Introduced Version
SENATE BILL No. 310
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 12-7-2-44.9; IC 12-15-2-6.5; IC 12-15-41.
Synopsis: Medicaid buy-in program. Removes consideration of
income and countable resources in determining an individual's
eligibility for participation in the Medicaid buy-in program (program).
Requires the office of the secretary of family and social services (office
of the secretary) to apply for a state plan amendment or waiver to
implement this provision. Prohibits the office of the secretary from
considering resources and whether the individual participated in a
specified program in determining the individual's eligibility or
continuous eligibility for the program. Allows a recipient's participation
in an employment network recognized by the federal Social Security
Administration to qualify as participating with an approved provider of
employment services. Changes minimum and maximum premiums that
a recipient must pay. Requires that the premium scale be promulgated
by administrative rule. Allows the office of the secretary to annually
review the premium amount that a recipient must pay in the program.
(Current law requires annual review of the premium amount.) Specifies
changes in circumstances that must result in an adjustment of the
premium. Specifies that a recipient in the program is eligible for the
same services as offered in the Medicaid program. States that an
individual's participation in the program does not preclude the
individual from participating in a Medicaid waiver program. Specifies
that a recipient of the program may simultaneously participate in a
Medicaid waiver program and requires the office of the secretary to
individually determine eligibility for both programs based on the
individual's medical need requirements.
Effective: July 1, 2023.
Yoder
January 12, 2023, read first time and referred to Committee on Family and Children
Services.
2023 IN 310—LS 7240/DI 147 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.
SENATE BILL No. 310
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 12-7-2-44.9 IS REPEALED [EFFECTIVE JULY
2 1, 2023]. Sec. 44.9. "Countable resources", for purposes of
3 IC 12-15-41, has the meaning set forth in IC 12-15-41-2.
4 SECTION 2. IC 12-15-2-6.5 IS AMENDED TO READ AS
5 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 6.5. Notwithstanding
6 section 6 of this chapter, beginning July 1, 2002, An individual who
7 meets the requirements of IC 12-15-41 is eligible for Medicaid.
8 SECTION 3. IC 12-15-41-2 IS REPEALED [EFFECTIVE JULY 1,
9 2023]. Sec. 2. As used in this chapter, "countable resources" means all
10 cash, other liquid assets, real property, and personal property owned by
11 an applicant for or a recipient of Medicaid under this chapter, or the
12 spouse of an applicant or a recipient, that could be converted to cash to
13 be used for support or maintenance, except the following:
14 (1) All resources disregarded by the office under this article for
15 the purpose of determining eligibility for Medicaid.
16 (2) Any resource eligible for exclusion under 42 U.S.C.
17 1396a(r)(2), including a retirement account established under 26
2023 IN 310—LS 7240/DI 147 2
1 U.S.C. 220 and held by either the applicant or recipient or the
2 applicant's or recipient's spouse.
3 (3) Subject to approval by the office, not more than twenty
4 thousand dollars ($20,000) in independence and self-sufficiency
5 accounts held by the applicant or recipient for the sole purpose of
6 purchasing goods or services, including assistive technology and
7 personal assistance, that:
8 (A) will increase the employability or independence of the
9 applicant or recipient; and
10 (B) are not services to which the recipient is entitled under
11 Medicaid or any other publicly funded program.
12 SECTION 4. IC 12-15-41-4 IS AMENDED TO READ AS
13 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 4. (a) To participate in
14 the buy-in program beginning July 1, 2002, an individual must meet the
15 following eligibility requirements: under IC 12-15-2-6, except as
16 follows:
17 (1) The individual has a severe medically determinable
18 impairment without regard to the individual's employment status.
19 (2) The individual must be at least sixteen (16) years of age but
20 not more than sixty-four (64) years of age.
21 (3) The individual must be engaged in a substantial and
22 reasonable work effort as determined by the office and as
23 permitted by federal law.
24 (4) The individual does not have countable resources that exceed
25 the resource limits for the federal Supplemental Security Income
26 program (42 U.S.C. 1382).
27 (5) The individual's annual gross income does not exceed three
28 hundred fifty percent (350%) of the federal income poverty level
29 for an individual. In determining an individual's income under this
30 subdivision, the office may not consider the following:
31 (A) The income of the individual's spouse.
