Introduced Version HOUSE BILL No. 1095 _____ DIGEST OF INTRODUCED BILL Citations Affected: IC 5-10-8-9; IC 12-15; IC 12-21-9; IC 12-23-18; IC 16-21-8.5; IC 27-8-5-15.8; IC 27-13-7-14.2. Synopsis: Mental health and addiction matters. Specifies that an individual's incarceration, hospitalization, or other temporary cessation in substance or chemical use may not be used as a factor in determining the individual's eligibility for coverage in: (1) a state employee health care plan; (2) Medicaid; (3) the healthy Indiana plan; (4) a policy of accident and sickness insurance; or (5) a health maintenance health care contract. Requires an opioid treatment program to: (1) provide a patient of the facility appropriate referrals for continuing care before releasing the patient from care by the facility; and (2) counsel female patients concerning the effects of the program treatment if the female is or becomes pregnant and provide to the patient birth control if requested by the patient. Requires the division of mental health and addiction (division) to annually perform an audit of 20% of an opioid treatment program facility's patient plans to ensure compliance with federal and state laws and regulations. Requires the division to establish a mental health and addiction program to reduce the stigma of mental illness and addiction. Requires hospitals to establish emergency room treatment protocols concerning treatment of a patient who is overdosing, has been provided an overdose intervention drug, or is otherwise identified as having a substance use disorder. Effective: July 1, 2023. Shackleford January 10, 2023, read first time and referred to Committee on Public Health. 2023 IN 1095—LS 6896/DI 104 Introduced First Regular Session of the 123rd General Assembly (2023) PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in this style type. Additions: Whenever a new statutory provision is being enacted (or a new constitutional provision adopted), the text of the new provision will appear in this style type. Also, the word NEW will appear in that style type in the introductory clause of each SECTION that adds a new provision to the Indiana Code or the Indiana Constitution. Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts between statutes enacted by the 2022 Regular Session of the General Assembly. HOUSE BILL No. 1095 A BILL FOR AN ACT to amend the Indiana Code concerning human services. Be it enacted by the General Assembly of the State of Indiana: 1 SECTION 1. IC 5-10-8-9 IS AMENDED TO READ AS FOLLOWS 2 [EFFECTIVE JULY 1, 2023]: Sec. 9. (a) This section does not apply 3 if the application of this section would increase the premiums of the 4 health services policy or plan, as certified under IC 27-8-5-15.7, by 5 more than four percent (4%) as a result of complying with subsection 6 (c). 7 (b) As used in this section, "coverage of services for mental illness" 8 includes benefits with respect to mental health services as defined by 9 the contract, policy, or plan for health services. The term includes 10 services for the treatment of substance abuse and chemical dependency 11 when the services are required in the treatment of a mental illness. 12 (c) If the state enters into a contract for health services through 13 prepaid health care delivery plans, medical self-insurance, or group 14 health insurance for state employees, the contract may not permit 15 treatment limitations or financial requirements on the coverage of 16 services for mental illness if similar limitations or requirements are not 17 imposed on the coverage of services for other medical or surgical 2023 IN 1095—LS 6896/DI 104 2 1 conditions. 2 (d) This section subsection applies to a contract for health services 3 through prepaid health care delivery plans, medical self-insurance, or 4 group medical coverage for state employees that is issued, entered into, 5 or renewed after June 30, 1997. June 30, 2023. If the state enters into 6 a contract for health services through prepaid health care delivery 7 plans, medical self-insurance, or group health insurance for state 8 employees, the contract may not allow an individual's 9 incarceration, hospitalization, or other temporary cessation in 10 substance or chemical use to factor into a determination of an 11 individual's eligibility for coverage of the treatment of substance 12 abuse or chemical dependency. 13 (e) This section does not require the contract for health services to 14 offer mental health benefits. 15 SECTION 2. IC 12-15-5-13, AS AMENDED BY P.L.179-2019, 16 SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE 17 JULY 1, 2023]: Sec. 13. (a) The office shall provide coverage for 18 treatment of opioid or alcohol dependence that includes the following: 19 (1) Counseling services that address the psychological and 20 behavioral aspects of addiction. 