Rep. Dave Heine

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.

Requires the commissioner of the department of insurance to provide an order directing the discontinuance of an illegal, unauthorized, or unsafe practice of an insurance company. Provides that a health plan may not require a participating provider to seek prior authorization for a particular health service if the health plan approved at least 90% of the prior authorization requests for the particular health service in the previous six month period. 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. Requires a health plan to provide annual and quarterly financial statements to the department of insurance. Establishes an approval process for a health plan's proposed premium rate increase of 5% or greater as compared to the previous calendar year. 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. Requires an insurer and a health maintenance organization to provide a contracted provider with notice of a proposed material change to the agreement between the insurer or health maintenance organization and the contracted provider at least 90 days prior to the proposed effective date. Establishes requirements for the contents of a notice of a proposed material change. Requires an insurer or health maintenance organization to provide a contracted provider with notice at least 15 days prior to a change to an existing prior authorization, precertification, notification, referral program, edit program, or specific edits.

A CONCURRENT RESOLUTION terminating the public health emergency first declared on March 6, 2020, in Executive Order 20-02.

Establishes the Indiana heritage commerce district program. Permits a municipality with a population of not more than 25,000 and that has been designated as an Indiana main street program area for not less than two years to establish a heritage commerce district. Establishes the heritage commerce district fund. Provides that the office of community and rural affairs may make grants not exceeding $500,000 to qualified districts. Provides that grant applicants must provide local matching funds. Specifies sources from which a grant applicant may solicit and accept local matching funds for purposes of a grant. Makes an appropriation.

Allows the legislative body of a city to adopt an ordinance establishing a youth sports and tourism development area (tax area). Requires that the tax area include a facility or complex of facilities used by youth sports teams and organizations for practice or competitive sporting events. Requires the legislative body to make findings when adopting an ordinance. Requires the legislative body to submit an ordinance establishing a tax area to the budget committee and budget agency for review and approval. Allows a tax area to receive incremental state and local income tax revenue and incremental sales tax revenue attributable to the tax area. Requires a city that establishes a tax area to establish a youth sports and tourism development area fund. Limits the amount of incremental tax revenue that may be allocated to: (1) $1,000,000 per tax area per year; and (2) a total of $10,000,000 per tax area. Provides that a tax area terminates not later than 20 years after incremental tax revenues are first allocated to the tax area.

Adds and amends definitions under the Indiana grain buyers and warehouse licensing law (licensing law). Requires contracts to purchase grain from producers to contain a notice that deferred priced grain must be priced within the crop year. Modifies the duties of the director (director) of the Indiana grain buyers and warehouse licensing agency (agency). Specifies that the grain indemnity fund consists of fines collected by the director. Increases the maximum amount of a bond required for a license. Requires that if the director finds a deficiency in minimum net worth before the licensee's next audit by the agency, the director shall issue a notice of deficiency to the licensee stating that the licensee has 30 days to correct the deficiency and if the licensee fails to correct a deficiency in minimum net worth within the 30 day period, the director may issue a fine. Provides that if a licensee fails to correct a deficiency in minimum net worth within 60 days of receiving a fine the director may issue a temporary suspension. Provides that a licensee may not enter into a deferred pricing agreement after July 1, 2022, that extends beyond the crop year for the delivered grain. Provides that if a deferred pricing agreement in connection with a grain purchase was entered into before July 1, 2021, the licensee shall complete the licensee's payment obligations to the seller under the agreement before January 1, 2024. Establishes criteria to determine the price date in the deferred pricing agreement. Provides that if a licensee fails to price grain, the director may impose a fine. Adds a definition of "conflict of interest". Provides that the attorney general may designate an attorney representative to serve on the board (board) of the Indiana grain indemnity corporation (corporation). Modifies duties of the board. Provides that a board member of the corporation with a conflict of interest in a proceeding before the board is recused from the proceedings. Provides that, if a board member is found to have violated the terms of a confidentiality agreement, the board member forfeits the member's appointment to the board and shall be removed as a member of the board. Requires that if a board member is suspected of violating a confidentiality agreement the matter must be referred to the office of the attorney general. Allows the corporation to: (1) study fund solvency, practices, and procedures; and (2) pay legal fees and legal expenses in actions brought against the corporation or the board of the corporation. Increases the amount from $250,000 to $350,000 that may be transferred to the administrative expense account (account). Adds a study of fund solvency, practices, and procedures, professional development and training programs, technology software updates and technology support services, and professional training for board members to listed administrative expenses allowed from the account.

Requires the department of child services (department) to establish before October 1, 2021, policies and procedures to allow for child and family services to be provided remotely. Specifies factors that a child and family services provider and the department may consider in making a determination as to whether remote provision of services is appropriate for a child. Provides that a child and family services provider's first meeting with a family, or with a child who lives with the child's family, must be conducted in person unless a declared health emergency makes an in person meeting unsafe. Provides that after a child and family services provider's first meeting with a family or with a child who lives with the child's family, or for purposes of providing services to a child who does not live with the child's family, the provider has the discretion to provide services to the family or child remotely for up to 14 days after the initial request for consultation if providing services remotely is in the best interest of the child and family, unless: (1) a decision is reached on the use of remote services at a child and family team meeting less than 14 days after the request for consultation; or (2) the department communicates to the provider a preliminary determination as to the role of remote services pending the child and family team meeting.

Provides that certified level two assessor-appraisers and certified level three assessor-appraisers may serve as tax representatives under certain circumstances. Provides that a taxpayer may submit a written complaint to the department of local government finance if the taxpayer has reason to believe the assessing official failed to adhere to Uniform Standards of Professional Appraisal Practice or does not have the necessary competency to perform the assessment. Provides that notice of a taxpayer's right to submit a written complaint must be included on the taxpayer's notice of assessment or reassessment.

A CONCURRENT RESOLUTION recognizing Hoosier Direct Support Professionals.

Honoring Jerrilee K. Mosier on the occasion of her retirement.