Allows the secretary of family and social services (secretary) to issue a waiver of human services statutory provisions and administrative rules if the secretary determines that the waiver is necessary to claim certain enhanced federal matching funds available to the Medicaid program. Allows the secretary to issue an emergency declaration for purposes of participating in specified authorized federal Supplemental Nutrition Assistance Program (SNAP) emergency allotments. Requires the secretary to prepare and submit any waivers or emergency declarations to the budget committee. Allows the state health commissioner of the state department of health or the commissioner's designated public health authority to issue standing orders, prescriptions, or protocols to administer or dispense certain immunizations for individuals who are at least five years old (current law limits the age for the commissioner's issuance of standing orders, prescriptions, and protocols for individuals who are at least 11 years old).
Sponsored bills
Requires review by the budget committee before a request for proposal for the procurement of a covered population in a risk based managed care program or a capitated managed care program (program) is issued. Sets forth requirements that the office of the secretary (office) must ensure are met before the office may contract with an entity to operate a program. Sets forth provisions that must be included in a contract with an entity to operate the program. Requires the office to do the following: (1) determine all eligibility requirements; and (2) determine the base reimbursement rate structure, methodology, and reimbursement rates that are sufficient to provide an adequate number of providers to provide home and community based services. Requires a managed care organization to contract with any providers that meet specified requirements for the program. Prohibits a managed care organization from delegating or subcontracting specified functions within the program unless certain conditions are met. Requires the office to apply to amend the aged and disabled waiver to ensure that an individual in need of waiver services is authorized for reimbursable services within 72 hours of determining the individual would qualify for Medicaid and the waiver services. Expires the program on July 1, 2027. Requires the office to annually provide the budget committee information concerning the number of Medicaid recipients in certain categories and reimbursement rates for home and community based services. Allows the office of the attorney general to investigate and prosecute complaints concerning employment agencies. Provides that the division of consumer protection is responsible for the investigation of complaints concerning employment agencies.
Honoring the life of Kim Vincent.
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.
A CONCURRENT RESOLUTION congratulating Memphis Lee for receiving the Indianapolis Colts High School Man of the Year Award.
Provides 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 received by the insurer 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 received or estimated to be received by the insurer 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 or estimated to be received by the insurer 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 a process by which a physician or employer may require binding arbitration to determine a reasonable price to purchase a release from a noncompete agreement.
Adds one member representing the Alzheimer's Association, Greater Indiana Chapter, to the Medicaid advisory committee.
Adopts the audiology and speech-language pathology interstate compact. Establishes requirements regarding: (1) speech-language pathology assistants; and (2) the supervision of speech-language pathology support personnel. Requires the speech-language pathology and audiology board to adopt rules not later than June 30, 2023. Makes conforming amendments.
Allows a provider that has entered into a contract with a managed care organization, after exhausting any internal procedures of the managed care organization for provider grievances and appeals, to request an administrative appeal within the office of Medicaid policy and planning of the managed care organization's action in denying or reducing reimbursement for claims for covered services provided to an applicant, pending applicant, conditionally eligible individual, or member. Establishes a procedure for an administrative appeal, including a hearing before an administrative law judge that could be followed by agency review and then by judicial review. Prohibits a provision in a contract between a provider and a managed care organization that would negate or restrict the right of a provider to an administrative appeal and provides that such a contract provision is void and unenforceable. Repeals a provision under which Medicaid law is controlling when Medicaid law conflicts with insurance law. Provides that if the office of the secretary of family and social services or a contractor of the office fails to pay or denies a clean claim for any eligible Medicaid service within certain time limits due to the office or contractor incorrectly processing the clean claim because of errors attributable to the internal system of an insurer or managed care organization, the office or contractor may not assert that the provider failed to meet the timely filing requirements for the claim. Requires the office of the secretary of family and social services (FSSA) to prepare a report that describes every type of report that must be prepared by a Medicaid contractor or managed care entity and submitted to FSSA or the office of Medicaid policy and planning. Specifies the information that must be contained in the report. Requires FSSA to submit the report to the Medicaid advisory committee (advisory committee) and the general assembly. Requires the advisory committee to hold public hearings on the report.