32 (B) Income disregarded under the state Medicaid plan's
33 financial methodology, including income disregarded under
34 the federal Supplemental Security Income program (42 U.S.C.
35 1382) as impairment related work expenses (IRWE).
36 (b) Beginning July 1, 2023, in determining an individual's
37 eligibility and continuous eligibility for the buy-in program, the
38 office of the secretary may not consider:
39 (1) any resource limitations, including resources of the
40 individual's spouse, if applicable; or
41 (2) whether the individual is a current or past beneficiary of:
42 (A) the federal Social Security Administration program; or
2023 IN 310—LS 7240/DI 147 3
1 (B) the Medicaid program as an individual with a disability
2 under IC 12-15-2-3.5.
3 SECTION 5. IC 12-15-41-5 IS AMENDED TO READ AS
4 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 5. An individual who
5 is enrolled in the buy-in program and who no longer meets the
6 eligibility requirements set forth in section 4 of this chapter due to an
7 improvement in the individual's medical condition continues to be
8 eligible for Medicaid coverage under the buy-in program if the
9 individual meets the following requirements:
10 (1) The individual continues to have a severe medically
11 determinable impairment, as determined by the office and as
12 allowed by federal law.
13 (2) The individual is employed and earning a monthly wage that
14 is not less than the federal minimum hourly wage times forty (40).
15 (3) The individual does not have income or countable resources
16 in excess of the limits established under section 4 of this chapter.
17 (4) (3) The individual is at least sixteen (16) years of age and less
18 than sixty-five (65) years of age.
19 (5) (4) The individual pays any premiums or other cost sharing
20 required under this chapter.
21 (6) (5) The individual meets all other eligibility requirements
22 under this chapter.
23 SECTION 6. IC 12-15-41-6 IS AMENDED TO READ AS
24 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 6. (a) An individual
25 who is enrolled in the buy-in program and who is unable to maintain
26 employment for involuntary reasons, including temporary leave due to
27 a health problem or involuntary termination, continues to be eligible for
28 Medicaid coverage under the buy-in program if the individual meets
29 the following requirements:
30 (1) Within sixty (60) days after the date on which the individual
31 becomes unemployed, the individual, or an authorized
32 representative of the individual, submits a written request to the
33 office that the individual's Medicaid coverage be continued.
34 (2) The individual maintains a connection to the workforce during
35 the individual's continued eligibility period by participating in at
36 least one (1) of the following activities:
37 (A) Enrollment in a state or federal vocational rehabilitation
38 program.
39 (B) Enrollment or registration with the office of workforce
40 development.
41 (C) Participation in a transition from school to work program.
42 (D) Participation with an approved provider of employment
2023 IN 310—LS 7240/DI 147 4
1 services, including an employment network recognized by
2 the federal Social Security Administration.
3 (E) Provision of documentation from the individual's employer
4 that the individual is on temporary involuntary leave.
5 (3) The individual does not have income or countable resources
6 in excess of the limits established under section 4 of this chapter.
7 (4) (3) The individual is at least sixteen (16) years of age and less
8 than sixty-five (65) years of age.
9 (5) (4) The individual pays any premiums or other cost sharing
10 required under this chapter.
11 (6) (5) The individual meets all other eligibility requirements
12 under this chapter.
13 (b) The office shall continue Medicaid coverage under the buy-in
14 program for an individual described in subsection (a) for up to twelve
15 (12) months from the date of the individual's involuntary loss of
16 employment.
17 (c) If an individual is ineligible for continued coverage under the
18 buy-in program because the individual:
19 (1) fails to meet the requirements of subsection (a); or
20 (2) has already met twelve (12) months of continuing eligibility
21 under this section;
22 the individual must meet the applicable eligibility requirements of
23 IC 12-15-2-6 this article to continue to be eligible for Medicaid.
24 SECTION 7. IC 12-15-41-7 IS AMENDED TO READ AS
25 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 7. (a) The office shall
26 develop a sliding scale of premiums for individuals participating in the
27 buy-in program.
28 (b) The sliding scale of premiums required under subsection (a)
29 must:
30 (1) be based on the annual gross income of the individual and, if
31 married, the individual's spouse; and
32 (2) provide for a minimum monthly premium of twenty-five
33 dollars ($25) five dollars ($5) and a maximum monthly premium
34 of two hundred seventy-five dollars ($275). ($200).
