Amends the duties of the office of the secretary of family and social services (office) concerning Medicaid home and community based services waivers (waiver). Requires: (1) a provider of waiver services to provide certain documentation to a waiver recipient; (2) a waiver recipient to review the documentation and report errors or inconsistencies; and (3) the recipient's case manager to provide assistance to the recipient in reviewing the documentation and reporting any errors or inconsistencies. Requires certain Medicaid recipients to choose the recipient's provider of integrated health care coordination. Provides that integrated health care coordination provided by a provider of assisted living services is not duplicative of certain other services. Establishes a time frame in which the bureau of disabilities services must review and approve or deny requests for an increase in service units provided to certain individuals with a disability. Requires the office to apply to the federal government for: (1) a new Medicaid waiver to provide assisted living services; and (2) an amendment to a specific Medicaid home and community based services waiver to establish an individual cost limit of not more than the institutional cost of nursing facility services. Specifies that provisions concerning reimbursement for assisted living services for individuals who are aged and disabled and receiving services under a Medicaid waiver apply to the new assisted living Medicaid waiver. Provides that, beginning July 1, 2027, an individual is no longer a member of the covered population upon receiving nursing facility services for 100 consecutive days. Provides that on the one hundredth day, the individual is not a member of the covered population and shall receive Medicaid services under a fee for service program. Provides that a provision prohibiting the office from reducing reimbursement for home health services expires June 30, 2027. Requires the office to collaborate with certain entities to develop a new reimbursement methodology for home health services. Specifies that public notice of at least six months (rather than one year) must be provided before a health facility service reimbursement that results in a reduction in reimbursement may be changed. Amends the definition of "bulk drug substance" for provisions concerning drug compounding. Provides that a claim by the estate recovery unit of the office of Medicaid policy and planning (estate recovery unit) is forever barred unless the estate recovery unit files a claim in the court in which the decedent's estate is being administered not later than nine months after the date of death of the decedent.
Adds the 9-8-8 crisis response center and a mobile crisis team as first responders. Requires certified peers to be trained and certified by the division of mental health and addiction or an approved nationally accredited certification body. Amends the definition of "qualified provider" concerning the Medicaid program. Requires the office of the secretary of family and social services to limit presumptive eligibility determinations to qualified providers and sets forth requirements. Requires rules to be adopted concerning the implementation and administration of certification requirements for specified entities and amends standards. Allows a home health agency that meets certain conditions to continue to provide services to a Medicaid recipient and receive Medicaid reimbursement while the home health agency's application for Medicare enrollment is pending if the home health agency submitted the application or initiated the enrollment process before April 1, 2026. Changes the name of the division of disability and rehabilitative services to the division of disability, aging, and rehabilitative services. Repeals the division of aging and moves existing statutes and administrative rules to other locations. Renames the bureau of aging and in-home services to the bureau of better aging (bureau) and designates the bureau to perform certain duties once performed by the division of aging. Eliminates the requirement of a preferred drug list report. Extends the expiration of the micro facility pilot program. Authorizes the legislative services agency to prepare any legislation necessary to conform with the changes made.
Amends the definition of "ambulatory outpatient surgical center" to remove the requirement that a surgical procedure is permitted to be performed only by a physician, dentist, or podiatrist who has certain hospital privileges. Prohibits a hospital, debt collector, or other third party from pursuing medical debt collection if the hospital is noncompliant with specified statutes. Requires the Indiana department of health (state department) to determine on a semiannual basis whether a hospital is in compliance with the statutes and notify a hospital concerning the state department's compliance determination. Authorizes the attorney general to suspend the authority of a hospital to pursue medical debt collection when the state department has made a final determination that the hospital is noncompliant. Creates an affirmative defense for a debtor if the collection attempt occurred while the hospital was noncompliant. Requires a hospital to provide the state department with 60 days written notice if the hospital plans to: (1) close and permanently terminate all hospital operations; or (2) completely eliminate a service line for longer than 90 days. Allows for a waiver of the notification requirements in specified circumstances.
Requires an initiating party that submits a request for independent dispute resolution to provide written notice to the facility not later than three business days after submitting the request. Allows a health carrier to provide notice to an out of network provider and a facility if, during any 90 day period, an initiating party submits requests for independent dispute resolutions that, in the aggregate, include 25 or more qualified disputes. Provides that if a health carrier provides the notice, the health carrier, the out of network provider, and the facility shall engage in good faith efforts to negotiate a resolution. Prohibits a health carrier from assessing a facility or a provider an administrative fee or penalty related to the provision of care to an individual that involves an out of network provider. Provides that if a health carrier assesses a facility or a provider an administrative fee or penalty related to the provision of care to an individual that involves an out of network provider, the health carrier commits an unfair and deceptive act or practice in the business of insurance.
