Rep. Julie McGuire

Establishes a limited medical license for individuals who: (1) have graduated from certain international medical programs; (2) obtain a health care facility sponsor in an underserved area; and (3) meet certain other criteria. Provides that a limited medical license authorizes the recipient to practice medicine only at a health care facility in an underserved area. Enables the medical licensing board of Indiana (board) to revoke a limited medical license if the recipient stops working as a physician at a health care facility in an underserved area. Provides that a limited medical license may be converted to an unlimited license. Allows the board to require a comprehensive evaluation to determine the individual's competency before issuing an unlimited medical license. Allows, until June 30, 2027, an applicant for an unlimited license to practice osteopathic medicine to take all levels of the Comprehensive Osteopathic Medical Licensing Examination not later than ten years from the date the applicant first passes level 1 of the examination.

Establishes: (1) a state directed payment program (program) for hospitals; and (2) a managed care assessment fee. Changes disproportionate share payments when a state directed payment program is in effect. Allows the incremental hospital fee fund to be used to fund the Medicaid program. Requires a nonprofit hospital system to submit audited financial statements. Provides for a $10,000 per day penalty for failure to submit the hospital's financial statements. Requires the office of management and budget (office) to: (1) develop a methodology to be used in conducting a study of commercial inpatient hospital prices and outpatient hospital prices; and (2) upon budget committee review, conduct the study to determine Indiana's statewide average inpatient and outpatient hospital prices. Requires the office to submit a report of the study to the governor and general assembly. Before June 30, 2029, requires an Indiana nonprofit hospital system's aggregate average inpatient and outpatient hospital prices to at least be equal to or less than the statewide average. States that a violation by the Indiana nonprofit hospital system results in a forfeiture of its nonprofit status. Requires, before October 1 of each year, every nonprofit hospital to provide the Indiana department of health with specified federally filed forms and specified data used to complete the forms. Requires the Indiana department of health to submit these forms to the health care cost oversight task force and impose a fine of $10,000 per day on a nonprofit hospital for failure to submit the nonprofit hospital's forms. Provides an exemption from health care billing requirements for a facility located in a specified populated municipality. Requires a third party administrator to disclose commissions and fees to policyholders in a separate notification. Requires an insurer and a health maintenance organization to submit specified data information to the all payer claims data base. Requires an insurance producer or third party administrator to, before or at the time of sale, provide the plan sponsor with a statement from the insurer or health maintenance organization, disclosing commissions and fees that the insurance producer or third party administrator will receive. Changes the time frame in which certain information and claims data must be submitted to a contract holder as part of an audit or claims data request. Sets requirements for certain hospitals concerning a direct to employer health care arrangement. Beginning January 1, 2026, requires a state employee health plan, a policy of accident and sickness insurance, and a health maintenance organization contract to provide a plan sponsor with the national average drug acquisition cost of a generic drug. States that if an agreement between a health plan and a pharmacy benefit manager provides that less than 85% of the estimated rebates will be deducted from the cost of prescription drugs before a covered individual's cost sharing requirement is determined, the pharmacy benefit manager must provide the policyholder with an annual notice that includes: (1) an explanation of what a rebate is; (2) an explanation of how rebates accrue to the health plan from the manufacturer; and (3) the aggregate amount of rebates that accrued to the health plan for prescription drugs dispensed under the policyholder's health plan for the previous year. Places limitations on hospital health provider contracts linking to or negotiating reimbursement or terms under a separate hospital health care provider contract or product. Requires the office to: (1) study the effect, including the fiscal impact, of requiring physician reimbursement rates under a commercial policy to be set at a minimum reimbursement rate; and (2) report its findings under the study. Requires certain health carriers to provide claims data to a contract holder not more than four times per year (current law allows for the provision of the data twice annually). Requires certain insurers and health maintenance organizations to file specified information concerning changes in hospital reimbursement to the department of insurance.

Requires, not later than October 1, 2025, the secretary of education to compile and prepare a report concerning school bus driver safety education training. Makes certain changes concerning the process of filling a school board vacancy. Provides that a superintendent is preferred (current law says required) to hold a master's degree from certain institutions. Provides that certain covered school buildings are not required to revert to a school corporation if the building is subject to ongoing renovations. Provides that a superintendent must discuss a plan for annual performance evaluations with teachers (instead of teachers or the teachers' representative). Requires, not later than August 1, 2025, the early learning advisory committee, in coordination with the department of education, to assess certain prekindergarten program matters and submit a report to the legislative council. Removes a provision that contracts with certain superintendents must be in a form of a regular teacher's contract.

