Indiana 2023 Regular Session

Indiana Senate Bill SB0207 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. 207
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 12-14-30-6.5; IC 12-15; IC 12-17.6-3-3.
7	7	Synopsis: FSSA matters. Limits work requirements for Supplemental
8	8	Nutrition Assistance Program (SNAP) recipients to the minimum
9	9	required by federal law. Changes the requirements for submitting
10	10	eligibility information for an individual who is: (1) less than 19 years
11	11	of age; and (2) a recipient of either the Medicaid program or the
12	12	children's health insurance program (CHIP) (programs). (Current law
13	13	concerning the submission of eligibility information in the programs
14	14	applies to individuals less than three years of age.) Prohibits the office
15	15	of the secretary of family and social services (office) from requiring a
16	16	participant of the healthy Indiana plan (plan) to cost share or otherwise
17	17	make copayments in order to participate in the plan. Prohibits the office
18	18	from requiring an individual to work or be a student in order to
19	19	participate in the plan.
20	20	Effective: July 1, 2023.
21	21	Breaux
22	22	January 10, 2023, read first time and referred to Committee on Family and Children
23	23	Services.
24	24	2023 IN 207—LS 7036/DI 104 Introduced
25	25	First Regular Session of the 123rd General Assembly (2023)
26	26	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
27	27	Constitution) is being amended, the text of the existing provision will appear in this style type,
28	28	additions will appear in this style type, and deletions will appear in this style type.
29	29	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
30	30	provision adopted), the text of the new provision will appear in this style type. Also, the
31	31	word NEW will appear in that style type in the introductory clause of each SECTION that adds
32	32	a new provision to the Indiana Code or the Indiana Constitution.
33	33	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
34	34	between statutes enacted by the 2022 Regular Session of the General Assembly.
35	35	SENATE BILL No. 207
36	36	A BILL FOR AN ACT to amend the Indiana Code concerning
37	37	human services.
38	38	Be it enacted by the General Assembly of the State of Indiana:
39	39	1 SECTION 1. IC 12-14-30-6.5 IS ADDED TO THE INDIANA
40	40	2 CODE AS A NEW SECTION TO READ AS FOLLOWS
41	41	3 [EFFECTIVE JULY 1, 2023]: Sec. 6.5. The division may not require
42	42	4 a SNAP recipient to meet any work requirements that are stricter
43	43	5 than what is required by federal law for the SNAP program.
44	44	6 SECTION 2. IC 12-15-2-15.8, AS ADDED BY P.L.218-2007,
45	45	7 SECTION 10, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
46	46	8 JULY 1, 2023]: Sec. 15.8. After an individual who is less than three (3)
47	47	9 nineteen (19) years of age is determined to be eligible for Medicaid
48	48	10 under section 14 of this chapter, the individual is not required to submit
49	49	11 eligibility information more frequently than once in a twelve (12)
50	50	12 month period until the child becomes three (3) nineteen (19) years of
51	51	13 age.
52	52	14 SECTION 3. IC 12-15-44.5-3.5, AS AMENDED BY
53	53	15 P.L.180-2022(ss), SECTION 16, IS AMENDED TO READ AS
54	54	16 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 3.5. (a) The plan must
55	55	17 include the following in a manner and to the extent determined by the
56	56	2023 IN 207—LS 7036/DI 104 2
57	57	1 office:
58	58	2 (1) Mental health care services.
59	59	3 (2) Inpatient hospital services.
60	60	4 (3) Prescription drug coverage, including coverage of a long
61	61	5 acting, nonaddictive medication assistance treatment drug if the
62	62	6 drug is being prescribed for the treatment of substance abuse.
63	63	7 (4) Emergency room services.
64	64	8 (5) Physician office services.
65	65	9 (6) Diagnostic services.
66	66	10 (7) Outpatient services, including therapy services.
67	67	11 (8) Comprehensive disease management.
68	68	12 (9) Home health services, including case management.
69	69	13 (10) Urgent care center services.
70	70	14 (11) Preventative care services.
71	71	15 (12) Family planning services:
72	72	16 (A) including contraceptives and sexually transmitted disease
73	73	17 testing, as described in federal Medicaid law (42 U.S.C. 1396
74	74	18 et seq.); and
75	75	19 (B) not including abortion or abortifacients.