Prohibits health practitioners and other specified individuals from performing pelvic, prostate, or rectal examinations on an anesthetized or unconscious patient except in specified circumstances. Specifies the requirements of a notice of informed consent.
Changes the statewide standing order for the dispensing of a smoking cessation product to a tobacco, vaping, or nicotine cessation product. Amends the date by which a hospital must submit the hospital's fiscal report and patient information report to the state department. Removes a requirement that a home health aide competency evaluation program include at least 75 hours of training and 16 hours of classroom training before supervised practical training. Adds Parkinson's disease to the definition of "chronic disease" for provisions concerning the chronic disease registry. Requires: (1) the state department to maintain a trauma registry; and (2) certain health care facilities to submit data to the registry. Establishes requirements for the handling and transporting of infectious waste. Sets forth factors the state department must consider in determining the nature of and civil penalty for a violation of infectious waste requirements. Expands provisions concerning epinephrine, including provisions allowing a pharmacist to dispense and an entity to prescribe epinephrine rather than auto-injectable epinephrine. Removes the expiration of provisions concerning lead screening for children. Requires a registered manufacturer, processor, repackager, or wholesale distributor of food, drugs, or cosmetics to comply with federal regulations concerning good manufacturing practices. Allows the state health commissioner to enter and inspect the premises of the manufacturer, processor, repackager, or wholesale distributor. Permits a local health department to conduct inspections of certain manufacturers, processors, repackagers, or wholesale distributors. Amends the information a local child fatality review team and the statewide child fatality review committee may review in conducting a child fatality review. Allows a suicide and overdose fatality review team and a fetal-infant mortality review team to provide records to the state department. Requires the state department to maintain the confidentiality of these records. Requires a medical school to: (1) include nutrition education in the school's curriculum; and (2) require students to complete a rural health rotation. Voids administrative rules concerning infectious waste and the state trauma registry.
Requires the Indiana State Nurses Association, any time there is a vacancy or expiration of a term on the board of nursing, to recommend to the governor a list of qualified nurses for appointment. (Current law requires the Indiana State Nurses Association to recommend the list when there is a vacancy on the board.) Allows an institution that has been operating an eligible nursing program for at least five years to increase the enrollment in any eligible nursing program at any rate the institution considers appropriate.
Requires a hospital to: (1) disclose information concerning payment assistance programs; (2) post signs concerning the programs in specified locations of the hospital; and (3) make information concerning the programs available to individuals through the hospital's patient portal. Requires a hospital to make a reasonable effort to notify individuals of available payment assistance programs before beginning a collection action against the individual. Prohibits the use of downcoding in a specified manner. Prohibits a provider from using an automated process, system, or tool to submit a health benefits claim without the review of a provider or other person involved in the development of the claim for submission. Prohibits an insurer that issues a policy of accident and sickness insurance (insurer) and a health maintenance organization from retroactively reducing the reimbursement rate for any CPT code. Sets forth limitations on the time frame in which an insurer and a health maintenance organization: (1) may request repayment of an overpayment, adjust a subsequent claim, recoup a paid claim, or retroactively audit a paid claim; and (2) is required to correct a payment error to a provider. Provides that if an insurer or a health maintenance organization recoups payment from a provider due to an error in coordination of benefits, the provider may submit a claim for the same services to the appropriate insurer or health maintenance organization.
Prohibits a state employee health plan, a policy of accident and sickness insurance, and a health maintenance organization that provides coverage for advanced, metastatic cancer and associated conditions from requiring that, before providing coverage for a prescription drug, the insured fail to successfully respond to a different prescription drug or prove a history of failure of a different prescription drug.
Provides that a public safety employee who: (1) becomes disabled on or after January 1, 2020; (2) receives a Class 1 or a Class 2 impairment benefit; and (3) is eligible for group health insurance coverage for the public safety employee and the public safety employee's spouse or dependents; must pay no more than the amount that the public safety employee would have been required to pay if still serving as a current active public safety employee employed by the local unit public employer. Specifies that the public safety employee must file a written request for insurance coverage with the employer before June 1, 2026, or within 90 days after the public safety employee begins receiving disability benefits, whichever is later. Specifies that if a public safety agency closes, merges, or otherwise ceases to exist, the local unit public employer that caused the public safety agency to cease to exist, shall continue to provide certain insurance coverage. Provides that a surviving spouse or dependent of a public safety employee who dies in the line of duty must pay the same amount that the public safety employee would have been required to pay if still serving as a current active public safety employee employed by the local unit public employer for coverage selected by the surviving spouse or dependent under the group health insurance program.
