Indiana 2023 Regular Session

Indiana Senate Bill SB0310 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. 310
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 12-7-2-44.9; IC 12-15-2-6.5; IC 12-15-41.
7	7	Synopsis: Medicaid buy-in program. Removes consideration of
8	8	income and countable resources in determining an individual's
9	9	eligibility for participation in the Medicaid buy-in program (program).
10	10	Requires the office of the secretary of family and social services (office
11	11	of the secretary) to apply for a state plan amendment or waiver to
12	12	implement this provision. Prohibits the office of the secretary from
13	13	considering resources and whether the individual participated in a
14	14	specified program in determining the individual's eligibility or
15	15	continuous eligibility for the program. Allows a recipient's participation
16	16	in an employment network recognized by the federal Social Security
17	17	Administration to qualify as participating with an approved provider of
18	18	employment services. Changes minimum and maximum premiums that
19	19	a recipient must pay. Requires that the premium scale be promulgated
20	20	by administrative rule. Allows the office of the secretary to annually
21	21	review the premium amount that a recipient must pay in the program.
22	22	(Current law requires annual review of the premium amount.) Specifies
23	23	changes in circumstances that must result in an adjustment of the
24	24	premium. Specifies that a recipient in the program is eligible for the
25	25	same services as offered in the Medicaid program. States that an
26	26	individual's participation in the program does not preclude the
27	27	individual from participating in a Medicaid waiver program. Specifies
28	28	that a recipient of the program may simultaneously participate in a
29	29	Medicaid waiver program and requires the office of the secretary to
30	30	individually determine eligibility for both programs based on the
31	31	individual's medical need requirements.
32	32	Effective: July 1, 2023.
33	33	Yoder
34	34	January 12, 2023, read first time and referred to Committee on Family and Children
35	35	Services.
36	36	2023 IN 310—LS 7240/DI 147 Introduced
37	37	First Regular Session of the 123rd General Assembly (2023)
38	38	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
39	39	Constitution) is being amended, the text of the existing provision will appear in this style type,
40	40	additions will appear in this style type, and deletions will appear in this style type.
41	41	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
42	42	provision adopted), the text of the new provision will appear in this style type. Also, the
43	43	word NEW will appear in that style type in the introductory clause of each SECTION that adds
44	44	a new provision to the Indiana Code or the Indiana Constitution.
45	45	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
46	46	between statutes enacted by the 2022 Regular Session of the General Assembly.
47	47	SENATE BILL No. 310
48	48	A BILL FOR AN ACT to amend the Indiana Code concerning
49	49	human services.
50	50	Be it enacted by the General Assembly of the State of Indiana:
51	51	1 SECTION 1. IC 12-7-2-44.9 IS REPEALED [EFFECTIVE JULY
52	52	2 1, 2023]. Sec. 44.9. "Countable resources", for purposes of
53	53	3 IC 12-15-41, has the meaning set forth in IC 12-15-41-2.
54	54	4 SECTION 2. IC 12-15-2-6.5 IS AMENDED TO READ AS
55	55	5 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 6.5. Notwithstanding
56	56	6 section 6 of this chapter, beginning July 1, 2002, An individual who
57	57	7 meets the requirements of IC 12-15-41 is eligible for Medicaid.
58	58	8 SECTION 3. IC 12-15-41-2 IS REPEALED [EFFECTIVE JULY 1,
59	59	9 2023]. Sec. 2. As used in this chapter, "countable resources" means all
60	60	10 cash, other liquid assets, real property, and personal property owned by
61	61	11 an applicant for or a recipient of Medicaid under this chapter, or the
62	62	12 spouse of an applicant or a recipient, that could be converted to cash to
63	63	13 be used for support or maintenance, except the following:
64	64	14 (1) All resources disregarded by the office under this article for
65	65	15 the purpose of determining eligibility for Medicaid.
66	66	16 (2) Any resource eligible for exclusion under 42 U.S.C.
