Rep. Rita Fleming

Creates a direct liquor seller's permit with an annual permit fee of $500 for a liquor manufacturer that wants to sell and ship liquor directly to Indiana consumers. Provides that a person that sells and ships liquor directly to a consumer without a direct liquor seller's permit commits: (1) a Class A infraction for the first violation; (2) a Class A misdemeanor for a second violation that is done knowingly and within 10 years of the first infraction or conviction; and (3) a Level 6 felony for a third or subsequent violation that is done knowingly and within 10 years of the first two infractions or convictions.

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.

Requires a health care provider who provides telehealth services to obtain written health care consent for the provision of telehealth services. Requires a prescriber who provides telehealth services to a patient to conduct certain components of a physical examination and document the results in the patient's medical record. Allows a prescriber to issue a prescription for a controlled substance to a patient: (1) who is receiving services through the use of telehealth; and (2) who has been previously examined by the prescriber in person. Creates an exception by allowing a prescriber who specializes in psychiatry to issue a prescription for a controlled substance to a patient who is receiving psychiatric services through the use of telehealth.

Provides that, beginning January 1, 2023, a practitioner holding a license issued by the board of chiropractic examiners, the state board of dentistry, the state board of health facility administrators, the medical licensing board, the state board of nursing, the optometry board, the board of pharmacy, the board of podiatric medicine, the speech-language pathology and audiology board, the state psychology board, the board of physical therapy, the respiratory care committee, the occupational therapy committee, the behavioral health and human services licensing board, the physician assistant committee, or the athletic trainers board is subject to disciplinary sanctions if the practitioner: (1) communicates or disseminates to the general public an advertisement that includes deceptive or misleading information or does not prominently state the type of license held by the practitioner; or (2) fails, while providing direct patient care, to wear an identification badge that clearly sets forth the practitioner's first and last name, type of license, and, if applicable, status as a student, intern, trainee, or resident. Establishes certain exceptions. Provides, for purposes of the law prohibiting the unlawful practice of medicine or osteopathic medicine, that "the practice of medicine or osteopathic medicine" includes attaching to an individual's name the words "anesthesiologist", "cardiologist", "dermatologist", or other specified words that identify a member of a medical specialty.

Requires the office of the secretary of family and social services (office) to apply for a Medicaid state plan amendment or Medicaid waiver for the following: (1) Reimbursement of Medicaid rehabilitation option services for a Medicaid eligible recipient who is undertaking an initial assessment, intake, or counseling in a community mental health center. (2) Reimbursement for Medicaid rehabilitation option services concurrently with reimbursement under the residential addiction treatment program. Requires a community mental health center to commence a plan of treatment within two weeks for a Medicaid recipient who receives services after the office has amended the state plan. Specifies that for purposes of a community mental health center, telehealth services satisfy any face to face meeting requirement between a clinician and consumer. Requires at least two members of the division of mental health and addiction planning and advisory council to be community mental health center chief executive officers or designees. Specifies that the division of mental health and addiction (division) has primary oversight over suicide prevention and crisis services activities and coordination and designation of the 9-8-8 crisis hotline centers. Sets forth requirements to be designated as a 9-8-8 crisis hotline center. Establishes the statewide 9-8-8 trust fund. Allows advanced practice registered nurses and physician assistants to perform certain duties that are performed by a physician under the home health agencies laws. Allows a nonprofit association of cities and towns to participate in the state aggregate prescription drug purchasing program. Requires a public school that issues, after June 30, 2022, a student identification card to a student in grade 6, 7, 8, 9, 10, 11, or 12 to include on the student identification card the 9-8-8 crisis hotline and other crisis hotline phone numbers. Delays the requirement that a prescription for a controlled substance be in an electronic format until January 1, 2022. Allows for an exemption from the requirement of issuing a controlled substance prescription in an electronic format if the dispensing pharmacy or provider is unable to receive or process an electronically transmitted prescription. Requires certain rules adopted by the Indiana board of pharmacy (board) to be substantially similar to certain federal regulations. Adds behavior analysts to the definition of "practitioner" for purposes of the telehealth laws. Amends the definition of "telehealth". Amends the required graduate level courses and clinical experience that an applicant is required to obtain for a license as a clinical addiction counselor. Allows a pharmacist and pharmacy technician to administer an immunization for coronavirus disease. Allows a registered nurse to provide for the direct supervision of a pharmacist intern or pharmacist student who administers an immunization. Changes references of the "pharmacist in charge" to the "pharmacist on duty". Allows a pharmacist to supervise eight pharmacy interns. Allows a pharmacy technician to work remotely to perform specified responsibilities. Provides that the board shall hold the pharmacy permit holder accountable, rather than the qualifying pharmacy, for staffing violations if the qualifying pharmacist does not have the authority to make staffing determinations. Specifies that a transfer of a prescription includes a schedule II controlled substance. Removes the requirement that a pharmacist provide a patient with a written advance beneficiary notice that states that the patient may not be eligible for reimbursement for the device or supply. Changes remote dispensing facility requirements concerning location of the facility. Changes how long a remote dispensing facility must retain a surveillance recording from 45 days to 30 days. Removes specified physical requirements that a video monitor being used by the remote facility must meet. Adds therapeutic substitution to the definition of "protocol" for purposes of drug regimen adjustments and defines "therapeutic alternative" and specifies use of therapeutic alternative requirements for protocols. Removes a requirement for drug protocols concerning availability of medical records. Allows for physician assistants and advanced practice registered nurses to make referrals to pharmacists. Removes the requirement that the executive director of the Indiana professional licensing agency provide advice and consent before a majority of the members of the physical therapist committee may call a meeting. Requires the medical licensing board to adopt rules before January 1, 2022, that are required under the laws concerning physician assistants. Adds any plan or program that provides payment, reimbursement, or indemnification for the cost of prescription drugs to the definition of a "health plan". Adds two members to the justice reinvestment advisory council.

