Requires the state employee health plan, policies of accident and sickness insurance, and health maintenance organization contracts to provide coverage for wearable cardioverter defibrillators. Specifies requirements for credentialing a provider for the Medicaid program, an accident and sickness insurance policy, and a health maintenance organization contract. Establishes a provisional credential until a decision is made on a provider's credentialing application and allows for retroactive reimbursement. Provides that a hospital's quality assessment and improvement program must include a process for determining and reporting the occurrence of serious reportable events. Provides that the medical staff of a hospital may make recommendations on the granting of clinical privileges and the appointment or reappointment of an applicant to the governing board for a period not to exceed 36 months. Requires a hospital with an emergency department to have at least one physician on site and on duty who is responsible for the emergency department. Requires the legislative services agency to conduct an analysis of licensing fees and provide a report to the budget committee. Allows the commissioner of the department of insurance (commissioner) to issue an order to discontinue a violation of a law (current law specifies orders or rules). Requires the commissioner to consider specified information before approving or disapproving a premium rate increase. Requires a domestic stock insurer to file specified information with the department of insurance. Prohibits the state employee health plan from requiring prior authorization for certain specified services. Changes prior authorization time requirements for urgent care situations. Adds an employee benefit plan that is subject to the federal Employee Retirement Income Security Act of 1974 and a state employee health plan to the definition of "health payer" for the purposes of the all payer claims data base (data base). Allows the department of insurance to adopt rules on certain matters concerning the data base. Requires a health plan to post certain information on the health plan's website. Prohibits an insurer and a health maintenance organization from altering a CPT code for a claim or paying for a CPT code of lesser monetary value unless: (1) the CPT code submitted is not in accordance with certain guidelines and rules, or the terms and conditions of a participating provider's agreement or contract with the insurer or health maintenance organization; or (2) the medical record of the claim has been reviewed by an employee or contractor of the insurer or health maintenance organization. Requires an insurer and a health maintenance organization to provide a contracted provider with a current reimbursement rate schedule at specified times. Urges the study by an interim committee of: (1) prior authorization exemptions for certain health care providers; and (2) whether Indiana should adopt an interstate mobility of occupational licensing. Requires a collaborating physician or physician designee to review certain patient encounters performed by a physician assistant within 14 business days. Requires a health plan to offer a health care provider the option to request a peer to peer review by a clinical peer concerning an adverse determination on a prior authorization request.
Sponsored bills
Provides that beginning July 1, 2023, a primary care physician and an employer may not enter into a noncompete agreement. Provides that beginning July 1, 2023, a physician noncompete agreement is not enforceable if any of the following circumstances occur: (1) The employer terminates the physician's employment without cause. (2) The physician terminates the physician's employment for cause. (3) The physician's employment contract has expired and the physician and employer have fulfilled the obligations of the contract. Specifies a process by which a physician or employer may pursue mediation to determine a reasonable price to purchase a release from a noncompete agreement.
Defines "core public health services" for purposes of public health laws. Adds members to the executive board of the Indiana department of health (state department). Removes a provision allowing the state department to establish branch offices. Provides that the state department may provide services to local health departments. Requires each local board of health to establish a local public health services fund to receive state funding. Provides a method of allocation of state funding to local boards of health, subject to state appropriations. Specifies the percentage of how additional funding may be expended on core public health services. Allows the local health department to enter into contracts or approve grants for core public health services. Allows the state department to issue guidance to local health departments. Requires the state department to make annual local health department reports available to the public. Changes the qualification requirements for a local health officer and requires certain training. Requires the state department to identify state level metrics and county level metrics and requires certain local health departments to report to the state department activities and metrics on the delivery of core public health services. Requires the state department to annually report on the metrics to the budget committee and publish information concerning the metrics on the Internet. Requires that a local health department post a position or contract for the provision or administration of core public health services for at least 30 days. Requires a local health department to provide certain education before administering a vaccine. Requires a multiple county health department to maintain at least one physical office in each represented county. Provides that a new city health department cannot be created after December 31, 2022, but allows current city health departments to continue to operate. Creates the Indiana trauma care commission. Allows a school corporation that cannot obtain an ophthalmologist or optometrist to perform the modified clinical technique vision test to conduct certain specified vision screenings. Requires the school to send to the parent of a student any recommendation for further testing by the vision screener. Allows for standing orders to be used for emergency stock medication in schools. Allows the state health commissioner or designee to issue a statewide standing order, prescription, or protocol for emergency stock medication for schools. Removes the distance requirement for an access practice dentist to provide communication with a dental hygienist. Repeals provisions concerning the Indiana local health department trust account.