76	76	20 (13) Hospice services.
77	77	21 (14) Substance abuse services.
78	78	22 (15) Donated breast milk that meets requirements developed by
79	79	23 the office of Medicaid policy and planning.
80	80	24 (16) A service determined by the secretary to be required by
81	81	25 federal law as a benchmark service under the federal Patient
82	82	26 Protection and Affordable Care Act.
83	83	27 (b) The plan may not permit treatment limitations or financial
84	84	28 requirements on the coverage of mental health care services or
85	85	29 substance abuse services if similar limitations or requirements are not
86	86	30 imposed on the coverage of services for other medical or surgical
87	87	31 conditions.
88	88	32 (c) The plan may provide vision services and dental services. only
89	89	33 to individuals who regularly make the required monthly contributions
90	90	34 for the plan as set forth in section 4.7(c) of this chapter.
91	91	35 (d) The benefit package offered in the plan:
92	92	36 (1) must be benchmarked to a commercial health plan described
93	93	37 in 45 CFR 155.100(a)(1) or 45 CFR 155.100(a)(4); and
94	94	38 (2) may not include a benefit that is not present in at least one (1)
95	95	39 of these commercial benchmark options.
96	96	40 (e) The office shall provide to an individual who participates in the
97	97	41 plan a list of health care services that qualify as preventative care
98	98	42 services for the age, gender, and preexisting conditions of the
99	99	2023 IN 207—LS 7036/DI 104 3
100	100	1 individual. The office shall consult with the federal Centers for Disease
101	101	2 Control and Prevention for a list of recommended preventative care
102	102	3 services.
103	103	4 (f) The plan shall, at no cost to the individual, provide payment of
104	104	5 preventative care services described in 42 U.S.C. 300gg-13 for an
105	105	6 individual who participates in the plan.
106	106	7 (g) The plan shall, at no cost to the individual, provide payments of
107	107	8 not more than five hundred dollars ($500) per year for preventative
108	108	9 care services not described in subsection (f). Any additional
109	109	10 preventative care services covered under the plan and received by the
110	110	11 individual during the year are subject to the deductible. and payment
111	111	12 requirements of the plan.
112	112	13 (h) The office shall apply to the United States Department of Health
113	113	14 and Human Services for any amendment to the waiver necessary to
114	114	15 implement the providing of the services or supplies described in
115	115	16 subsection (a)(15). This subsection expires July 1, 2024.
116	116	17 SECTION 4. IC 12-15-44.5-4.5, AS ADDED BY P.L.30-2016,
117	117	18 SECTION 30, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
118	118	19 JULY 1, 2023]: Sec. 4.5. (a) An individual who participates in the plan
119	119	20 must have a health care account to which payments may be made for
120	120	21 the individual's participation in the plan.
121	121	22 (b) An individual's health care account must be used to pay the
122	122	23 individual's deductible for health care services under the plan.
123	123	24 (c) An individual's deductible must be at least two thousand five
124	124	25 hundred dollars ($2,500) per year.
125	125	26 (d) An individual may make payments to the individual's health care
126	126	27 account as follows:
127	127	28 (1) An employer withholding or causing to be withheld from an
128	128	29 employee's wages or salary, after taxes are deducted from the
129	129	30 wages or salary, the individual's contribution under this chapter
130	130	31 and distributed equally throughout the calendar year.
131	131	32 (2) Submission of the individual's contribution under this chapter
132	132	33 to the office to deposit in the individual's health care account in
133	133	34 a manner prescribed by the office.
134	134	35 (3) Another method determined by the office.
135	135	36 (e) An individual may not be required to contribute to the
136	136	37 individual's health care account.
137	137	38 SECTION 5. IC 12-15-44.5-4.7, AS AMENDED BY P.L.152-2017,
138	138	39 SECTION 33, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
139	139	40 JULY 1, 2023]: Sec. 4.7. (a) To participate in the plan, an individual
140	140	41 must apply for the plan on a form prescribed by the office. The office
141	141	42 may develop and allow a joint application for a household.
