Indiana 2022 Regular Session

Indiana Senate Bill SB0384 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2	Introduced Version
3	3	SENATE BILL No. 384
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 12-7-2-44.9; IC 12-15.
7	7	Synopsis: Medicaid buy-in program. Removes consideration of
8	8	countable resources in determining an individual's eligibility for
9	9	participation in the Medicaid buy-in program (program). Prohibits the
10	10	office of the secretary of family and social services (office of the
11	11	secretary) from considering resources and whether the individual
12	12	participated in a specified program in determining the individual's
13	13	eligibility or continuous eligibility for the program. Allows a recipient's
14	14	participation in an employment network recognized by the federal
15	15	Social Security Administration to qualify as participating with an
16	16	approved provider of employment services. Changes minimum and
17	17	maximum premiums that a recipient must pay and how the amount of
18	18	premium is calculated for the program. Requires that the premium
19	19	scale be promulgated by administrative rule. Allows the office of the
20	20	secretary to annually review the premium amount that a recipient must
21	21	pay in the program. (Current law requires annual review of the
22	22	premium amount.) Specifies changes in circumstances that must result
23	23	in an adjustment of the premium. Specifies that a recipient in the
24	24	program is eligible for the same services as offered in the Medicaid
25	25	program. States that an individual's participation in the program does
26	26	not preclude the individual from participating in a Medicaid waiver
27	27	program. Specifies that a recipient of the program may simultaneously
28	28	participate in a Medicaid waiver program and requires the office of the
29	29	secretary to individually determine eligibility for both programs based
30	30	on the individual's medical need requirements.
31	31	Effective: July 1, 2022.
32	32	Yoder
33	33	January 11, 2022, read first time and referred to Committee on Health and Provider
34	34	Services.
35	35	2022 IN 384—LS 6843/DI 104 Introduced
36	36	Second Regular Session of the 122nd General Assembly (2022)
37	37	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
38	38	Constitution) is being amended, the text of the existing provision will appear in this style type,
39	39	additions will appear in this style type, and deletions will appear in this style type.
40	40	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
41	41	provision adopted), the text of the new provision will appear in this style type. Also, the
42	42	word NEW will appear in that style type in the introductory clause of each SECTION that adds
43	43	a new provision to the Indiana Code or the Indiana Constitution.
44	44	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
45	45	between statutes enacted by the 2021 Regular Session of the General Assembly.
46	46	SENATE BILL No. 384
47	47	A BILL FOR AN ACT to amend the Indiana Code concerning
48	48	Medicaid.
49	49	Be it enacted by the General Assembly of the State of Indiana:
50	50	1 SECTION 1. IC 12-7-2-44.9 IS REPEALED [EFFECTIVE JULY
51	51	2 1, 2022]. Sec. 44.9. "Countable resources", for purposes of
52	52	3 IC 12-15-41, has the meaning set forth in IC 12-15-41-2.
53	53	4 SECTION 2. IC 12-15-2-6.5 IS AMENDED TO READ AS
54	54	5 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 6.5. Notwithstanding
55	55	6 section 6 of this chapter, beginning July 1, 2002, An individual who
56	56	7 meets the requirements of IC 12-15-41 is eligible for Medicaid.
57	57	8 SECTION 3. IC 12-15-41-2 IS REPEALED [EFFECTIVE JULY 1,
58	58	9 2022]. Sec. 2. As used in this chapter, "countable resources" means all
59	59	10 cash, other liquid assets, real property, and personal property owned by
60	60	11 an applicant for or a recipient of Medicaid under this chapter, or the
61	61	12 spouse of an applicant or a recipient, that could be converted to cash to
62	62	13 be used for support or maintenance, except the following:
63	63	14 (1) All resources disregarded by the office under this article for
64	64	15 the purpose of determining eligibility for Medicaid.
65	65	16 (2) Any resource eligible for exclusion under 42 U.S.C.