Repeals the requirement that local floodplain administrators use the "best floodplain mapping data" as provided by the department of natural resources (department) and located on the Indiana Floodplain Information Portal when reviewing an application for a permit to authorize construction in or near a floodplain. Provides that, after June 30, 2023, a county or municipality may not issue a permit for construction activity in or near a floodplain unless the permit applicant is allowed to elect whether the local floodplain administrator will use: (1) the department's "best floodplain mapping data"; or (2) an engineering study provided by the permit applicant; in reviewing the permit application. Prohibits a local floodplain administrator from issuing a permit authorizing a structure or construction activity in or near a floodplain if the issuance of the permit will violate National Flood Insurance Program requirements. Provides that, after June 30, 2025, an individual may not serve as the floodplain administrator of a county or municipality unless the individual has successfully completed: (1) the Certified Floodplain Manager program of the Association of State Floodplain Managers; or (2) another course or training program for local floodplain managers that is approved by the Federal Emergency Management Agency or the department. Provides that a person that has: (1) an ownership interest; (2) a leasehold interest; or (3) a security interest; in a parcel of real property may at any time request a review by the department of the department's "best floodplain mapping data" that applies to the parcel of real property. Requires the department to conduct the review at no cost to the person requesting the review and to use a detailed hydrologic modeling method in conducting the review. Provides that: (1) if the person requesting the review has applied to a local floodplain administrator for a permit authorizing the construction of a structure or other construction activity on the parcel of real property; and (2) the department does not complete the review within 120 days after the review was requested; the person may elect whether the local floodplain administrator, in reviewing the person's permit application, will use the department's "best floodplain mapping data" or an engineering study provided by the person. Provides that, in the disclosure form that is adopted by the Indiana real estate commission and that must be submitted to a prospective buyer of real estate before the prospective buyer's offer is accepted, the owner of real estate must disclose the fact that all or a portion of the owner's real estate is located within a community's floodplain boundaries, as indicated in a Federal Emergency Management Agency Flood Insurance Rate Map, if the owner has personal knowledge of that fact.
Provides (beginning January 1, 2024) that the office of Medicaid policy and planning may not require: (1) a provider that is licensed, certified, registered, or authorized with the appropriate state agency or board and exclusively offers telehealth services to maintain a physical address or site in Indiana to be eligible for enrollment as a Medicaid provider; or (2) a telehealth provider group with providers that are licensed, certified, registered, or authorized with the appropriate state agency or board to have an in-state service address to be eligible to enroll as a Medicaid vendor or Medicaid provider group.
Requires a pharmacy benefit manager to provide a report to the department of insurance at least every six months. Provides that the report must include the: (1) overall aggregate amount charged to a health plan for all pharmaceutical claims processed by the pharmacy benefit manager; and (2) overall aggregate amount paid to pharmacies for claims processed by the pharmacy benefit manager. Requires that, for individual health insurance coverage, the defined cost sharing for a prescription drug be calculated at the point of sale and based on a price that is reduced by an amount equal to at least 85% of all rebates in connection with the dispensing or administration of the prescription drug. Requires that, for group health insurance coverage, an insurer: (1) pass through to a plan sponsor 100% of all rebates concerning the dispensing or administration of prescription drugs to the covered individuals of the plan sponsor; (2) provide a plan sponsor, at the time of contracting, the option of calculating defined cost sharing for covered individuals of the plan sponsor at the point of sale based on a price that is reduced by some or all of the rebates received concerning the dispensing or administration of the prescription drug; and (3) disclose specified information to the plan sponsor. Allows the department of insurance to enforce the provisions and impose a civil penalty.