21 (2) When medically indicated, drug treatment involving agents 22 approved by the federal Food and Drug Administration for the: 23 (A) treatment of opioid or alcohol dependence; or 24 (B) prevention of relapse to opioids or alcohol after 25 detoxification. 26 (3) When determined by the treatment plan to be medically 27 necessary, inpatient detoxification in accordance with the most 28 current edition of the American Society of Addiction Medicine 29 Patient Placement Criteria. 30 In determining eligibility for substance abuse treatment for a 31 recipient, the office or a managed care organization may not 32 consider an individual's incarceration, hospitalization, or other 33 temporary cessation in substance or chemical use as a factor to 34 deny eligibility. 35 (b) The office shall: 36 (1) develop quality measures to ensure; and 37 (2) require a managed care organization to report; 38 compliance with the coverage required under subsection (a). 39 (c) The office may implement quality capitation withholding of 40 reimbursement to ensure that a managed care organization has 41 provided the coverage required under subsection (a). 42 (d) The office shall report the clinical use of the medications 2023 IN 1095—LS 6896/DI 104 3 1 covered under this section to the mental health Medicaid quality 2 advisory committee established by IC 12-15-35-51. The mental health 3 Medicaid quality advisory committee may make recommendations to 4 the office concerning this section. 5 SECTION 3. IC 12-15-44.5-3.5, AS AMENDED BY 6 P.L.180-2022(ss), SECTION 16, IS AMENDED TO READ AS 7 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 3.5. (a) The plan must 8 include the following in a manner and to the extent determined by the 9 office: 10 (1) Mental health care services. 11 (2) Inpatient hospital services. 12 (3) Prescription drug coverage, including coverage of a long 13 acting, nonaddictive medication assistance treatment drug if the 14 drug is being prescribed for the treatment of substance abuse. 15 (4) Emergency room services. 16 (5) Physician office services. 17 (6) Diagnostic services. 18 (7) Outpatient services, including therapy services. 19 (8) Comprehensive disease management. 20 (9) Home health services, including case management. 21 (10) Urgent care center services. 22 (11) Preventative care services. 23 (12) Family planning services: 24 (A) including contraceptives and sexually transmitted disease 25 testing, as described in federal Medicaid law (42 U.S.C. 1396 26 et seq.); and 27 (B) not including abortion or abortifacients. 28 (13) Hospice services. 29 (14) Substance abuse services. 30 (15) Donated breast milk that meets requirements developed by 31 the office of Medicaid policy and planning. 32 (16) A service determined by the secretary to be required by 33 federal law as a benchmark service under the federal Patient 34 Protection and Affordable Care Act. 35 (b) The plan may not permit the following: 36 (1) Treatment limitations or financial requirements on the 37 coverage of mental health care services or substance abuse 38 services if similar limitations or requirements are not imposed on 39 the coverage of services for other medical or surgical conditions. 40 (2) In determining coverage for substance abuse treatment, 41 the plan may not factor in an individual's incarceration, 42 hospitalization, or other temporary cessation in substance or 2023 IN 1095—LS 6896/DI 104 4 1 chemical use when determining the individual's eligibility for 2 the treatment. 3 (c) The plan may provide vision services and dental services only 4 to individuals who regularly make the required monthly contributions 5 for the plan as set forth in section 4.7(c) of this chapter. 6 (d) The benefit package offered in the plan: 7 (1) must be benchmarked to a commercial health plan described 8 in 45 CFR 155.100(a)(1) or 45 CFR 155.100(a)(4); and 9 (2) may not include a benefit that is not present in at least one (1) 10 of these commercial benchmark options. 11 (e) The office shall provide to an individual who participates in the 12 plan a list of health care services that qualify as preventative care 13 services for the age, gender, and preexisting conditions of the 14 individual. The office shall consult with the federal Centers for Disease 15 Control and Prevention for a list of recommended preventative care 16 services. 