142	142	2023 IN 207—LS 7036/DI 104 4
143	143	1 (b) The office may not require an applicant or participant of the
144	144	2 plan to make copayments or other cost sharing requirements to the
145	145	3 participant's health care account in order to participate in or
146	146	4 remain a member of the plan.
147	147	5 (b) A pregnant woman is not subject to the cost sharing provisions
148	148	6 of the plan. Subsections (c) through (g) do not apply to a pregnant
149	149	7 woman participating in the plan.
150	150	8 (c) An applicant who is approved to participate in the plan does not
151	151	9 begin benefits under the plan until a payment of at least:
152	152	10 (1) one-twelfth (1/12) of the annual income contribution amount;
153	153	11 or
154	154	12 (2) ten dollars ($10);
155	155	13 is made to the individual's health care account established under
156	156	14 section 4.5 of this chapter for the individual's participation in the plan.
157	157	15 To continue to participate in the plan, an individual must contribute to
158	158	16 the individual's health care account at least two percent (2%) of the
159	159	17 individual's annual household income per year or an amount
160	160	18 determined by the secretary that is based on the individual's annual
161	161	19 household income per year, but not less than one dollar ($1) per month.
162	162	20 The amount determined by the secretary under this subsection must be
163	163	21 approved by the United States Department of Health and Human
164	164	22 Services and must be budget neutral to the state as determined by the
165	165	23 state budget agency.
166	166	24 (d) If an applicant who is approved to participate in the plan fails to
167	167	25 make the initial payment into the individual's health care account, at
168	168	26 least the following must occur:
169	169	27 (1) If the individual has an annual income that is at or below one
170	170	28 hundred percent (100%) of the federal poverty income level, the
171	171	29 individual's benefits are reduced as specified in subsection (e)(1).
172	172	30 (2) If the individual has an annual income of more than one
173	173	31 hundred percent (100%) of the federal poverty income level, the
174	174	32 individual is not enrolled in the plan.
175	175	33 (e) If an enrolled individual's required monthly payment to the plan
176	176	34 is not made within sixty (60) days after the required payment date, the
177	177	35 following, at a minimum, occur:
178	178	36 (1) For an individual who has an annual income that is at or below
179	179	37 one hundred percent (100%) of the federal income poverty level,
180	180	38 the individual is:
181	181	39 (A) transferred to a plan that has a material reduction in
182	182	40 benefits, including the elimination of benefits for vision and
183	183	41 dental services; and
184	184	42 (B) required to make copayments for the provision of services
185	185	2023 IN 207—LS 7036/DI 104 5
186	186	1 that may not be paid from the individual's health care account.
187	187	2 (2) For an individual who has an annual income of more than one
188	188	3 hundred percent (100%) of the federal poverty income level, the
189	189	4 individual shall be terminated from the plan and may not reenroll
190	190	5 in the plan for at least six (6) months.
191	191	6 (f) The state shall contribute to the individual's health care account
192	192	7 the difference between the individual's payment required under this
193	193	8 section and the plan deductible set forth in section 4.5(c) of this
194	194	9 chapter.
195	195	10 (g) (c) A member shall remain enrolled with the same managed care
196	196	11 organization during the member's benefit period. A member may
197	197	12 change managed care organizations as follows:
198	198	13 (1) Without cause:
199	199	14 (A) before making a contribution or before finalizing
200	200	15 enrollment; in accordance with subsection (d)(1); or
201	201	16 (B) during the annual plan renewal process.
202	202	17 (2) For cause, as determined by the office.
203	203	18 SECTION 6. IC 12-15-44.5-4.9, AS AMENDED BY P.L.114-2018,
204	204	19 SECTION 6, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
205	205	20 JULY 1, 2023]: Sec. 4.9. (a) An individual who is approved to
206	206	21 participate in the plan is eligible for a twelve (12) month plan period if
207	207	22 the individual continues to meet the plan requirements specified in this
208	208	23 chapter.
209	209	24 (b) If an individual chooses to renew participation in the plan, the
210	210	25 individual is subject to an annual renewal process at the end of the
211	211	26 benefit period to determine continued eligibility for participating in the
212	212	27 plan. If the individual does not complete the renewal process, the
213	213	28 individual may not reenroll in the plan for at least six (6) months.
