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The facility is responsible for the completion and submission of the prior authorization request to the appropriate reviewing authority. State facilities submit the PA request to the IHCP office; privately owned facilities submit the PA request to the appropriate prior authorization contractor based on the program assignment of the member. If a prior authorization request is disapproved for inpatient psychiatric hospital and psychiatric residential treatment facility services individuals described in 2422.10.05 may still be eligible for all other Medicaid services, while residing in the psychiatric facility, provided that all other financial and non-financial eligibility criteria are met.

2422.10.15 PERSONS AGED 65 AND OLDER/INPATIENT PSYCHIATRIC CARE For applicants/recipients aged sixty-five and older who are admitted to Medicaid certified psychiatric facilities, the procedures explained above are applicable except that a disapproved Form 1261A does not render the person ineligible for Medicaid. Disapproval indicated on screen Living Arrangement/Domicile-Details page means that Medicaid will not provide reimbursement to the facility for inpatient psychiatric services. If the recipient remains in the facility, community budgeting is to be used. Refer to Section 2422.10.10.

2424.00.00 LEVEL OF CARE/PREADMISSION SCREENING A Medicaid applicant/recipient who enters a nursing facility, Intermediate Care Facilities for the Mentally Retarded (ICF/IID), or Community Residential/Developmentally Disabled (CRF/DD) must first undergo preadmission screening to determine whether the individual requires the level of care provided by a nursing facility or is entitled to reimbursement on his behalf in an ICF/IID or CRF/DD. When completing Facility-Details Page, the caseworker will assume preadmission screening/level of care is approved unless there is information to the contrary. The preadmission screening field should be completed by entering "S" - screened, followed by the date that the individual entered the nursing facility. (The date that the preadmission screening was completed may be used if it is known.) The caseworker may then proceed with the eligibility determination, including authorization if the individual passes eligibility.

If preadmission screening and/or level of care is denied for the individual, the DFR will receive a Form 450B, Physician's Certification for Long Term Care Services, which indicates a denial. The worker should monitor the Forms 450B that are received by the DFR. When a denial is received, the worker should change the preadmission screening field on –Facility-Details Page. The