where the service was provided. A review described under this subsection must be documented by the signature of the supervising provider. (e) In developing a plan of treatment, the following must be completed to demonstrate active treatment with a client: (1) A signed client consent form. (2) The completion of a list of requirements concerning audit compliance, as determined by the division in collaboration with community mental health centers, that verifies active participation in the development of the client's plan of treatment. (3) Either: (A) the signature of the client on the client's plan of treatment; or (B) if the direct care provider, after a good faith effort, is unable to obtain the client's signature on the client's plan of treatment: (i) the provision of documentation by the provider of the reasons the provider was unable to obtain the signature; (ii) the continuation of attempting to obtain the client's signature on the client's plan of treatment; and (iii) a determination by the division, based on the documentation in item (i), that the direct care provider has made a good faith effort to obtain the signature. IC 12-15-13.6 Chapter 13.6. Audit of Prescription Drug Cost Sharing 12-15-13.6-1 Audit of Medicaid prescription drug cost sharing; request for proposal 12-15-13.6-2 Look back period 12-15-13.6-3 Audit requirements 12-15-13.6-4 Audit results
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