Provides that certain students have the opportunity to retake the determinant evaluation of reading skills at least twice in the summer before grade 3 retention requirements apply. Requires the department of education to establish a registration process for schools to exempt certain English language learners from compliance with grade 3 retention requirements until the beginning of the 2027-2028 school year. Allows required career fairs to be held off of school property if the school provides transportation. Amends agreement requirements with regard to the employment aid readiness network (EARN) Indiana program. Makes a technical correction.

Specifies the persons that may file an action to obtain an injunction against an individual practicing dentistry without a license and the action that is required or allowed to be included in an injunction. Specifies information that a dentist who maintains a dental office must submit to the state board of dentistry. States that language concerning the administration of dental anesthetics may not be construed to prohibit a physician from practicing in a dental office. Allows a dentist to delegate the authority to take x-ray images to a dental assistant working in certain correctional facilities without direct supervision as long as the dentist is available to supervise the dental assistant remotely. Removes certain language regarding the regulation of dentists.

Requires each school corporation and charter middle school to automatically enroll a student who meets certain conditions in a middle school advanced math course. Allows a parent of a student to opt out of automatic enrollment. Requires the department of education to submit a report to the legislative council that includes certain middle school advanced math course student percentage information. Establishes requirements regarding: (1) mathematics screening, evaluation, and intervention; and (2) teacher preparation program math curriculum and content.

Sets forth requirements for a utilization review entity that requires prior authorization of a health care service. Prohibits a utilization review entity from requiring prior authorization for the first 12 physical therapy or chiropractic visits of each new episode of care. Provides that a claim for reimbursement for a covered service or item provided to an insured or enrollee may not be denied on the sole basis that the referring provider is an out of network provider. Repeals superseded provisions regarding prior authorization. Makes corresponding changes.

