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.
Rep. Martin Carbaugh
Sponsored bills
Provides that a contractor that employs 10 or more employees on a design-build public works project must provide its employees access to a training program applicable to the tasks to be performed in the normal course of the employee's employment with the contractor on the public project. Provides that a tier 1 or tier 2 contractor that employs 50 or more journeymen must participate in an apprenticeship or training program that meets certain standards. Requires design-builders and any member of a team working on a design-build public works project to comply with certain statutes. Provides that a public agency awarding a contract for a construction manager as constructor project may not take certain actions based on a bidder's, offeror's, or contractor's entering into, refusing to enter into, adhering to, or refusing to adhere to an agreement with a labor organization.
Specifies services to be included as part of a covered colorectal cancer screening for policies of accident and sickness insurance and health maintenance organization (HMO) contracts. Defines "follow-up colonoscopy". Provides that a policy of accident and sickness insurance or HMO contract must cover: (1) a colorectal cancer screening test assigned either an "A" or "B" grade by the United States Preventive Services Task Force; and (2) A follow up colonoscopy if the result of a non-invasive colorectal cancer screening test with an "A" or "B" grade from the United States Preventive Services Task Force is positive. Provides that a high deductible health plan may impose a deductible requirement for a follow-up colonoscopy if these colorectal cancer screening requirements would be inconsistent with Internal Revenue Code provisions concerning high deductible health plans.
Authorizes a local unit (county, municipality, town, township, or school corporation) to establish a workforce retention and recruitment program (program) and fund (fund) for the purposes of recruiting and retaining individuals who will satisfy the current and future workforce needs of the unit's employers or provide substantial economic impact to the unit, including providing incentives in the form of grants or loans to qualified workers. Defines "qualified worker" for purposes of the program. Requires a qualified worker who receives a grant or loan from the fund to enter into an incentive agreement. Authorizes the unit to transfer money into the fund from other sources. Provides that the executive of the unit shall administer the fund in coordination with a workforce fund board of managers (workforce fund managers) appointed by the executive of the unit. Requires the workforce fund managers to annually submit a report setting out their activities during the preceding calendar year to the executive of the unit, the fiscal body of the unit, and the department of local government finance. Makes conforming changes.
Urges the legislative council to assign to the interim study committee on pension management oversight the task of studying whether the trustee of the state police pension trust and the police benefit fund should be the board of trustees of the Indiana public retirement system. Specifies that the corpus and income of the pension trust shall be distributed to participants and their beneficiaries in accordance with certain provisions.
Terms of U.S. Senators and Members of Congress. Applies to Congress for a Convention for proposing Amendments under Article V of the United States Constitution to provide limits to the number of terms that an individual may serve in the United States House of Representatives and in the United States Senate.
A CONCURRENT RESOLUTION urging Governor Holcomb to proclaim the week of May 1, 2022, as Tardive Dyskinesia Awareness Week.
Provides that a hospital, physician, or physician group: (1) may not withdraw from a Medicare advantage network for any part of a calendar year after the calendar year has begun; (2) may withdraw from a Medicare advantage network only for an entire calendar year; and (3) may withdraw for an entire calendar year only by giving notice of the withdrawal to the insurer that operates the Medicare advantage plan not later than September 1 immediately preceding the calendar year. Provides that an insurer operating a Medicare advantage plan: (1) may not remove a hospital, physician, or physician group from the Medicare advantage plan's Medicare advantage network for any part of a calendar year after the calendar year has begun; (2) may remove a hospital, physician, or physician group from the Medicare advantage network only for an entire calendar year; and (2) may remove a hospital, physician, or physician group from the Medicare advantage network for a calendar year only by giving notice of the removal to the hospital, physician, or physician group not later than September 1 immediately preceding the calendar year. Makes certain exceptions. Provides that notice of the withdrawal or removal of a hospital, physician, or physician group from a Medicare advantage network must be given by letter, telephone message, or electronic mail message at least 60 days before the withdrawal or removal to each individual who is covered by the Medicare advantage plan and who, not more than two years before the date of the withdrawal or removal, was seen or treated by the physician or a physician of the physician group or was an inpatient in or received medical treatment in the hospital. Empowers the insurance commissioner to impose penalties for violations and authorizes the insurance commissioner to adopt administrative rules.
Requires a board that issues a license for certain regulated occupations to issue a license to an individual who: (1) is licensed in another state or jurisdiction in the regulated occupation; (2) has established residency in Indiana; (3) has passed a substantially equivalent examination as determined by the appropriate board; (4) is and has been in good standing; (5) pays a fee; and (6) completes the licensure application form. Allows for a board that requires an applicant to submit to a national criminal history background check to maintain that requirement even if an individual who applies for a license for a regulated occupation meets all of the license endorsement requirements. Provides that nothing in this bill prevents or supersedes a: (1) compact; or (2) reciprocity or comity agreement; if established by the board or the general assembly. Provides that, if a board has entered into a national reciprocal or endorsement agreement or a reciprocal or endorsement agreement with one or more states, then those agreements remain in effect.
Permits an individual who seeks to adopt a child less than 18 years of age to file a petition for adoption in any county in Indiana if either of the following is filed with the petition: (1) A written consent to the adoption from each individual whose consent to the adoption is required under Indiana law; (2) A certified copy of a court order terminating the parental rights of each parent whose consent to the adoption is required under Indiana law. Requires notice of an adoption petition to be delivered to imprisoned or detained individuals. Specifies certain requirements when delivering notice of a petition for adoption to an individual whose address is unknown. Provides that certain notice requirements concerning petitions for adoption are met even when the recipient of the notice refuses to accept the offer or tender of the notice. Requires that the notice of an adoption must be given to the local office of the department of child services, if the child is the subject of an open or pending child in need of services proceeding. Mandates that the notice of an adoption must be given to the entity, facility, or individual of which the child is a ward if the child is a subject of an open or pending juvenile delinquency proceeding. Specifies certain other requirements concerning notice for petitions for adoption. Requires the setting aside of an adoption decree if notice is not properly effectuated and the adoption decree is challenged within 45 days of when it was entered. Allows the court to set aside a dismissal of a motion to contest under certain circumstances. Allows the court to consider, in the context of a motion to contest, (1) the parent's substance abuse; (2) the parent's voluntary unemployment; or (3) instability in the parent's household, if the parent has made substantial and continuing progress and it appears reasonably likely that progress will continue. Makes conforming amendments..