17 (f) The plan shall, at no cost to the individual, provide payment of 18 preventative care services described in 42 U.S.C. 300gg-13 for an 19 individual who participates in the plan. 20 (g) The plan shall, at no cost to the individual, provide payments of 21 not more than five hundred dollars ($500) per year for preventative 22 care services not described in subsection (f). Any additional 23 preventative care services covered under the plan and received by the 24 individual during the year are subject to the deductible and payment 25 requirements of the plan. 26 (h) The office shall apply to the United States Department of Health 27 and Human Services for any amendment to the waiver necessary to 28 implement the providing of the services or supplies described in 29 subsection (a)(15). This subsection expires July 1, 2024. 30 SECTION 4. IC 12-21-9 IS ADDED TO THE INDIANA CODE AS 31 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY 32 1, 2023]: 33 Chapter 9. Mental Health Education Program 34 Sec. 1. The division shall establish and administer a statewide 35 program to reduce the stigma of mental illness and addiction in 36 Indiana. 37 Sec. 2. The program must include the following: 38 (1) Awareness raising interventions, including signs or 39 symptoms that an individual may be suffering from a mental 40 illness or addiction. 41 (2) Literacy programs to improve knowledge of mental 42 illnesses and addiction. 2023 IN 1095—LS 6896/DI 104 5 1 (3) Dissemination of lists of resources available on a regional 2 basis to individuals who believe they are suffering from a 3 mental illness or addiction. 4 (4) The benefits of obtaining services to treat a mental illness 5 or addiction. 6 (5) Dissemination of educational materials targeted to 7 different ages and populations. 8 SECTION 5. IC 12-23-18-0.5, AS AMENDED BY P.L.8-2016, 9 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE 10 JULY 1, 2023]: Sec. 0.5. (a) An opioid treatment program shall not 11 operate in Indiana unless the opioid treatment program meets the 12 following conditions: 13 (1) Is specifically approved and the opioid treatment facility is 14 certified by the division. 15 (2) Is in compliance with state and federal law. 16 (3) Provides treatment for opioid addiction using a drug approved 17 by the federal Food and Drug Administration for the treatment of 18 opioid addiction, including: 19 (A) opioid maintenance; 20 (B) detoxification; 21 (C) overdose reversal; 22 (D) relapse prevention; and 23 (E) long acting, nonaddictive medication assisted treatment 24 medications. 25 (4) Beginning July 1, 2017, is: 26 (A) enrolled: 27 (i) as a Medicaid provider under IC 12-15; and 28 (ii) as a healthy Indiana plan provider under IC 12-15-44.2; 29 or 30 (B) enrolled as an ordering, prescribing, or referring provider 31 in accordance with Section 6401 of the federal Patient 32 Protection and Affordable Care Act (P.L. 111-148), as 33 amended by the federal Health Care and Education 34 Reconciliation Act of 2010 (P.L. 111-152) and maintains a 35 memorandum of understanding with a community mental 36 health center for the purpose of ordering, prescribing, or 37 referring treatments covered by Medicaid and the healthy 38 Indiana plan. 39 (5) Provides to a patient of the opioid treatment facility who 40 is being released from the program referrals to appropriate 41 providers to continue the care that: 42 (A) the facility deems appropriate for the patient; or 2023 IN 1095—LS 6896/DI 104 6 1 (B) the patient requests; 2 before the patient's release from care of the facility. 3 (b) Separate specific approval and certification under this chapter 4 is required for each location at which an opioid treatment program is 5 operated. If an opioid treatment program moves the opioid treatment 6 program's facility to another location, the opioid treatment program's 7 certification does not apply to the new location and certification for the 8 new location under this chapter is required. 9 (c) Each opioid treatment program that is enrolled as an ordering, 10 prescribing, or referring provider shall report to the office on an annual 11 basis the services provided to Indiana Medicaid patients. The report 12 must include the following: 13 (1) The number of Medicaid patients seen by the ordering, 14 prescribing, or referring provider. 15 (2) The services received by the provider's Medicaid patients, 16 including any drugs prescribed. 17 (3) The number of Medicaid patients referred to other providers. 18 (4) Any other provider types to which the Medicaid patients were 19 referred. 