Introduced Version
HOUSE BILL No. 1514
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 12-15.
Synopsis: Health matters. Provides that orthotic devices are provided
under Medicaid. Requires the office of the secretary of family and
social services and a managed care organization to reimburse under
Medicaid a provider of prosthetic and orthotic devices at a rate
comparable to the federal Medicare reimbursement rate.
Effective: July 1, 2023.
Barrett
January 19, 2023, read first time and referred to Committee on Public Health.
2023 IN 1514—LS 7244/DI 77 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. 1514
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 12-15-5-1, AS AMENDED BY P.L.180-2022(ss),
2 SECTION 15, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2023]: Sec. 1. (a) Except as provided in IC 12-15-2-12,
4 IC 12-15-6, and IC 12-15-21, the following services and supplies are
5 provided under Medicaid:
6 (1) Inpatient hospital services.
7 (2) Nursing facility services.
8 (3) Physician's services, including services provided under
9 IC 25-10-1 and IC 25-22.5-1.
10 (4) Outpatient hospital or clinic services.
11 (5) Home health care services.
12 (6) Private duty nursing services.
13 (7) Physical therapy and related services.
14 (8) Dental services.
15 (9) Prescribed laboratory and x-ray services.
16 (10) Prescribed drugs and pharmacist services.
17 (11) Eyeglasses. and prosthetic devices.
2023 IN 1514—LS 7244/DI 77 2
1 (12) Optometric services.
2 (13) Diagnostic, screening, preventive, and rehabilitative services.
3 (14) Podiatric medicine services.
4 (15) Hospice services.
5 (16) Services or supplies recognized under Indiana law and
6 specified under rules adopted by the office.
7 (17) Family planning services except the performance of
8 abortions.
9 (18) Nonmedical nursing care given in accordance with the tenets
10 and practices of a recognized church or religious denomination to
11 an individual qualified for Medicaid who depends upon healing
12 by prayer and spiritual means alone in accordance with the tenets
13 and practices of the individual's church or religious denomination.
14 (19) Services provided to individuals described in IC 12-15-2-8.
15 (20) Services provided under IC 12-15-34 and IC 12-15-32.
16 (21) Case management services provided to individuals described
17 in IC 12-15-2-13.
18 (22) Any other type of remedial care recognized under Indiana
19 law and specified by the United States Secretary of Health and
20 Human Services.
21 (23) Examinations required under IC 16-41-17-2(a)(10).
22 (24) Inpatient substance abuse detoxification services.
23 (25) Chronic pain management.
24 (26) Donated breast milk that meets requirements developed by
25 the office of Medicaid policy and planning.
26 (27) Prosthetic devices and orthotic devices.
27 (b) The office shall do the following:
28 (1) Apply to the United States Department of Health and Human
29 Services for any state plan amendment or waiver necessary to
30 implement the services or supplies described in subsection
31 (a)(26).
32 (2) Develop requirements for donated breast milk as described in
33 subsection (a)(26).
34 (3) As soon as practicable, but not later than January 1, 2023, the
35 office shall:
36 (A) seek any necessary approval from the United States
37 Department of Health and Human Services; and
38 (B) adopt any written policies, procedures, or regulations
39 determined necessary;
40 to provide reimbursement for long-acting reversible
41 contraception. This subdivision expires June 30, 2023.
42 SECTION 2. IC 12-15-5-22 IS ADDED TO THE INDIANA CODE
2023 IN 1514—LS 7244/DI 77 3
1 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
2 1, 2023]: Sec. 22. (a) As used in this section, "orthotic device"
3 means a medically necessary rigid or semi-rigid device used for the
4 purpose of supporting a weak or deformed body member or
5 restricting or eliminating motion in a diseased or injured part of
6 the body.
7 (b) As used in this section, "prosthetic device" means an
8 artificial leg or arm, or any component part of the device.
9 (c) This section applies to an eligible provider that provides
10 orthotic devices or prosthetic devices, including repairs or
11 replacements, that are:
12 (1) provided or performed by a person that is:
13 (A) accredited as required under 42 U.S.C. 1395m(a)(20);
14 or
15 (B) a qualified practitioner (as defined in 42 U.S.C.
16 1395m(h)(1)(F)(iii));
17 (2) determined by the Medicaid recipient's physician to be
18 medically necessary to restore or maintain the enrollee's
19 ability to perform activities of daily living or essential job
20 related activities; and
21 (3) not solely for comfort or convenience.
22 (d) The reimbursement provided by the office of the secretary
23 for the devices and services under subsection (c) must be equal to
24 the reimbursement that is provided for the same device, repair, or
25 replacement under the federal Medicare reimbursement schedule.
26 SECTION 3. IC 12-15-12-24 IS ADDED TO THE INDIANA
27 CODE AS A NEW SECTION TO READ AS FOLLOWS
28 [EFFECTIVE JULY 1, 2023]: Sec. 24. (a) As used in this section,
29 "orthotic device" means a medically necessary rigid or semi-rigid
30 device used for the purpose of supporting a weak or deformed
31 body member or restricting or eliminating motion in a diseased or
32 injured part of the body.
33 (b) As used in this section, "prosthetic device" means an
34 artificial leg or arm, or any component part of the device.
35 (c) This section applies to a managed care provider that
36 provides orthotic devices or prosthetic devices, including repairs
37 or replacements, that are:
38 (1) provided or performed by a person that is:
39 (A) accredited as required under 42 U.S.C. 1395m(a)(20);
40 or
41 (B) a qualified practitioner (as defined in 42 U.S.C.
42 1395m(h)(1)(F)(iii));
2023 IN 1514—LS 7244/DI 77 4
1 (2) determined by the enrollee's physician to be medically
2 necessary to restore or maintain the enrollee's ability to
3 perform activities of daily living or essential job related
4 activities; and
5 (3) not solely for comfort or convenience.
6 (d) The reimbursement provided by a managed care
7 organization for the devices and services under subsection (c) must
8 be equal to the reimbursement that is provided for the same device,
9 repair, or replacement under the federal Medicare reimbursement
10 schedule.
2023 IN 1514—LS 7244/DI 77