66	66	17 1396a(r)(2), including a retirement account established under 26
67	67	2022 IN 384—LS 6843/DI 104 2
68	68	1 U.S.C. 220 and held by either the applicant or recipient or the
69	69	2 applicant's or recipient's spouse.
70	70	3 (3) Subject to approval by the office, not more than twenty
71	71	4 thousand dollars ($20,000) in independence and self-sufficiency
72	72	5 accounts held by the applicant or recipient for the sole purpose of
73	73	6 purchasing goods or services, including assistive technology and
74	74	7 personal assistance, that:
75	75	8 (A) will increase the employability or independence of the
76	76	9 applicant or recipient; and
77	77	10 (B) are not services to which the recipient is entitled under
78	78	11 Medicaid or any other publicly funded program.
79	79	12 SECTION 4. IC 12-15-41-4 IS AMENDED TO READ AS
80	80	13 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 4. (a) To participate in
81	81	14 the buy-in program beginning July 1, 2002, an individual must meet the
82	82	15 following eligibility requirements: under IC 12-15-2-6, except as
83	83	16 follows:
84	84	17 (1) The individual has a severe medically determinable
85	85	18 impairment without regard to the individual's employment status.
86	86	19 (2) The individual must be at least sixteen (16) years of age but
87	87	20 not more than sixty-four (64) years of age.
88	88	21 (3) The individual must be engaged in a substantial and
89	89	22 reasonable work effort as determined by the office and as
90	90	23 permitted by federal law.
91	91	24 (4) The individual does not have countable resources that exceed
92	92	25 the resource limits for the federal Supplemental Security Income
93	93	26 program (42 U.S.C. 1382).
94	94	27 (5) (4) The individual's annual gross income does not exceed
95	95	28 three hundred fifty percent (350%) of the federal income poverty
96	96	29 level for an individual. In determining an individual's income
97	97	30 under this subdivision, the office may not consider the following:
98	98	31 (A) The income of the individual's spouse.
99	99	32 (B) Income disregarded under the state Medicaid plan's
100	100	33 financial methodology, including income disregarded under
101	101	34 the federal Supplemental Security Income program (42 U.S.C.
102	102	35 1382) as impairment related work expenses (IRWE).
103	103	36 (b) Beginning July 1, 2022, in determining an individual's
104	104	37 eligibility and continuous eligibility for the buy-in program, the
105	105	38 office of the secretary may not consider:
106	106	39 (1) any resource limitations, including resources of the
107	107	40 individual's spouse, if applicable; or
108	108	41 (2) whether the individual is a current or past beneficiary of:
109	109	42 (A) the federal Social Security Administration program; or
110	110	2022 IN 384—LS 6843/DI 104 3
111	111	1 (B) the Medicaid program as an individual with a disability
112	112	2 under IC 12-15-2-3.5.
113	113	3 SECTION 5. IC 12-15-41-5 IS AMENDED TO READ AS
114	114	4 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 5. An individual who
115	115	5 is enrolled in the buy-in program and who no longer meets the
116	116	6 eligibility requirements set forth in section 4 of this chapter due to an
117	117	7 improvement in the individual's medical condition continues to be
118	118	8 eligible for Medicaid coverage under the buy-in program if the
119	119	9 individual meets the following requirements:
120	120	10 (1) The individual continues to have a severe medically
121	121	11 determinable impairment, as determined by the office and as
122	122	12 allowed by federal law.
123	123	13 (2) The individual is employed and earning a monthly wage that
124	124	14 is not less than the federal minimum hourly wage times forty (40).
125	125	15 (3) The individual does not have income or countable resources
126	126	16 in excess of the limits established under section 4 of this chapter.
127	127	17 (4) The individual is at least sixteen (16) years of age and less
128	128	18 than sixty-five (65) years of age.
129	129	19 (5) The individual pays any premiums or other cost sharing
130	130	20 required under this chapter.
