Authorizes the office of the secretary of family and social services to implement a risk based managed care program for certain Medicaid recipients. Requires the office of Medicaid policy and planning to convene a workgroup and, with managed care organizations, to conduct a claims submission testing period before the risk based managed care program is established.~ Provides that, during the first 210 days after the risk based managed care program is implemented, a provider that experiences a financial emergency due to claims payment issues shall receive temporary emergency assistance from the managed care organizations with which the provider is contracted. Amends statutes concerning Medicaid provider agreements, health insurance reimbursement agreements, and Medicare supplement insurance to specify that a 15 day period consists of 15 business days. Requires the Indiana department of health to grant a hospital an extension of time to file the hospital's fiscal report if the hospital shows good cause for the extension. Removes an expired provision concerning hospital fiscal reports. Eliminates the requirement that a provider who is licensed in Indiana, physically located outside Indiana, but providing telehealth services to patients who are in Indiana, file a certification constituting a waiver of jurisdiction. Makes a number of changes in the law concerning health facility administrators, including eliminating the requirement that a health facility administrator display the individual's license in a prominent location in the individual's principal office and providing that a particular course of study for administrators in training is not mandatory. Specifies: (1) the manner in which certain nurse applicants may demonstrate English proficiency; (2) that a graduate of a foreign nursing school must pass a specified examination; and (3) additional credentialing verification assessment organizations for certain nurse applicants. Prohibits a third party administrator or another person from arranging for a dental provider to provide dental services for a dental plan that sets the amount of the fee for any dental services unless the dental services are covered services under the dental plan. Provides that a contracting entity (a dental carrier, a third party administrator, or another person that enters into a provider network contract with providers of dental services) may not grant a third party access to the provider network contract or to dental services or contractual discounts provided pursuant to the provider network contract unless certain conditions are satisfied. Provides that when a dental provider network contract is entered into, renewed, or materially modified, any provider that is a party to the network contract must be allowed to choose not to participate in the third party access. Prohibits a contracting entity from: (1) altering the rights or status under a provider network contract of a dental provider that chooses not to participate in third party access; or (2) rejecting a provider as a party to a provider network contract because the provider chose not to participate in third party access. Authorizes the insurance commissioner to issue a cease and desist order against a person that violates any of these prohibitions and, if the person violates the cease and desist order, to impose a civil penalty upon the person and suspend or revoke the person's certificate of authority. Provides that if a covered individual assigns the covered individual's rights to benefits for dental services to the provider of the dental services, the dental carrier shall pay the benefits assigned by the covered individual to the provider of the dental services. However, prohibits the provider from billing the covered individual (except for a copayment, coinsurance, or a deductible amount) if the provider is in the dental carrier's network. Requires the Indiana state board of nursing to amend a specified administrative rule to conform with this act. Requires the medical licensing board to study certain rules concerning office based setting accreditations and report to the general assembly.
Sponsored bills
Specifies that, for purposes of the statute concerning the replacement of customer owned lead service lines by water utilities, a municipally owned utility includes a utility company owned, operated, or held in trust by a consolidated city. Provides that the following apply with respect to the owner of a building, structure, or dwelling, other than a multi-family residential property that contains more than four dwelling units, that is served by a customer owned lead service line within or connected to a water utility's system: (1) That upon request by the water utility, the owner shall replace, or cause to be replaced, the customer owned portion of the lead service line by: (A) enrolling in the water utility's lead service line replacement program; or (B) replacing the customer owned portion of the lead service line through the owner's own agents or contractors and at the owner's own expense. (2) That if the owner: (A) does not enroll in the water utility's lead service line replacement program; (B) does not replace the customer owned portion of the lead service line; or (C) fails to communicate with the water utility regarding the replacement; the water utility or the water utility's agent may enter the property to replace the customer owned portion of the lead service line. (3) That the: (A) water utility; and (B) occupant of the property, if the property is occupied by a person other than the owner; are not liable to the owner with respect to any replacement made under these provisions. (4) That if a water utility attempts to avail itself of the remedies set forth in these provisions and is prevented from doing so by the owner of the property, the water utility may, in accordance with state law, disconnect water service to the owner's property. Provides that the following apply with respect to the owner of a multi-family residential property that contains more than four dwelling units: (1) That the owner may elect to participate in the water utility's lead service line replacement program. (2) That the owner must communicate to the water utility the owner's election to participate not later than 45 days after receiving the water utility's request. (3) That if the owner does not communicate the owner's election to participate within this 45 day period, the owner, or any future owner of the property, is responsible for replacing the customer owned portion of the lead service line through the owner's own agents or contractors and at the owner's own expense. Provides that in the case of a: (1) building; (2) structure; or (3) dwelling; that a water utility has determined to be abandoned or unserviceable, the water utility may disconnect water service to the property and require the owner, or any future owner, of the property to install a new service line. Provides that these provisions may be incorporated, without the need for further approval by the Indiana utility regulatory commission (IURC), into a water utility's lead service line replacement plan that has been previously approved by the IURC.
Requires a health plan (which includes a policy of accident and sickness insurance, a health maintenance organization contract, the Medicaid risk based managed care program, and a state employee health plan) to provide coverage for biomarker testing for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee's disease or condition when biomarker testing is supported by medical and scientific evidence. Requires the office of Medicaid policy and planning to provide biomarker testing as a Medicaid program service, and to apply to the United States Department of Health and Human Services for approval of any waiver necessary under the federal Medicaid program for the purpose of providing biomarker testing. Provides that coverage is not required for biomarker testing for screening purposes. Provides that if a prior authorization requirement applies to biomarker testing, the health plan or a third party acting on behalf of the health plan must: (1) approve or deny a request for prior authorization; and (2) notify the covered individual of the approval or denial; in not more than five business days in the case of a nonurgent request or in not more than 48 hours in the case of an urgent request. Requires the office of the secretary of family and social services to report certain information to the budget committee on Medicaid reimbursement rates provided for biomarker testing.
Recognizing the 100th anniversary of the establishment of diplomatic relations between the United States of America and Ireland.
A CONCURRENT RESOLUTION opposing and condemning assisted suicide.
A CONCURRENT RESOLUTION opposing and condemning assisted suicide.
A CONCURRENT RESOLUTION urging the Indiana Department of Transportation to rename that portion of State Road 32 from County Road 900 West to State Road 1 the "Kyle Osgood Memorial Mile".
A CONCURRENT RESOLUTION urging the Indiana Department of Transportation to rename that portion of State Road 32 from County Road 900 West to State Road 1 the "Kyle Osgood Memorial Mile".
Specifies that coverage of breast cancer rehabilitative services and reconstructive surgery incident to a mastectomy includes chest wall reconstruction and aesthetic flat closure. Requires a facility performing a mammography examination to provide: (1) an assessment of the patient's breast tissue density using specified classifications; (2) written notice to the patient and the referring provider; and (3) concerning the notice to the patient, specified notification language depending on whether the facility determined the patient to have dense breast tissue or not dense breast tissue. Requires the medical licensing board of Indiana to amend an administrative code rule to remove references to "high breast density" and to align with the breast tissue density classifications in this act.
A CONCURRENT RESOLUTION celebrating the 100th year anniversary of Riley Children's Health at Indiana University Health.