20 SECTION 6. IC 12-23-18-5, AS AMENDED BY P.L.181-2021, 21 SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE 22 JULY 1, 2023]: Sec. 5. (a) The division shall adopt rules under 23 IC 4-22-2 to establish the following: 24 (1) Standards for operation of an opioid treatment program in 25 Indiana, including the following requirements: 26 (A) Except as otherwise prescribed by the division, an opioid 27 treatment program shall obtain prior authorization from the 28 division for any patient receiving more than fourteen (14) days 29 of opioid maintenance treatment medications at one (1) time 30 and the division may approve the authorization only under the 31 following circumstances: 32 (i) A physician licensed under IC 25-22.5 has issued an 33 order for the opioid treatment medication. 34 (ii) The patient has not tested positive under a drug test for 35 a drug for which the patient does not have a prescription for 36 a period of time set forth by the division. 37 (iii) The opioid treatment program has determined that the 38 benefit to the patient in receiving the take home opioid 39 treatment medication outweighs the potential risk of 40 diversion of the take home opioid treatment medication. 41 (B) Minimum requirements for a licensed physician's regular: 42 (i) physical presence in the opioid treatment facility; and 2023 IN 1095—LS 6896/DI 104 7 1 (ii) physical evaluation and progress evaluation of each 2 opioid treatment program patient. 3 (C) Minimum staffing requirements by licensed and 4 unlicensed personnel. 5 (D) Clinical standards for the appropriate tapering of a patient 6 on and off of an opioid treatment medication. 7 (E) The provision of counseling to female patients upon 8 admission and periodically through the patient's treatment 9 by the facility concerning the effects of the program 10 treatment if the female is or becomes pregnant, and the 11 provision to the patient of birth control if requested by the 12 patient. 13 (2) A requirement that, not later than February 28 of each year, a 14 current diversion control plan that meets the requirements of 21 15 CFR Part 290 and 42 CFR Part 8 be submitted for each opioid 16 treatment facility. 17 (3) Fees to be paid by an opioid treatment program for deposit in 18 the fund for annual certification under this chapter as described 19 in section 3 of this chapter. 20 The fees established under this subsection must be sufficient to pay the 21 cost of implementing this chapter. 22 (b) The division shall conduct an annual onsite visit of each opioid 23 treatment program facility to assess compliance with this chapter. As 24 part of an annual onsite visit, the division shall audit at least twenty 25 percent (20%) of the opioid treatment program facility's patient 26 plans to determine whether the facility is complying with federal 27 and state rules and regulations, including the following: 28 (1) Meeting tapering standards established by the division 29 under subsection (a)(1)(D). 30 (2) Complying with the goal of providing a patient with the 31 minimal clinically necessary medication dose, with the goal of 32 opioid abstinence as set forth in section 5.3 of this chapter. 33 (3) Performing and complying with the drug testing 34 requirements for patients set forth in section 2.5 of this 35 chapter. 36 (4) Racial demographics of the patients. 37 Any personally identifying information and medical information 38 of a patient obtained through the audit are confidential. 39 (c) Not later than April 1 of each year, the division shall report to 40 the general assembly in electronic format under IC 5-14-6 the 41 following information: 42 (1) The number of prior authorizations that were approved under 2023 IN 1095—LS 6896/DI 104 8 1 subsection (a)(1)(A) in the previous year and the: 2 (A) time frame for each approval; and 3 (B) duration of each approved treatment. 4 (2) The number of authorizations under subdivision (1) that were, 5 in the previous year, revoked due to a patient's violation of an 6 applicable term or condition. 7 (3) The number of each of the actions taken under section 5.8(a) 8 of this chapter in the previous year. 9 (4) The number and type of violations assessed for each action 10 specified in section 5.8(a) of this chapter in the previous year. 11 (d) A facility shall report, in a manner prescribed by the division, all 12 information required by the division to complete the report described 13 in subsection (c). 14 SECTION 7. IC 16-21-8.5 IS ADDED TO THE INDIANA CODE 15 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE 16 JULY 1, 2023]: 17 Chapter 8.5. Emergency Room Treatment of Patients With 18 Substance Use Disorders 19 Sec. 1. Not later than January 1, 2024, a hospital licensed under 20 this article shall have established protocols on the emergency room 21 treatment of a patient who: 22 (1) is overdosing on a substance; 23 (2) has been provided an overdose intervention drug 24 immediately prior to being transported to the hospital; or 25 (3) is otherwise identified as having a substance use disorder. 