Specifies certain entities, actions taken, or factors considered to which the ESG commitment provisions do not apply. Provides that if the treasurer of state concludes that the service provider has made an ESG commitment, the treasurer of state shall provide the name of the service provider and research supporting the conclusion to the board of trustees of the Indiana public retirement system (board). Prohibits the board from making an investment decision with the purpose of influencing any social or environmental policy or attempting to influence the governance of any corporation for nonfinancial purposes. Prohibits the Indiana public retirement system (system) from making an ESG commitment with respect to system assets. Provides that in making and supervising investments of the system, the board shall discharge its duties solely in the financial interest of the participants and beneficiaries of the system for the exclusive purposes of providing financial benefits to participants and beneficiaries and defraying reasonable expenses of administering the system. Provides that the board, in accordance with certain fiduciary duties, shall make investment decisions with the primary purpose of maximizing the target rate of return on the board's investments. Prohibits the board from entering a contract or modifying, amending, or continuing a contract with a service provider that has made an ESG commitment unless taking the action violates the board's fiduciary duty to the system's participants and beneficiaries. Requires the board to continue contracting with a service provider that has made an ESG commitment if the board determines that there is not a comparable service provider to replace the service provider. Requires the board to, at least annually, tabulate and report all proxy votes made by a service provider that is not a private market fund in relation to the administration of the system. Specifies certain persons and entities that are immune from civil liability and entitled to indemnification. Requires the board to: (1) ensure that reasonable efforts are made during the due diligence process before an investment is made and in monitoring investments in the public employees' defined contribution plan, an annuity savings account for the public employees' retirement fund or the Indiana state teachers' retirement fund, the teachers' defined contribution plan, the legislators' defined contribution plan, and a private market fund to determine whether any investments would violate the requirement that the board discharge its duties solely in the financial interest of the participants and beneficiaries of the system; and (2) take appropriate action, if necessary, consistent with the board's fiduciary duties. Defines terms and makes conforming amendments.
Establishes the prescription drug donation repository program (program). Establishes a fee on each person who is issued a license, registration, or certificate by a health profession board for the program. Allows a person to donate prescription drugs and supplies to a central repository or local repository for use by an individual who is an eligible recipient. Excludes abortion inducing drugs and controlled substances from the program. Allows an eligible entity to apply to participate as a local repository in the program. Establishes criteria for the acceptance and distribution of donated prescription drugs and supplies. Sets a maximum handling fee that may be charged for the dispensing of a prescription drug or supplies under the program. Allows an entity that participates in a drug donation repository or program in another state to participate in the program in Indiana if that state's program allows for donations to repositories located in Indiana. Establishes immunity for certain persons under the program.
Allows a long acting reversible contraceptive that is prescribed to and obtained for a Medicaid recipient to be transferred to another Medicaid recipient if certain requirements are met.
Requires the housing and community development authority to: (1) assess the feasibility of the development of new assisted living communities for low and middle income individuals; and (2) determine possible funding for the assisted living communities; and submit a report to the legislative services agency. Requires the office of the secretary of family and social services (office) to contract with more than one entity to provide functional eligibility determinations for individuals applying for the aged and disabled Medicaid waiver. Requires the office to report to the budget committee and legislative council certain information concerning: (1) the average length of time to conduct function eligibility assessments; and (2) a plan to provide functional eligibility not later than 72 hours from the eligibility assessment. Removes the requirement that the transfer of comprehensive care beds in a health facility must equalize the number of certified Medicaid beds in the county. Allows a health facility that transfers comprehensive care beds to reduce the facility's count of licensed comprehensive care beds by the number of beds transferred. Allows the receiving facility to increase the: (1) count of licensed comprehensive care beds; and (2) number of beds that are Medicaid certified. Requires the office to reimburse the provider of assisted living services if an increase in the level of services for a recipient is approved by the office. Specifies that integrated health care coordination and transportation are assisted living services. Prohibits the office from reducing the scope of services that may be provided by an assisted living services provider under the Medicaid aged and disabled waiver, as in effect on July 1, 2021. Specifies provisions that must be included in a risk based managed care program or capitated managed care program for specified Medicaid recipients. Requires the Indiana department of health (state department) to establish and administer the registration of a temporary health care service agency. Repeals current laws concerning the regulation of employment services. Removes references to a residential care facility administrator as a separate classification of license. Sets forth requirements for health facility administrators, residential care facility administrators, administrators in training, preceptors, and student interns. Sets forth notification requirements to the state department upon a vacancy or new hire of a residential care administrator. Makes conforming changes.