*EH1216.1* February 16, 2024 ENGROSSED HOUSE BILL No. 1216 _____ DIGEST OF HB 1216 (Updated February 14, 2024 11:53 am - DI 104) Citations Affected: IC 12-15; IC 12-26. Synopsis: Medicaid reimbursement for certain detainees. Removes provisions in current law specifying that services provided to an individual while the individual is committed to a facility for mental health services are medically necessary when provided in accordance with generally accepted clinical care guidelines. Requires Medicaid reimbursement for Medicaid covered services provided to a Medicaid recipient while the individual is detained to a facility for mental health services. Amends the requirements for an application for detention. Effective: Upon passage. Steuerwald, McNamara, Jeter, Moseley (SENATE SPONSORS — JOHNSON T, CHARBONNEAU, BROWN L) January 9, 2024, read first time and referred to Committee on Public Health. January 16, 2024, amended, reported — Do Pass. January 18, 2024, read second time, ordered engrossed. January 19, 2024, engrossed. January 22, 2024, read third time, passed. Yeas 93, nays 0. SENATE ACTION February 5, 2024, read first time and referred to Committee on Health and Provider Services. February 15, 2024, amended, reported favorably — Do Pass; reassigned to Committee on Appropriations. EH 1216—LS 6547/DI 147 February 16, 2024 Second Regular Session of the 123rd General Assembly (2024) 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 2023 Regular Session of the General Assembly. ENGROSSED HOUSE BILL No. 1216 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 12-15-5-13.5, AS ADDED BY P.L.205-2023, 2 SECTION 4, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE 3 UPON PASSAGE]: Sec. 13.5. (a) Services provided to an individual 4 while detained under IC 12-26-5 are medically necessary when 5 provided in accordance with generally accepted clinical care 6 guidelines. 7 (b) The office shall require managed care organizations to consider 8 services provided to an individual while detained under IC 12-26-5 as 9 medically necessary when provided in accordance with generally 10 accepted clinical care guidelines. (a) As used in this section, "office" 11 includes the following: 12 (1) The office of the secretary of family and social services. 13 (2) A managed care organization that has contracted with the 14 office of Medicaid policy and planning under IC 12-15. 15 (3) A person that has contracted with a managed care 16 organization described in subdivision (2). 17 (b) The office shall reimburse for Medicaid covered services EH 1216—LS 6547/DI 147 2 1 provided to a Medicaid recipient while detained under IC 12-26-5, 2 regardless of medical necessity criteria, for the earlier of: 3 (1) a period not to exceed fourteen (14) days, excluding 4 Saturdays, Sundays, and legal holidays; or 5 (2) the date of a final hearing under IC 12-26-5-11. 6 (c) The office shall reimburse for Medicaid covered services 7 provided to a Medicaid recipient in accordance with a mental 8 health or substance use disorder treatment plan while the 9 individual is detained under a final order after a final hearing 10 under IC 12-26-5-11, subject to medical necessity criteria 11 according to clinical care guidelines established and published by 12 the office of the secretary. 13 SECTION 2. IC 12-26-5-1, AS AMENDED BY P.L.205-2023, 14 SECTION 10, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE 15 UPON PASSAGE]: Sec. 1. (a) Except as otherwise provided in this 16 chapter, an individual may be detained in a facility for not more than 17 seventy-two (72) hours under this chapter, excluding Saturdays, 18 Sundays, and legal holidays, if a written application for detention is 19 filed with a court of competent jurisdiction in accordance with this 20 section. 21 (b) An individual may be detained in a facility for not more than 22 forty-eight (48) hours from the time of admission, excluding Saturdays, 23 Sundays, and legal holidays, unless the facility files an application for 24 detention, on a form prepared by the office of judicial administration, 25 with a court of competent jurisdiction within the forty-eight (48) hour 26 period. If the facility timely files an application for detention, the 27 individual may be detained for not more than seventy-two (72) hours 28 from the time of admission, excluding Saturdays, Sundays, and legal 29 holidays, unless the court approves the application for detention. If the 30 court approves the application for detention, the individual may be held 31 for not more than fourteen (14) days, from the time of admission, 32 excluding Saturdays, Sundays, and legal holidays, pending a final 33 hearing under section 11 of this chapter. If a patient is admitted to a 34 facility after midnight and before 8:00 a.m., the time periods described 35 in this subsection begin to run