67	67	17 1396a(r)(2), including a retirement account established under 26
68	68	2023 IN 310—LS 7240/DI 147 2
69	69	1 U.S.C. 220 and held by either the applicant or recipient or the
70	70	2 applicant's or recipient's spouse.
71	71	3 (3) Subject to approval by the office, not more than twenty
72	72	4 thousand dollars ($20,000) in independence and self-sufficiency
73	73	5 accounts held by the applicant or recipient for the sole purpose of
74	74	6 purchasing goods or services, including assistive technology and
75	75	7 personal assistance, that:
76	76	8 (A) will increase the employability or independence of the
77	77	9 applicant or recipient; and
78	78	10 (B) are not services to which the recipient is entitled under
79	79	11 Medicaid or any other publicly funded program.
80	80	12 SECTION 4. IC 12-15-41-4 IS AMENDED TO READ AS
81	81	13 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 4. (a) To participate in
82	82	14 the buy-in program beginning July 1, 2002, an individual must meet the
83	83	15 following eligibility requirements: under IC 12-15-2-6, except as
84	84	16 follows:
85	85	17 (1) The individual has a severe medically determinable
86	86	18 impairment without regard to the individual's employment status.
87	87	19 (2) The individual must be at least sixteen (16) years of age but
88	88	20 not more than sixty-four (64) years of age.
89	89	21 (3) The individual must be engaged in a substantial and
90	90	22 reasonable work effort as determined by the office and as
91	91	23 permitted by federal law.
92	92	24 (4) The individual does not have countable resources that exceed
93	93	25 the resource limits for the federal Supplemental Security Income
94	94	26 program (42 U.S.C. 1382).
95	95	27 (5) The individual's annual gross income does not exceed three
96	96	28 hundred fifty percent (350%) of the federal income poverty level
97	97	29 for an individual. In determining an individual's income under this
98	98	30 subdivision, the office may not consider the following:
99	99	31 (A) The income of the individual's spouse.
100	100	32 (B) Income disregarded under the state Medicaid plan's
101	101	33 financial methodology, including income disregarded under
102	102	34 the federal Supplemental Security Income program (42 U.S.C.
103	103	35 1382) as impairment related work expenses (IRWE).
104	104	36 (b) Beginning July 1, 2023, in determining an individual's
105	105	37 eligibility and continuous eligibility for the buy-in program, the
106	106	38 office of the secretary may not consider:
107	107	39 (1) any resource limitations, including resources of the
108	108	40 individual's spouse, if applicable; or
109	109	41 (2) whether the individual is a current or past beneficiary of:
110	110	42 (A) the federal Social Security Administration program; or
111	111	2023 IN 310—LS 7240/DI 147 3
112	112	1 (B) the Medicaid program as an individual with a disability
113	113	2 under IC 12-15-2-3.5.
114	114	3 SECTION 5. IC 12-15-41-5 IS AMENDED TO READ AS
115	115	4 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 5. An individual who
116	116	5 is enrolled in the buy-in program and who no longer meets the
117	117	6 eligibility requirements set forth in section 4 of this chapter due to an
118	118	7 improvement in the individual's medical condition continues to be
119	119	8 eligible for Medicaid coverage under the buy-in program if the
120	120	9 individual meets the following requirements:
121	121	10 (1) The individual continues to have a severe medically
122	122	11 determinable impairment, as determined by the office and as
123	123	12 allowed by federal law.
124	124	13 (2) The individual is employed and earning a monthly wage that
125	125	14 is not less than the federal minimum hourly wage times forty (40).
126	126	15 (3) The individual does not have income or countable resources
127	127	16 in excess of the limits established under section 4 of this chapter.
128	128	17 (4) (3) The individual is at least sixteen (16) years of age and less
129	129	18 than sixty-five (65) years of age.
130	130	19 (5) (4) The individual pays any premiums or other cost sharing
131	131	20 required under this chapter.
132	132	21 (6) (5) The individual meets all other eligibility requirements
133	133	22 under this chapter.