Requires the family and social services administration (FSSA) to provide address information to the department of child services (department) under specified circumstances subject to federal approval of a state plan amendment or waiver allowing FSSA to do so. Provides that it is the policy of the state of Indiana and the purpose of Indiana family and juvenile law to: (1) recognize the responsibility of the state and of the department for the safety of children who are abused or neglected; (2) recognize that a parent's interest in receiving services at the time and expense of the state for purposes of reunification is limited; (3) promote the safety of all children involved in the juvenile justice system; and (4) ensure timely placement of children in foster care into permanent homes. Provides that a procedural deadline in a: (1) child in need of services (CHINS) proceeding; or (2) termination of parent-child relationship (TPR) proceeding; is not subject to waiver by a party to the proceeding, except as permitted in specified circumstances under current law. Provides that an individual with whom a child is placed during CHINS proceedings is entitled to attend, in its entirety, any hearing conducted as part of: (1) the CHINS proceedings; or (2) TPR proceedings resulting from a TPR petition filed with regard to the child during the CHINS proceedings. Provides that a court shall allow an individual who is providing care and supervision of a child as: (1) a foster parent; (2) a long term foster parent; or (3) an unlicensed kinship caregiver; at the time the child is the subject of a CHINS proceeding or TPR proceeding to intervene as a party during any stage of the proceeding if the court makes specified findings. Provides that a court shall allow an individual who is providing care and supervision for a child to intervene in a TPR proceeding concerning the child. Provides that a child is a CHINS if, before the child becomes 18 years of age: (1) the child's physical or mental health is seriously endangered due to failure of the child's parent, guardian, or custodian to protect the child from exposure to the use, possession, sale, or manufacture of illegal drugs; and (2) the child needs care, treatment, or rehabilitation that the child is not receiving and that is unlikely to be provided or accepted without the coercive intervention of the court. Removes a rebuttable presumption in current law that a child's physical or mental health is seriously endangered based on evidence of illegal manufacture of a drug or controlled substance occurring at the child's residence and provides that there is a rebuttable presumption that a child is a CHINS if the court finds that the child's parent, guardian, or custodian willfully or knowingly: (1) exposed the child to the illegal manufacture or distribution of a legend drug or controlled substance; or (2) exposed the child to: (A) methamphetamine; (B) fentanyl; or (C) a fentanyl containing substance; for which the parent, guardian, or custodian did not have a valid prescription. Amends the factors a court must consider when determining whether to detain a child who has been removed from the child's parent, guardian, or custodian to include considerations relating to exposure of the child to a fentanyl containing substance or fentanyl related substance. Provides that the rights of the: (1) child; (2) child's parents, guardian, or custodian; (3) department; and (4) guardian ad litem or court appointed special advocate; as parties to a proceeding regarding the child under Indiana juvenile law include rights of discovery, subpoena, examination of witnesses, and presentation of evidence at any hearing in the proceeding. Provides that the statutory deadline for holding of a factfinding hearing in a CHINS proceeding may be extended if the court finds that the extension is necessitated by: (1) unanticipated, emergent circumstances; (2) the circumstances of the case; or (3) the Indiana Rules of Trial Procedure. Provides that there is a rebuttable presumption that a child is a CHINS if the court finds that the child lives in the same household as an adult who is subject to an order issued in a CHINS proceeding that requires the adult to participate in a program of care, treatment, or rehabilitation. Adds factors that a court must consider in determining appropriate reunification services in which a child's parent, guardian, or custodian will be required to participate under the child's dispositional decree. Provides that: (1) a dispositional decree that: (A) is entered under specified circumstances; and (B) requires a parent, guardian, or custodian to complete reunification services; may not provide for the parent, guardian, or custodian to receive the reunification services for more than a specified length of time, subject to extension for specified causes; and (2) a court reviewing the dispositional decree shall consider the amount of time remaining for the parent, guardian, or custodian to complete the reunification services. Specifies that the requirement that a court reviewing a dispositional decree must determine whether the department has made reasonable efforts to provide family services does not apply if a finding has been made that reasonable efforts for family preservation or reunification are not required. Provides that in determining the extent to which reasonable efforts to reunify or preserve a family are appropriate, the child's welfare (in addition to the child's health and safety, under current law) is of paramount concern. Provides that if the department conducts a criminal history check of: (1) a parent, guardian, or custodian; or (2) a household member of the parent, guardian, or custodian; before reunifying a child with the parent, guardian, or custodian, the department shall (rather than may, under current law) use the results of the criminal history check to decide whether it is safe for the child to return home and shall provide the results of the criminal history check to the court. Requires a court to hold a permanency hearing for a child: (1) who has been removed from the child's parent, guardian, or custodian for at least 12 months; or (2) with regard to whom at least 12 months have expired since a dispositional decree was entered; at the request of any party to the CHINS proceeding that requests a permanency hearing on the basis that continuation of efforts to reunify or preserve the child's family are inconsistent with the best interests of the child. Provides that if a child has, at the time of a permanency hearing, been removed from the child's parent for at least 12 of the most recent 22 months, the permanency plan for the child must include at least one intended permanent or long term care and custody arrangement that would not return the child to the care and custody of the parent, guardian, or custodian from whose care and custody the child has been removed. Provides that if a child is less than 16 years of age, the intended permanent or long term care and custody arrangement for the child may be guardianship or placement with a permanent custodian only if the proposed guardian or custodian appears before the court and testifies as to the individual's willingness to assume custody of the child. Provides that: (1) if a court approves a permanency plan for a child under which adoption is the only intended permanent or long term care and custody arrangement, the department shall publish specified information regarding the child to facilitate adoption of the child; and (2) the information published by the department to facilitate adoption of a child who is: (A) a CHINS; and (B) a hard to place child; may include the child's first name and picture. Requires a court to hold an initial hearing on a TPR petition not later than 30 days after the petition is filed. Provides that under specified circumstances, a TPR petition regarding a child and the child's parent: (1) must be filed by the department; and (2) may be filed by: (A) the child's guardian ad litem or court appointed special advocate; or (B) an individual: (i) with whom the child is placed during the CHINS proceedings; and (ii) who is an intervenor in the CHINS proceedings. Amends the allegations that may be asserted in a TPR petition. Removes a provision requiring a person that files a TPR petition to also file a: (1) copy of the order approving the permanency plan for the child; or (2) permanency plan for the child. Provides that the deadline for holding a hearing regarding a TPR petition may be extended if the court finds that extension of the deadline is necessitated by: (1) unanticipated, emergent circumstances; (2) the circumstances of the case; or (3) the Indiana Rules of Trial Procedure. Provides that a representative of a licensed child placing agency that is providing services to a child during child in need of services (CHINS) proceedings is entitled to attend, in its entirety, any hearing conducted as part of: (1) the CHINS proceedings; or (2) termination of parent-child relationship (TPR) proceedings resulting from a TPR petition filed with regard to the child during the CHINS proceedings. Provides that the requirement that DCS publish specified information regarding a child to facilitate adoption of the child does not apply if the child is already in a pre-adoptive placement in a proposed adoptive home. Makes conforming and technical changes.

Establishes the child welfare task force (task force) to study specified topics regarding child welfare services in Indiana. Requires the task force to submit a report not later than October 15, 2026, and not later than October 15, 2027, for review by the interim study committee on child services.

Maddy summaryHouse Concurrent Resolution 43 is a non-binding resolution that expresses the Indiana legislature's support for a healthier Indiana. It serves to formally encourage initiatives and efforts aimed at improving the well-being of the state's residents.