26 Sec. 2. The protocols required in section 1 of this chapter must 27 include the following: 28 (1) An assessment of the patient before discharge by a 29 provider whose scope of practice includes providing 30 treatment for an individual with a substance use disorder, 31 including: 32 (A) a physician licensed under IC 25-22.5; 33 (B) a psychologist licensed under IC 25-33; 34 (C) an addiction counselor or a clinical addiction counselor 35 licensed under IC 25-23.6-10.5; or 36 (D) a person described in IC 25-23.6-10.1-2. 37 (2) Treatment, assistance in obtaining treatment, or a referral 38 to treatment to a provider described in subdivision (1). 39 Sec. 3. The hospital shall provide training on the protocols to 40 any staff or contractor providing services in the emergency 41 department of the hospital. 42 SECTION 8. IC 27-8-5-15.8, AS ADDED BY P.L.103-2020, 2023 IN 1095—LS 6896/DI 104 9 1 SECTION 4, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE 2 JULY 1, 2023]: Sec. 15.8. (a) As used in this section, "treatment of a 3 mental illness or substance abuse" means: 4 (1) treatment for a mental illness, as defined in IC 12-7-2-130(1); 5 and 6 (2) treatment for drug abuse or alcohol abuse. 7 (b) As used in this section, "act" refers to the Paul Wellstone and 8 Pete Domenici Mental Health Parity and Addiction Act of 2008 and 9 any amendments thereto, plus any federal guidance or regulations 10 relevant to that act, including 45 CFR 146.136, 45 CFR 147.136, 45 11 CFR 147.160, and 45 CFR 156.115(a)(3). 12 (c) As used in this section, "nonquantitative treatment limitations" 13 refers to those limitations described in 26 CFR 54.9812-1, 29 CFR 14 2590.712, and 45 CFR 146.136. 15 (d) An insurer that issues a policy of accident and sickness 16 insurance that provides coverage of services for treatment of a mental 17 illness or substance abuse shall submit a report to the department not 18 later than December 31 of each year that contains the following 19 information: 20 (1) A description of the processes: 21 (A) used to develop or select the medical necessity criteria for 22 coverage of services for treatment of a mental illness or 23 substance abuse; and 24 (B) used to develop or select the medical necessity criteria for 25 coverage of services for treatment of other medical or surgical 26 conditions. 27 (2) Identification of all nonquantitative treatment limitations that 28 are applied to: 29 (A) coverage of services for treatment of a mental illness or 30 substance abuse; and 31 (B) coverage of services for treatment of other medical or 32 surgical conditions; 33 within each classification of benefits. 34 (e) Coverage of treatment of a mental illness or substance abuse 35 must meet the following: 36 (1) There may be no separate nonquantitative treatment 37 limitations that apply to coverage of services for treatment of a 38 mental illness or substance abuse that do not apply to coverage of 39 services for treatment of other medical or surgical conditions 40 within any classification of benefits. 41 (2) An individual's incarceration, hospitalization, or other 42 temporary cessation in substance or chemical use may not 2023 IN 1095—LS 6896/DI 104 10 1 factor into a determination of the individual's eligibility for 2 coverage of the treatment of mental illness or substance 3 abuse. 4 (f) An insurer that issues a policy of accident and sickness insurance 5 that provides coverage of services for treatment of a mental illness or 6 substance abuse shall also submit an analysis showing the insurer's 7 compliance with this section and the act to the department not later 8 than December 31 of each year. The analysis must do the following: 9 (1) Identify the factors used to determine that a nonquantitative 10 treatment limitation will apply to a benefit, including factors that 11 were considered but rejected. 12 (2) Identify and define the specific evidentiary standards used to 13 define the factors and any other evidence relied upon in designing 14 each nonquantitative treatment limitation. 15 (3) Provide the comparative analyses, including the results of the 16 analyses, performed to determine the following: 17 (A) That the processes and strategies used to design each 18 nonquantitative treatment limitation for coverage of services 19 for treatment of a mental illness or substance abuse are 20 comparable to, and applied no more stringently than, the 21 processes and strategies used to design each nonquantitative 22 treatment limitation for coverage of services for treatment of 23 other medical or surgical conditions. 