Replaces statutory references to "dangerous communicable disease" with "serious communicable disease". Replaces statutory references to "carrier" with "individual with a communicable disease". Makes conforming amendments.

Provides that the state department of health (department) may officially be known as the Indiana department of health. Removes by July 1, 2022, appeals panels from the appeals process of department orders. Provides that the executive board or the department's designee may act as the ultimate authority for department matters under the administrative and procedures laws. Provides that the state health commissioner (commissioner) is the appointing authority and director of the department. Provides that any physicians employed by the department are governed by the state ethics commission's conflict of interest requirements. Allows the commissioner to designate in writing employees in the department who are licensed as a physician and may engage in the practice of medicine outside of their official duties. Provides that the state is not liable for any act performed by a physician employed by the department for any medical care provided to a patient by the physician that is provided in an individual capacity as a licensed physician. Removes the executive board of the department from determining the commissioner's salary. Provides that the commissioner's salary is determined by the governor and the state budget agency. Removes the executive board's approval for the commissioner to organize the personnel and functions of the department into divisions and subdivisions. Specifies that the state department of health may release certain information to an Indiana nonprofit entity that performs health data services for health care providers if specified conditions are met. Extends the expiration of the syringe exchange program until July 1, 2026.

Defines "wellness program". Specifies that the proceedings and deliberations of a wellness program are confidential. Specifies certain exceptions. Provides that all minutes, records, reports, written expert opinions, written communications, and other comparable memoranda prepared or created by a wellness program are privileged. Specifies certain exceptions. Prohibits all wellness program personnel and participants from revealing or disclosing the substance of wellness program communications, records, and determinations to any person or entity outside of the wellness program. Specifies certain exceptions. Allows a court to order in writing the release of confidential or privileged information belonging to a wellness program after a hearing if the court makes specified findings. Provides that the exchange of confidential or privileged information or memoranda between wellness groups does not result in the waiver of applicable confidentiality and privilege provisions. Provides that confidentiality and privilege provisions applicable to certain records do not make the records inaccessible to people or entities that would otherwise be eligible to receive or access the records under existing state or federal law. Provides that the confidentiality and privilege provisions applicable to wellness groups do not abrogate, limit, or restrict any other privacy protection applicable to a patient or the patient's health or medical information. Specifies that certain individuals may not be named as a party in a civil suit in connection with certain actions taken with respect to a wellness program. Provides that a member, consultant, or participant who comprises or participates in a wellness program is not required to report a licensed physician to the medical licensing board for any act, omission, statement, discovery, or disclosure unless the licensed physician presents a threat to himself or herself, to his or her patients, or to the general public.

A CONCURRENT RESOLUTION recognizing Hoosier Direct Support Professionals.

Allows an employee to request an accommodation for the employee's pregnancy. Requires an employer to respond to an employee's request for an accommodation within a reasonable time frame. Provides that a request for accommodation does not require an employer to provide an accommodation for an employee's pregnancy, or impose a duty or obligation upon the employer to provide an accommodation or an exception to the employer's policies unless existing federal or state laws require that an accommodation must be made. Prohibits an employer from disciplining, terminating, or retaliating against an employee because the employee has requested or used an accommodation for the employee's pregnancy.