134	134	23 SECTION 6. IC 12-15-41-6 IS AMENDED TO READ AS
135	135	24 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 6. (a) An individual
136	136	25 who is enrolled in the buy-in program and who is unable to maintain
137	137	26 employment for involuntary reasons, including temporary leave due to
138	138	27 a health problem or involuntary termination, continues to be eligible for
139	139	28 Medicaid coverage under the buy-in program if the individual meets
140	140	29 the following requirements:
141	141	30 (1) Within sixty (60) days after the date on which the individual
142	142	31 becomes unemployed, the individual, or an authorized
143	143	32 representative of the individual, submits a written request to the
144	144	33 office that the individual's Medicaid coverage be continued.
145	145	34 (2) The individual maintains a connection to the workforce during
146	146	35 the individual's continued eligibility period by participating in at
147	147	36 least one (1) of the following activities:
148	148	37 (A) Enrollment in a state or federal vocational rehabilitation
149	149	38 program.
150	150	39 (B) Enrollment or registration with the office of workforce
151	151	40 development.
152	152	41 (C) Participation in a transition from school to work program.
153	153	42 (D) Participation with an approved provider of employment
154	154	2023 IN 310—LS 7240/DI 147 4
155	155	1 services, including an employment network recognized by
156	156	2 the federal Social Security Administration.
157	157	3 (E) Provision of documentation from the individual's employer
158	158	4 that the individual is on temporary involuntary leave.
159	159	5 (3) The individual does not have income or countable resources
160	160	6 in excess of the limits established under section 4 of this chapter.
161	161	7 (4) (3) The individual is at least sixteen (16) years of age and less
162	162	8 than sixty-five (65) years of age.
163	163	9 (5) (4) The individual pays any premiums or other cost sharing
164	164	10 required under this chapter.
165	165	11 (6) (5) The individual meets all other eligibility requirements
166	166	12 under this chapter.
167	167	13 (b) The office shall continue Medicaid coverage under the buy-in
168	168	14 program for an individual described in subsection (a) for up to twelve
169	169	15 (12) months from the date of the individual's involuntary loss of
170	170	16 employment.
171	171	17 (c) If an individual is ineligible for continued coverage under the
172	172	18 buy-in program because the individual:
173	173	19 (1) fails to meet the requirements of subsection (a); or
174	174	20 (2) has already met twelve (12) months of continuing eligibility
175	175	21 under this section;
176	176	22 the individual must meet the applicable eligibility requirements of
177	177	23 IC 12-15-2-6 this article to continue to be eligible for Medicaid.
178	178	24 SECTION 7. IC 12-15-41-7 IS AMENDED TO READ AS
179	179	25 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 7. (a) The office shall
180	180	26 develop a sliding scale of premiums for individuals participating in the
181	181	27 buy-in program.
182	182	28 (b) The sliding scale of premiums required under subsection (a)
183	183	29 must:
184	184	30 (1) be based on the annual gross income of the individual and, if
185	185	31 married, the individual's spouse; and
186	186	32 (2) provide for a minimum monthly premium of twenty-five
187	187	33 dollars ($25) five dollars ($5) and a maximum monthly premium
188	188	34 of two hundred seventy-five dollars ($275). ($200).
189	189	35 (c) Subject to the minimum and maximum amounts described in
190	190	36 subsection (b), the office may annually adjust the scale of premiums
191	191	37 adopted under this section only by administrative rule under
192	192	38 IC 4-22-2.
193	193	39 SECTION 8. IC 12-15-41-8 IS AMENDED TO READ AS
194	194	40 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 8. (a) An individual
195	195	41 whose gross annual income, including the gross annual income of the
196	196	42 individual's spouse, if married, is less than one hundred fifty percent
197	197	2023 IN 310—LS 7240/DI 147 5
198	198	1 (150%) of the federal income poverty level for the size of the
199	199	2 individual's or couple's family may not be required to pay a premium
200	200	3 to participate in the buy-in program.