24 (B) That the processes and strategies used to apply each 25 nonquantitative treatment limitation for treatment of a mental 26 illness or substance abuse are comparable to, and applied no 27 more stringently than, the processes and strategies used to 28 apply each nonquantitative limitation for treatment of other 29 medical or surgical conditions. 30 (g) The department shall adopt rules to ensure compliance with this 31 section and the applicable provisions of the act. 32 SECTION 9. IC 27-13-7-14.2, AS ADDED BY P.L.103-2020, 33 SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE 34 JULY 1, 2023]: Sec. 14.2. (a) As used in this section, "treatment of a 35 mental illness or substance abuse" means: 36 (1) treatment for a mental illness, as defined in IC 12-7-2-130(1); 37 and 38 (2) treatment for drug abuse or alcohol abuse. 39 (b) As used in this section, "act" refers to the Paul Wellstone and 40 Pete Domenici Mental Health Parity and Addiction Act of 2008 and 41 any amendments thereto, plus any federal guidance or regulations 42 relevant to that act, including 45 CFR 146.136, 45 CFR 147.136, 45 2023 IN 1095—LS 6896/DI 104 11 1 CFR 147.160, and 45 CFR 156.115(a)(3). 2 (c) As used in this section, "nonquantitative treatment limitations" 3 refers to those limitations described in 26 CFR 54.9812-1, 29 CFR 4 2590.712, and 45 CFR 146.136. 5 (d) An individual contract or a group contract that provides 6 coverage of services for treatment of a mental illness or substance 7 abuse shall submit a report to the department not later than December 8 31 of each year that contains the following information: 9 (1) A description of the processes: 10 (A) used to develop or select the medical necessity criteria for 11 coverage of services for treatment of a mental illness or 12 substance abuse; and 13 (B) used to develop or select the medical necessity criteria for 14 coverage of services for treatment of other medical or surgical 15 conditions. 16 (2) Identification of all nonquantitative treatment limitations that 17 are applied to: 18 (A) coverage of services for treatment of a mental illness or 19 substance abuse; and 20 (B) coverage of services for treatment of other medical or 21 surgical conditions; 22 within each classification of benefits. 23 (e) Coverage of treatment of a mental illness or substance abuse 24 must meet the following: 25 (1) There may be no separate nonquantitative treatment 26 limitations that apply to coverage of services for treatment of a 27 mental illness or substance abuse that do not apply to coverage of 28 services for treatment of other medical or surgical conditions 29 within any classification of benefits. 30 (2) An individual's incarceration, hospitalization, or other 31 temporary cessation in substance or chemical use may not 32 factor into a determination of the individual's eligibility for 33 coverage of the treatment of mental illness or substance 34 abuse. 35 (f) An individual contract or a group contract that provides coverage 36 of services for treatment of a mental illness or substance abuse shall 37 also submit an analysis showing the insurer's compliance with this 38 section and the act to the department not later than December 31 of 39 each year. The analysis must do the following: 40 (1) Identify the factors used to determine that a nonquantitative 41 treatment limitation will apply to a benefit, including factors that 42 were considered but rejected. 2023 IN 1095—LS 6896/DI 104 12 1 (2) Identify and define the specific evidentiary standards used to 2 define the factors and any other evidence relied upon in designing 3 each nonquantitative treatment limitation. 4 (3) Provide the comparative analyses, including the results of the 5 analyses, performed to determine the following: 6 (A) That the processes and strategies used to design each 7 nonquantitative treatment limitation for coverage of services 8 for treatment of a mental illness or substance abuse are 9 comparable to, and applied no more stringently than, the 10 processes and strategies used to design each nonquantitative 11 treatment limitation for coverage of services for treatment of 12 other medical or surgical conditions. 13 (B) That the processes and strategies used to apply each 14 nonquantitative treatment limitation for treatment of a mental 15 illness or substance abuse are comparable to, and applied no 16 more stringently than, the processes and strategies used to 17 apply each nonquantitative limitation for treatment of other 18 medical or surgical conditions. 19 (g) The department shall adopt rules to ensure compliance with this 20 section and the applicable provisions of the act. 2023 IN 1095—LS 6896/DI 104