131	131	21 (6) The individual meets all other eligibility requirements under
132	132	22 this chapter.
133	133	23 SECTION 6. IC 12-15-41-6 IS AMENDED TO READ AS
134	134	24 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 6. (a) An individual
135	135	25 who is enrolled in the buy-in program and who is unable to maintain
136	136	26 employment for involuntary reasons, including temporary leave due to
137	137	27 a health problem or involuntary termination, continues to be eligible for
138	138	28 Medicaid coverage under the buy-in program if the individual meets
139	139	29 the following requirements:
140	140	30 (1) Within sixty (60) days after the date on which the individual
141	141	31 becomes unemployed, the individual, or an authorized
142	142	32 representative of the individual, submits a written request to the
143	143	33 office that the individual's Medicaid coverage be continued.
144	144	34 (2) The individual maintains a connection to the workforce during
145	145	35 the individual's continued eligibility period by participating in at
146	146	36 least one (1) of the following activities:
147	147	37 (A) Enrollment in a state or federal vocational rehabilitation
148	148	38 program.
149	149	39 (B) Enrollment or registration with the office of workforce
150	150	40 development.
151	151	41 (C) Participation in a transition from school to work program.
152	152	42 (D) Participation with an approved provider of employment
153	153	2022 IN 384—LS 6843/DI 104 4
154	154	1 services, including an employment network recognized by
155	155	2 the federal Social Security Administration.
156	156	3 (E) Provision of documentation from the individual's employer
157	157	4 that the individual is on temporary involuntary leave.
158	158	5 (3) The individual does not have income or countable resources
159	159	6 in excess of the limits established under section 4 of this chapter.
160	160	7 (4) The individual is at least sixteen (16) years of age and less
161	161	8 than sixty-five (65) years of age.
162	162	9 (5) The individual pays any premiums or other cost sharing
163	163	10 required under this chapter.
164	164	11 (6) The individual meets all other eligibility requirements under
165	165	12 this chapter.
166	166	13 (b) The office shall continue Medicaid coverage under the buy-in
167	167	14 program for an individual described in subsection (a) for up to twelve
168	168	15 (12) months from the date of the individual's involuntary loss of
169	169	16 employment.
170	170	17 (c) If an individual is ineligible for continued coverage under the
171	171	18 buy-in program because the individual:
172	172	19 (1) fails to meet the requirements of subsection (a); or
173	173	20 (2) has already met twelve (12) months of continuing eligibility
174	174	21 under this section;
175	175	22 the individual must meet the applicable eligibility requirements of
176	176	23 IC 12-15-2-6 this article to continue to be eligible for Medicaid.
177	177	24 SECTION 7. IC 12-15-41-7 IS AMENDED TO READ AS
178	178	25 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 7. (a) The office shall
179	179	26 develop a sliding scale of premiums for individuals participating in the
180	180	27 buy-in program.
181	181	28 (b) The sliding scale of premiums required under subsection (a)
182	182	29 must:
183	183	30 (1) be based on the annual gross income of the individual and, if
184	184	31 married, the individual's spouse; and
185	185	32 (2) provide for a minimum monthly premium of twenty-five
186	186	33 dollars ($25) five dollars ($5) and a maximum monthly premium
187	187	34 of two hundred seventy-five dollars ($275). ($200).
188	188	35 (c) Subject to the minimum and maximum amounts described in
189	189	36 subsection (b), the office may annually adjust the scale of premiums
190	190	37 adopted under this section only by administrative rule under
191	191	38 IC 4-22-2.
192	192	39 SECTION 8. IC 12-15-41-8 IS AMENDED TO READ AS
193	193	40 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 8. (a) An individual
194	194	41 whose gross annual income, including the gross annual income of the
195	195	42 individual's spouse, if married, is less than one hundred fifty percent
196	196	2022 IN 384—LS 6843/DI 104 5
197	197	1 (150%) of the federal income poverty level for the size of the
198	198	2 individual's or couple's family may not be required to pay a premium
199	199	3 to participate in the buy-in program.
