LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
200 W. Washington St., Suite 301
Indianapolis, IN 46204
(317) 233-0696
iga.in.gov
FISCAL IMPACT STATEMENT
LS 6547 NOTE PREPARED: Mar 6, 2024
BILL NUMBER: HB 1216 BILL AMENDED: Feb 29, 2024
SUBJECT: Medicaid Reimbursement for Certain Detainees.
FIRST AUTHOR: Rep. Steuerwald BILL STATUS: Enrolled
FIRST SPONSOR: Sen. Johnson T
FUNDS AFFECTED:XGENERAL IMPACT: State
DEDICATED
XFEDERAL
Summary of Legislation: The bill 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. It requires Medicaid
reimbursement for Medicaid covered services provided to a Medicaid recipient while the individual is
detained to a facility for mental health services. It amends the requirements for an application for detention.
The bill sunsets this provision on June 30, 2025.
The bill also requires, on or before February 1, 2025, the Office of the Secretary of Family and Social
Services to report to the Budget Committee certain information for Medicaid claims data ranging from July
1, 2024, to December 31, 2024.
Effective Date: July 1, 2024.
Explanation of State Expenditures: The bill will have an indeterminate, but potentially significant increase
in state Medicaid costs for the duration of the program to provide services for Medicaid eligible individuals
in emergency detention and pursuant to a final court order. The bill requires the state to pay for all services
provided to such individuals without regard to medical necessity criteria. The potential increase is
indeterminate because the Office of the Secretary of Family and Social Services (FSSA) does not track the
legal status of individuals entering care on an emergency basis.
The FSSA will have an increased workload and expenditures to provide a report concerning Medicaid claims
between July 1, 2024, and December 31, 2024. Also, the FSSA will have a one-time increase in workload
to establish a system to track claims to which these provisions apply.
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Additional Information - In CY 2022, a total of 19,035 new emergency detention, temporary commitment,
and regular commitment cases were opened, and 4,924 were dismissed indicating that the defendant either
was discharged, chose voluntary admission, or the case was transferred to another county for involuntary
commitment. No distinction is made as to how many of these cases were considered as emergency detention.
[If additional information becomes available from the Office of Court Services, this fiscal note will be
updated.]
Since FSSA does not receive information on the legal status of a detainee, it is not possible to compare the
services that would be provided under the bill with the services currently reimbursed by the FSSA for people
in emergency detention. Also, often at the same time as a facility is pursuing emergency detention through
the courts, FSSA’s managed care entities or fee-for-service authorization managers are determining the level
of care and medical necessity that make up the reimbursement for the stay. The determination may not match
the services provided.
Explanation of State Revenues:
Explanation of Local Expenditures:
Explanation of Local Revenues:
State Agencies Affected: Office of the Secretary, Division of Mental Health and Addiction; Budget
Committee.
Local Agencies Affected:
Information Sources: Indiana Supreme Court, Indiana Office of Court Services, Quarterly Case Status
Reports Instructions, August 2023; ICOR Trial Court Statistics accessed December 22, 2023; Keith
McConomy, Ann Zerr, and Katrina Etter, FSSA.
Fiscal Analyst: Karen Rossen, 317-234-2106.
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