35 (c) Subject to the minimum and maximum amounts described in
36 subsection (b), the office may annually adjust the scale of premiums
37 adopted under this section only by administrative rule under
38 IC 4-22-2.
39 SECTION 8. IC 12-15-41-8 IS AMENDED TO READ AS
40 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 8. (a) An individual
41 whose gross annual income, including the gross annual income of the
42 individual's spouse, if married, is less than one hundred fifty percent
2023 IN 310—LS 7240/DI 147 5
1 (150%) of the federal income poverty level for the size of the
2 individual's or couple's family may not be required to pay a premium
3 to participate in the buy-in program.
4 (b) An individual whose gross annual income, including the gross
5 annual income of the individual's spouse, if married, is at least one
6 hundred fifty percent (150%) but not more than three hundred fifty
7 percent (350%) of the federal income poverty level for the size of the
8 individual's or couple's family, must pay a monthly premium in an
9 amount equal to:
10 (1) the lesser of:
11 (A) the amount prescribed by the sliding scale developed by
12 the office under section 7 of this chapter; or
13 (B) seven and one-half percent (7 1/2%) of the individual's or
14 couple's gross annual income divided by twelve (12); minus
15 (2) the monthly amount of any premium paid by the individual,
16 the individual's spouse, or the individual's parent for health
17 insurance that covers the individual.
18 SECTION 9. IC 12-15-41-9 IS AMENDED TO READ AS
19 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 9. (a) The office shall
20 may annually review the amount of the premium that an individual is
21 required to pay under section 8 of this chapter.
22 (b) In addition to the annual review required under subsection (a),
23 the office shall adjust the premium that an individual is required to pay
24 under section 8 of this chapter if:
25 (1) a change in the individual's income or family size is verified;
26 and
27 (2) there is a verified change in the amount of any premiums
28 paid by the individual, the individual's spouse, or the
29 individual's parent for health insurance that covers the
30 individual;
31 (2) (3) the sliding scale adopted under section 7 of this chapter
32 applied to the individual's changed circumstances prescribes a
33 premium for the individual that is different from the premium the
34 individual is paying; or
35 (4) the office determines that an error was made in calculating
36 the individual's premiums.
37 SECTION 10. IC 12-15-41-10 IS AMENDED TO READ AS
38 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 10. To the greatest
39 extent possible, the office shall use the same administrative procedures
40 regarding premiums for the buy-in program as are used for the
41 children's health insurance program established under IC 12-17.6,
42 including
2023 IN 310—LS 7240/DI 147 6
1 (1) the effect of nonpayment of a premium. and
2 (2) the collection of premiums.
3 SECTION 11. IC 12-15-41-12 IS AMENDED TO READ AS
4 FOLLOWS [EFFECTIVE JULY 1, 2023]: Sec. 12. (a) Except as
5 otherwise provided in this chapter, an individual participating in the
6 buy-in program:
7 (1) shall be eligible to receive the same benefits, including home
8 health care services and other services set forth in IC 12-15-5-1,
9 as a Medicaid recipient; and
10 (2) is subject to the same requirements, including cost sharing;
11 may not preclude the individual from also participating in a
12 Medicaid waiver program.
13 as an individual receiving Medicaid under IC 12-15-2-6.
14 (b) If an individual is participating in both the buy-in program
15 and a Medicaid waiver program, the office of the secretary shall
16 disregard the following concerning the Medicaid waiver program
17 ensuring the individual's joint participation:
18 (1) Income requirements.
19 (2) Resource requirements.
20 (3) Cost sharing requirements.
21 The office of the secretary shall determine eligibility on an
22 individual basis using medical need requirements of the individual
23 for an individual seeking to simultaneously participate in the
24 buy-in program and a Medicaid waiver program.
25 SECTION 12. [EFFECTIVE JULY 1, 2023] (a) As used in this
26 SECTION, "office" refers to the office of the secretary of family
27 and social services established by IC 12-8-1.5-1.
28 (b) The office shall apply to the United States Department of
29 Health and Human Services for a state plan amendment or waiver
30 necessary to implement IC 12-15-41-4(a), as amended by this act.
31 (c) This SECTION expires December 31, 2025.
2023 IN 310—LS 7240/DI 147