Rep. Donna Schaibley

Allows a municipality to designate a location as an outdoor refreshment area (area) with the approval of the alcohol and tobacco commission (commission). Prohibits an area from being located near a school or church unless the church or school does not object. Provides that if an area is approved, the commission designates retailer permittees (permittees) within the area. Allows a minor to be within the area.

A CONCURRENT RESOLUTION recognizing Wednesday, February 16, 2022, as a day to honor the work and mission of the regions of the American Red Cross serving the state of Indiana.

Specifies that the compliance of a practitioner and a provider facility with federal law meets the good faith estimate requirements concerning health service costs. Allows the commissioner of the department of insurance to issue an order to discontinue a violation of a law (current law specifies orders or rules). Requires a domestic stock insurer to file specified information with the department of insurance. Prohibits a health plan from requiring a health care provider to submit a prior authorization request to a third party and requires the health plan to transmit the request to the third party through secure electronic transmission. Amends the deadline by which a health plan must respond to a nonurgent care prior authorization request. Requires a health plan to offer a health care provider that submitted a prior authorization and received an adverse determination the option to request a peer to peer review by a clinical peer concerning the adverse determination. Requires a health plan to post notice of a technical issue with its claims submission system on the health plan's Internet web site. Requires a health plan to post on its Internet web site not later than February 1 of each year: (1) the 30 most frequently submitted CPT codes in the previous calendar year; and (2) the percentage of the 30 most frequently submitted CPT codes that were approved in the previous calendar year. Establishes an approval process for a health plan's proposed premium rate increase of 5% or greater as compared to the previous calendar year. Prohibits an insurer and a health maintenance organization from altering a CPT code for a claim unless the medical record of the claim has been reviewed by an employee who is a licensed physician. Requires an insurer and a health maintenance organization to provide a contracted provider with a current reimbursement rate schedule: (1) every two years; and (2) when three or more CPT code rates change in a 12 month period. Urges the study by an interim committee of prior authorization exemptions for certain health care providers.

Amends the statute concerning distributed electricity generation as follows: (1) Defines a "public use customer" of an electricity supplier as a customer that is: (A) a school corporation; or (B) a local unit. (2) Provides that an electricity supplier's net metering tariff must be made and remain available to customers until the earlier of: (A) January 1 of the first calendar year after the calendar year in which the aggregate amount of net metering facility nameplate capacity under the electricity supplier's net metering tariff equals at least 3% (versus 1.5% under current law) of the electricity supplier's most recent summer peak load; or (B) July 1, 2025 (versus July 1, 2022, under current law). (3) Provides that before July 1, 2022, an electricity supplier shall amend its net metering tariff, or file a new net metering tariff with the utility regulatory commission (IURC), to do the following: (A) Establish as the allowed limit on the aggregate amount of net metering facility nameplate capacity under the tariff an amount equal to at least 3% of the electricity supplier's most recent summer peak load. (B) Allow a public use customer that: (i) operates a net metering facility on a premises that the public use customer owns or controls before the installation of the net metering facility; and (ii) is billed by the electricity supplier for electricity measured at more than one meter; to choose to be billed or credited for the difference between the kilowatt hours delivered by the electricity supplier as measured by any one or more of those meters, not to exceed three, and the kilowatt hours generated and delivered to the electricity supplier by the net metering facility. (4) Provides that before July 1, 2022, the IURC shall make similar amendments to its net metering rules. (5) Specifies that any repairs, updates, or upgrades to portions of a net metering facility that do not increase the nameplate capacity of the net metering facility are not considered a replacement of the net metering facility for purposes of certain provisions providing for the extended availability of an electricity supplier's net metering tariff for customers that install a net metering facility before certain specified deadlines. (6) Specifies that net metering customers must comply with certain safety, performance, and reliability standards with which customers that produce distributed generation must comply. (7) Specifies that a net metering customer has certain rights regarding the installation and ownership of a net metering facility that a customer that produces distributed generation has with respect to the installation and ownership of distributed generation equipment. (8) Adds a noncode provision staying the implementation of a rate or tariff for the procurement of excess distributed generation for which an electricity supplier has applied or received approval from the IURC under current law, until such time as the conditions for the expiration of the electricity supplier's net metering tariff, as set forth in the bill, apply to the electricity supplier.

Requires a nonprofit hospital with more than 100 beds to report annually specified financial information to the state department of health. Requires a nonprofit hospital and a health carrier to post and send certain information at least 45 days before a public forum. Modifies requirements concerning the: (1) date on which the public forum must be held; (2) topics that must be discussed at a public forum; (3) submission of questions and feedback at a public forum; and (4) use of technology to allow attendance through real time audio and video through the Internet. Requires the insurance commissioner to report to the legislative council if the federal Transparency in Health Coverage rule (federal rule) is repealed or enforcement is stopped. Requires health payers to continue to post pricing information in compliance with the federal rule after the federal rule is repealed or stopped. Modifies the definition of "health payer" for purposes of the all payer claims data base.