200	200	4 (b) An individual whose gross annual income, including the gross
201	201	5 annual income of the individual's spouse, if married, is at least one
202	202	6 hundred fifty percent (150%) but not more than three hundred fifty
203	203	7 percent (350%) of the federal income poverty level for the size of the
204	204	8 individual's or couple's family, must pay a monthly premium in an
205	205	9 amount equal to:
206	206	10 (1) the lesser of:
207	207	11 (A) the amount prescribed by the sliding scale developed by
208	208	12 the office under section 7 of this chapter; or
209	209	13 (B) seven and one-half percent (7 1/2%) of the individual's or
210	210	14 couple's gross annual income divided by twelve (12); minus
211	211	15 (2) the monthly amount of any premium paid by the individual,
212	212	16 the individual's spouse, or the individual's parent for health
213	213	17 insurance that covers the individual.
214	214	18 SECTION 9. IC 12-15-41-9 IS AMENDED TO READ AS
215	215	19 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 9. (a) The office shall
216	216	20 may annually review the amount of the premium that an individual is
217	217	21 required to pay under section 8 of this chapter.
218	218	22 (b) In addition to the annual review required under subsection (a),
219	219	23 the office shall adjust the premium that an individual is required to pay
220	220	24 under section 8 of this chapter if:
221	221	25 (1) a change in the individual's income or family size is verified;
222	222	26 and
223	223	27 (2) there is a verified change in the amount of any premiums
224	224	28 paid by the individual, the individual's spouse, or the
225	225	29 individual's parent for health insurance that covers the
226	226	30 individual;
227	227	31 (2) (3) the sliding scale adopted under section 7 of this chapter
228	228	32 applied to the individual's changed circumstances prescribes a
229	229	33 premium for the individual that is different from the premium the
230	230	34 individual is paying; or
231	231	35 (4) the office determines that an error was made in calculating
232	232	36 the individual's premiums.
233	233	37 SECTION 10. IC 12-15-41-10 IS AMENDED TO READ AS
234	234	38 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 10. To the greatest
235	235	39 extent possible, the office shall use the same administrative procedures
236	236	40 regarding premiums for the buy-in program as are used for the
237	237	41 children's health insurance program established under IC 12-17.6,
238	238	42 including
239	239	2022 IN 384—LS 6843/DI 104 6
240	240	1 (1) the effect of nonpayment of a premium. and
241	241	2 (2) the collection of premiums.
242	242	3 SECTION 11. IC 12-15-41-12 IS AMENDED TO READ AS
243	243	4 FOLLOWS [EFFECTIVE JULY 1, 2022]: Sec. 12. (a) Except as
244	244	5 otherwise provided in this chapter, an individual participating in the
245	245	6 buy-in program:
246	246	7 (1) shall be eligible to receive the same benefits, including home
247	247	8 health care services and other services set forth in IC 12-15-5-1,
248	248	9 as a Medicaid recipient; and
249	249	10 (2) is subject to the same requirements, including cost sharing;
250	250	11 may not preclude the individual from also participating in a
251	251	12 Medicaid waiver program.
252	252	13 as an individual receiving Medicaid under IC 12-15-2-6.
253	253	14 (b) If an individual is participating in both the buy-in program
254	254	15 and a Medicaid waiver program, the office of the secretary shall
255	255	16 disregard the following concerning the Medicaid waiver program
256	256	17 ensuring the individual's joint participation:
257	257	18 (1) Income requirements.
258	258	19 (2) Resource requirements.
259	259	20 (3) Cost-sharing requirements.
260	260	21 The office of the secretary shall determine eligibility on an
261	261	22 individual basis using medical need requirements of the individual
262	262	23 for an individual seeking to simultaneously participate in the
263	263	24 buy-in program and a Medicaid waiver program.
264	264	2022 IN 384—LS 6843/DI 104