201	201	4 (b) An individual whose gross annual income, including the gross
202	202	5 annual income of the individual's spouse, if married, is at least one
203	203	6 hundred fifty percent (150%) but not more than three hundred fifty
204	204	7 percent (350%) of the federal income poverty level for the size of the
205	205	8 individual's or couple's family, must pay a monthly premium in an
206	206	9 amount equal to:
207	207	10 (1) the lesser of:
208	208	11 (A) the amount prescribed by the sliding scale developed by
209	209	12 the office under section 7 of this chapter; or
210	210	13 (B) seven and one-half percent (7 1/2%) of the individual's or
211	211	14 couple's gross annual income divided by twelve (12); minus
212	212	15 (2) the monthly amount of any premium paid by the individual,
213	213	16 the individual's spouse, or the individual's parent for health
214	214	17 insurance that covers the individual.
215	215	18 SECTION 9. IC 12-15-41-9 IS AMENDED TO READ AS
216	216	19 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 9. (a) The office shall
217	217	20 may annually review the amount of the premium that an individual is
218	218	21 required to pay under section 8 of this chapter.
219	219	22 (b) In addition to the annual review required under subsection (a),
220	220	23 the office shall adjust the premium that an individual is required to pay
221	221	24 under section 8 of this chapter if:
222	222	25 (1) a change in the individual's income or family size is verified;
223	223	26 and
224	224	27 (2) there is a verified change in the amount of any premiums
225	225	28 paid by the individual, the individual's spouse, or the
226	226	29 individual's parent for health insurance that covers the
227	227	30 individual;
228	228	31 (2) (3) the sliding scale adopted under section 7 of this chapter
229	229	32 applied to the individual's changed circumstances prescribes a
230	230	33 premium for the individual that is different from the premium the
231	231	34 individual is paying; or
232	232	35 (4) the office determines that an error was made in calculating
233	233	36 the individual's premiums.
234	234	37 SECTION 10. IC 12-15-41-10 IS AMENDED TO READ AS
235	235	38 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 10. To the greatest
236	236	39 extent possible, the office shall use the same administrative procedures
237	237	40 regarding premiums for the buy-in program as are used for the
238	238	41 children's health insurance program established under IC 12-17.6,
239	239	42 including
240	240	2023 IN 310—LS 7240/DI 147 6
241	241	1 (1) the effect of nonpayment of a premium. and
242	242	2 (2) the collection of premiums.
243	243	3 SECTION 11. IC 12-15-41-12 IS AMENDED TO READ AS
244	244	4 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 12. (a) Except as
245	245	5 otherwise provided in this chapter, an individual participating in the
246	246	6 buy-in program:
247	247	7 (1) shall be eligible to receive the same benefits, including home
248	248	8 health care services and other services set forth in IC 12-15-5-1,
249	249	9 as a Medicaid recipient; and
250	250	10 (2) is subject to the same requirements, including cost sharing;
251	251	11 may not preclude the individual from also participating in a
252	252	12 Medicaid waiver program.
253	253	13 as an individual receiving Medicaid under IC 12-15-2-6.
254	254	14 (b) If an individual is participating in both the buy-in program
255	255	15 and a Medicaid waiver program, the office of the secretary shall
256	256	16 disregard the following concerning the Medicaid waiver program
257	257	17 ensuring the individual's joint participation:
258	258	18 (1) Income requirements.
259	259	19 (2) Resource requirements.
260	260	20 (3) Cost sharing requirements.
261	261	21 The office of the secretary shall determine eligibility on an
262	262	22 individual basis using medical need requirements of the individual
263	263	23 for an individual seeking to simultaneously participate in the
264	264	24 buy-in program and a Medicaid waiver program.
265	265	25 SECTION 12. [EFFECTIVE JULY 1, 2023] (a) As used in this
266	266	26 SECTION, "office" refers to the office of the secretary of family
267	267	27 and social services established by IC 12-8-1.5-1.
268	268	28 (b) The office shall apply to the United States Department of
269	269	29 Health and Human Services for a state plan amendment or waiver
270	270	30 necessary to implement IC 12-15-41-4(a), as amended by this act.
271	271	31 (c) This SECTION expires December 31, 2025.
272	272	2023 IN 310—LS 7240/DI 147