Provides that a juvenile court in a child in need of services (CHINS) proceeding: (1) may extend the time to complete the required factfinding hearing: (A) for good cause shown; and (B) if the court determines that the extension is in the child's best interests; (2) may (rather than shall, under current law) dismiss a CHINS case without prejudice if the factfinding hearing is not held before the statutorily required deadline; (3) may not enter a dispositional decree approving or ordering placement of a child in another home if an: (A) individual who resides in the home; or (B) individual with whom a person residing in the home is engaged in a dating relationship or other ongoing, nonfamilial relationship (household member); has committed one or more specified offenses; and (4) may not approve a permanency plan under which the child would be placed: (A) with the child's parent, guardian, or custodian; or (B) with an adoptive parent; if a person who is currently residing in the home in which the child would reside has committed an act resulting in a substantiated report of child abuse or neglect or has committed one or more specified offenses. Provides that before reunifying a child with the child's parent, guardian, or custodian, the department of child services (department) shall (rather than may, under current law): (1) conduct a criminal history check of: (A) the parent, guardian, or custodian; and (B) a household member of the parent, guardian, or custodian; and (2) consider the results of the criminal history check in deciding whether it is safe for the child to return home. Provides that if the circumstances that prompted the removal of a child from the home of the child's parent, guardian, or custodian included danger to the child's physical or mental health or safety related to the use of alcohol or a controlled substance by the parent, guardian, or custodian, or by a household member of the parent, guardian, or custodian, the department may require as a condition of reunification of the child with the parent, guardian, or custodian that the parent, guardian, custodian, or household member: (1) successfully complete a substance abuse treatment program; and (2) submit to periodic, random testing for alcohol or controlled substances. Amends and adds to the conditions under which reasonable efforts to reunify a child with the child's parent, guardian, or custodian, or preserve a child's family, are not required. Provides that if a hearing regarding a petition to terminate the parent-child relationship is not held before the statutorily required deadline: (1) upon filing of a motion with the court by a party to the proceeding; and (2) absent good cause shown for the failure to hold the hearing before the statutorily required deadline; the court shall dismiss the petition without prejudice.

Requires an insurer to report aggregate information regarding certain health indicators of its covered individuals in Indiana to the department of insurance on an annual basis. Requires the department of insurance to publish the information on its Internet web site. Requires an insurer to provide its covered individuals and prospective covered individuals with notice of the published information. Requires an insurer to provide a self-funded health plan with the opportunity to include its information as part of the insurer's reported aggregate information.

Changes: (1) the dates on which a county or municipal ordinance may limit or prohibit the use of fireworks in the county or municipality; and (2) the types of fireworks to which such an ordinance may apply.

Requires certain businesses to post a notice with human trafficking hotline information in each public restroom of the business and in a conspicuous place near the public entrance or in another conspicuous location of the business in clear view of the public and employees where similar notices are customarily posted. Provides that a business owner who fails to comply with the human trafficking hotline notice requirement commits a Class C misdemeanor. Requires the Indiana criminal justice institute to administer the human trafficking hotline notice requirement. Requires every governmental entity, on the home page of its web site, to provide an identified hyperlink to the model human trafficking hotline notice that is on the Indiana criminal justice institute's web site. Provides that when a person seeking treatment as a victim arrives at an examination facility, the provider shall comply with certain requirements prior to commencing a forensic medical examination.

Provides that when a health plan makes an adverse determination in response to a health care provider's request for prior authorization of a health care service: (1) the health plan is required to provide the health care provider with an opportunity to have a peer to peer conversation with a clinical peer concerning the adverse determination; and (2) the peer to peer conversation opportunity must be provided not more than seven business days after the health plan receives the health care provider's request for the peer to peer conversation. Provides that after December 31, 2023: (1) if a health plan, during a six month evaluation period, approves at least 90% of a health care provider's requests for prior authorization for a particular type of health care service, the health plan may not require the health care provider to obtain prior authorization for that type of health care service for the entire duration of an exemption period of six calendar months immediately following the evaluation period; and (2) at the conclusion of the initial exemption period, the health plan shall continue a health care provider's exemption for consecutive periods of six months unless the health plan rescinds the health care provider's exemption; (3) a health plan's rescission of a health care provider's exemption must be based on: (A) a determination by a physician that, in cases randomly selected for review, less than 90% of the health care services provided by the health care provider met the health plan's medical necessity criteria; or (B) the health care provider committing health care provider fraud or the health care provider's license or legal authorization to provide health care services being suspended or revoked; (4) a health care provider whose exemption is rescinded may initiate a review of the rescission by an independent review panel; (5) the independent review panel is required to determine: (A) whether at least 90% of the health care services provided by the health care provider met the health plan's medical necessity criteria; or (B) whether the health care provider committed health care provider fraud or the health care provider's license or legal authorization to provide health care services is suspended or revoked; (6) the health plan is required to restore the health care provider's exemption if the independent review panel's determination is in favor of the health care provider; and (7) if a health care provider whose exemption is rescinded does not initiate a review or if the independent review panel's determination is not in favor of the health care provider, the health plan is not required to determine again whether the health care provider is entitled to an exemption until the first evaluation period beginning at least two years later. Requires the insurance commissioner to adopt rules.