214	214	29 (c) This subsection applies to participants who consistently made
215	215	30 the required payments in the individual's health care account. If the
216	216	31 individual receives the qualified preventative services recommended
217	217	32 to the individual during the year, the individual is eligible to have the
218	218	33 individual's unused share of the individual's health care account at the
219	219	34 end of the plan period, determined by the office, matched by the state
220	220	35 and carried over to the subsequent plan period. to reduce the
221	221	36 individual's required payments. If the individual did not, during the
222	222	37 plan period, receive all qualified preventative services recommended
223	223	38 to the individual, only the nonstate contribution to the health care
224	224	39 account may be used to reduce the individual's payments for the
225	225	40 subsequent plan period.
226	226	41 (d) For individuals participating in the plan who, in the past, did not
227	227	42 make consistent payments into the individual's health care account
228	228	2023 IN 207—LS 7036/DI 104 6
229	229	1 while participating in the plan, but:
230	230	2 (1) had a balance remaining in the individual's health care
231	231	3 account; and
232	232	4 (2) received all of the required preventative care services;
233	233	5 the office may elect to offer a discount on the individual's required
234	234	6 payments to the individual's health care account for the subsequent
235	235	7 benefit year. The amount of the discount under this subsection must be
236	236	8 related to the percentage of the health care account balance at the end
237	237	9 of the plan year but not to exceed a fifty percent (50%) discount of the
238	238	10 required contribution.
239	239	11 (e) (d) If an individual is no longer eligible for the plan or does not
240	240	12 renew participation in the plan at the end of the plan period, or is
241	241	13 terminated from the plan for nonpayment of a required payment, the
242	242	14 office shall, not more than one hundred twenty (120) days after the last
243	243	15 date of the plan benefit period, refund to the individual the amount
244	244	16 determined under STEP FOUR of subsection (f) (e) of any funds
245	245	17 remaining in the individual's health care account. as follows:
246	246	18 (1) An individual who is no longer eligible for the plan or does
247	247	19 not renew participation in the plan at the end of the plan period
248	248	20 shall receive the amount determined under STEP FOUR of
249	249	21 subsection (f).
250	250	22 (2) An individual who is terminated from the plan due to
251	251	23 nonpayment of a required payment shall receive the amount
252	252	24 determined under STEP SIX of subsection (f).
253	253	25 The office may charge a penalty for any voluntary withdrawals from the
254	254	26 health care account by the individual before the end of the plan benefit
255	255	27 year. The individual may receive the amount determined under STEP
256	256	28 SIX FIVE of subsection (f). (e).
257	257	29 (f) (e) The office shall determine the amount payable to an
258	258	30 individual described in subsection (e) (d) as follows:
259	259	31 STEP ONE: Determine the total amount paid into the individual's
260	260	32 health care account under this chapter.
261	261	33 STEP TWO: Determine the total amount paid into the individual's
262	262	34 health care account from all sources.
263	263	35 STEP THREE: Divide STEP ONE by STEP TWO.
264	264	36 STEP FOUR: Multiply the ratio determined in STEP THREE by
265	265	37 the total amount remaining in the individual's health care account.
266	266	38 STEP FIVE: Subtract any nonpayments of a required payment.
267	267	39 STEP SIX: FIVE: Multiply the amount determined under STEP
268	268	40 FIVE FOUR by at least seventy-five hundredths (0.75).
269	269	41 SECTION 7. IC 12-15-44.5-5.5, AS ADDED BY P.L.30-2016,
270	270	42 SECTION 33, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
271	271	2023 IN 207—LS 7036/DI 104 7
272	272	1 JULY 1, 2023]: Sec. 5.5. The office shall refer any member of the plan
273	273	2 who:
274	274	3 (1) is employed for less than twenty (20) hours per week; and
275	275	4 (2) is not a full-time student;
276	276	5 to a workforce training and job search program. The office may not
277	277	6 require an individual to be employed or be a full-time student in
278	278	7 order to participate in or remain a member of the plan.
279	279	8 SECTION 8. IC 12-15-44.5-10, AS AMENDED BY P.L.30-2016,
280	280	9 SECTION 35, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
281	281	10 JULY 1, 2023]: Sec. 10. (a) The secretary has the authority to provide
282	282	11 benefits to individuals eligible under the adult group described in 42
283	283	12 CFR 435.119 only in accordance with this chapter.