at 8:00 a.m. 36 (c) An application for detention under subsection (b) must contain 37 an attestation signed by a physician that the individual has been 38 examined by a physician, an advanced practice registered nurse, or a 39 physician assistant, and that based on this examination, or based on 40 other information provided to the physician, advanced practice 41 registered nurse, or physician assistant, the applicant believes that there 42 is probable cause to believe that: EH 1216—LS 6547/DI 147 3 1 (1) the individual is mentally ill and either dangerous or gravely 2 disabled; and 3 (2) the individual requires continuing involuntary detention to 4 receive care and treatment; 5 based on an examination by a physician, advanced practice 6 registered nurse, or physician assistant, or information given to a 7 physician, advanced practice registered nurse, or physician 8 assistant. 9 (d) A facility may not be required to first seek transfer of the 10 individual to a psychiatric hospital before commencing an application 11 for detention. 12 (e) A facility may commence an application for detention even if an 13 individual was not apprehended and transported to a facility under 14 section 0.5 of this chapter. 15 SECTION 3. An emergency is declared for this act. EH 1216—LS 6547/DI 147 4 COMMITTEE REPORT Mr. Speaker: Your Committee on Public Health, to which was referred House Bill 1216, has had the same under consideration and begs leave to report the same back to the House with the recommendation that said bill be amended as follows: Page 1, delete lines 1 through 17, begin a new paragraph and insert: "SECTION 1. IC 12-15-5-13.5, AS ADDED BY P.L.205-2023, SECTION 4, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 13.5. (a) Services provided to an individual while detained under IC 12-26-5 are medically necessary when provided in accordance with generally accepted clinical care guidelines. (b) The office shall require managed care organizations to consider services provided to an individual while detained under IC 12-26-5 as medically necessary when provided in accordance with generally accepted clinical care guidelines. (a) As used in this section, "office" includes the following: (1) The office of the secretary of family and social services. (2) A managed care organization that has contracted with the office of Medicaid policy and planning under IC 12-15. (3) A person that has contracted with a managed care organization described in subdivision (2). (b) The office shall reimburse for services required to be covered by the office of the secretary provided to an eligible individual while detained under IC 12-26-5, regardless of medical necessity criteria, for a period not to exceed fourteen (14) days, excluding Saturdays, Sundays, and legal holidays, or the date of a final hearing under IC 12-26-5-11, whichever occurs first. (c) The office shall reimburse for services required to be covered by the office of the secretary provided to an eligible individual in accordance with a mental health or substance use disorder treatment plan while the individual is detained pursuant to a final order issued under IC 12-26-5-11, subject to medical necessity criteria according to clinical care guidelines established and published by the office of the secretary.". Page 2, delete lines 1 through 12. and when so amended that said bill do pass. (Reference is to HB 1216 as introduced.) BARRETT EH 1216—LS 6547/DI 147 5 Committee Vote: yeas 11, nays 0. _____ COMMITTEE REPORT Madam President: The Senate Committee on Health and Provider Services, to which was referred House Bill No. 1216, has had the same under consideration and begs leave to report the same back to the Senate with the recommendation that said bill be AMENDED as follows: Page 1, delete line 17, begin a new paragraph and insert: "(b) The office shall reimburse for Medicaid covered services provided to a Medicaid recipient while detained under IC 12-26-5, regardless of medical necessity criteria, for the earlier of: (1) a period not to exceed fourteen (14) days, excluding Saturdays, Sundays, and legal holidays; or (2) the date of a final hearing under IC 12-26-5-11. (c) The office shall reimburse for Medicaid covered services provided to a Medicaid recipient in accordance with a mental health or substance use disorder treatment plan while the individual is detained under a final order after a final hearing under IC 12-26-5-11, subject to medical necessity criteria according to clinical care guidelines established and published by the office of the secretary.". Page 2, delete lines 1 through 12. and when so amended that said bill do pass and be reassigned to the Senate Committee on Appropriations. (Reference is to HB 1216 as printed January 16, 2024.) CHARBONNEAU, Chairperson Committee Vote: Yeas 10, Nays 0. EH 1216—LS 6547/DI 147