284	284	13 (b) The secretary may negotiate and make changes to the plan,
285	285	14 except that the secretary may not negotiate or change the plan in a way
286	286	15 that would do the following:
287	287	16 (1) Reduce the following:
288	288	17 (A) Contribution amounts below the minimum levels set forth
289	289	18 in section 4.7 of this chapter.
290	290	19 (B) deductible amounts below the minimum amount
291	291	20 established in section 4.5(c) of this chapter.
292	292	21 (2) Remove or reduce the penalties for nonpayment set forth in
293	293	22 section 4.7 of this chapter.
294	294	23 (3) (2) Revise the use of the health care account requirement set
295	295	24 forth in section 4.5 of this chapter.
296	296	25 (4) (3) Include noncommercial benefits or add additional plan
297	297	26 benefits in a manner inconsistent with section 3.5 of this chapter.
298	298	27 (5) (4) Allow services to begin
299	299	28 (A) without the payment established or required by; or
300	300	29 (B) earlier than the time frames frame otherwise established
301	301	30 by
302	302	31 section 4.7 of this chapter.
303	303	32 (6) (5) Reduce financial penalties for the inappropriate use of the
304	304	33 emergency room below the minimum levels set forth in section
305	305	34 5.7 of this chapter.
306	306	35 (7) (6) Permit members to change health plans without cause in
307	307	36 a manner inconsistent with section 4.7(g) 4.7(c) of this chapter.
308	308	37 (8) (7) Operate the plan in a manner that would obligate the state
309	309	38 to financial participation beyond the level of state appropriations
310	310	39 or funding otherwise authorized for the plan.
311	311	40 (c) The secretary may make changes to the plan under this chapter
312	312	41 if the changes are required by federal law or regulation.
313	313	42 SECTION 9. IC 12-17.6-3-3, AS AMENDED BY P.L.218-2007,
314	314	2023 IN 207—LS 7036/DI 104 8
315	315	1 SECTION 42, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
316	316	2 JULY 1, 2023]: Sec. 3. (a) Subject to subsections (b) and (c), a child
317	317	3 who is eligible for the program shall receive services from the program
318	318	4 until the earlier of the following:
319	319	5 (1) The child becomes financially ineligible.
320	320	6 (2) The child becomes nineteen (19) years of age.
321	321	7 (b) Subsection (a) applies only if the child and the child's family
322	322	8 comply with enrollment requirements.
323	323	9 (c) After a child who is less than three (3) nineteen (19) years of
324	324	10 age is determined to be eligible for the program, the child is not
325	325	11 required to submit eligibility information more frequently than once in
326	326	12 a twelve (12) month period until the child becomes three (3) nineteen
327	327	13 (19) years of age.
328	328	14 SECTION 10. [EFFECTIVE JULY 1, 2023] (a) Before September
329	329	15 1, 2023, the office of the secretary of family and social services shall
330	330	16 apply for any state plan amendment or Medicaid waiver necessary
331	331	17 to change the age set forth in IC 12-15-2-15.8, as amended by this
332	332	18 act, concerning continuous eligibility for the Medicaid program
333	333	19 from a Medicaid recipient who is less than three (3) years of age to
334	334	20 a Medicaid recipient who is less than nineteen (19) years of age.
335	335	21 (b) Before September 1, 2023, the office of Medicaid policy and
336	336	22 planning shall apply for any federal approval necessary to change
337	337	23 the age set forth in IC 12-17.6-3-3, as amended by this act,
338	338	24 concerning continuous eligibility for the children's health
339	339	25 insurance program from a recipient who is less than three (3) years
340	340	26 of age to a recipient who is less than nineteen (19) years of age.
341	341	27 (c) The office of the secretary of family and social services shall
342	342	28 apply for any amendment to the healthy Indiana plan Medicaid
343	343	29 waiver necessary to do the following:
344	344	30 (1) Eliminate copayment requirements for healthy Indiana
345	345	31 plan participants.
346	346	32 (2) Eliminate working requirements for healthy Indiana plan
347	347	33 participants.
348	348	34 (d) This SECTION expires December 31, 2023.
349	349	2023 IN 207—LS 7036/DI 104