Indiana 2025 Regular Session

Indiana Senate Bill SB0234 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. 234
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 2-5-54-7; IC 6-8.1-7-1; IC 12-15;
7	7	IC 16-19-3-19; IC 22-4-19-6.
8	8	Synopsis: Medicaid matters. Requires the office of the secretary of
9	9	family and social services (office) to report specified Medicaid data to
10	10	the Medicaid oversight committee. Requires the office to receive and
11	11	review data from specified federal and state agencies concerning
12	12	Medicaid recipients to determine whether circumstances have changed
13	13	that affect Medicaid eligibility for recipients. Prohibits the office from
14	14	accepting self-attestations of certain information in the administration
15	15	of the Medicaid program. Requires the office to apply for a Medicaid
16	16	state plan amendment to remove references to coverage under the
17	17	Medicaid plan of a certain population. Requires the office to establish:
18	18	(1) performance standards for hospitals that make presumptive
19	19	eligibility determinations and sets out action for when hospitals do not
20	20	comply with the standards; and (2) an appeals procedure for hospitals
21	21	that dispute the violation determination. Modifies eligibility categories
22	22	and requirements for the healthy Indiana plan (plan). Specifies
23	23	limitations for enrollment in the plan.
24	24	Effective: Upon passage; July 1, 2025.
25	25	Johnson T, Charbonneau
26	26	January 13, 2025, read first time and referred to Committee on Health and Provider
27	27	Services.
28	28	2025 IN 234—LS 6908/DI 104 Introduced
29	29	First Regular Session of the 124th General Assembly (2025)
30	30	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
31	31	Constitution) is being amended, the text of the existing provision will appear in this style type,
32	32	additions will appear in this style type, and deletions will appear in this style type.
33	33	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
34	34	provision adopted), the text of the new provision will appear in this style type. Also, the
35	35	word NEW will appear in that style type in the introductory clause of each SECTION that adds
36	36	a new provision to the Indiana Code or the Indiana Constitution.
37	37	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
38	38	between statutes enacted by the 2024 Regular Session of the General Assembly.
39	39	SENATE BILL No. 234
40	40	A BILL FOR AN ACT to amend the Indiana Code concerning
41	41	Medicaid.
42	42	Be it enacted by the General Assembly of the State of Indiana:
43	43	1 SECTION 1. IC 2-5-54-7 IS ADDED TO THE INDIANA CODE
44	44	2 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
45	45	3 1, 2025]: Sec. 7. Before October 1 of each year, the office of the
46	46	4 secretary of family and social services shall report the following
47	47	5 aggregate, nonconfidential, and nonpersonally identifying
48	48	6 information to the oversight committee concerning the Medicaid
49	49	7 program for the previous calendar year:
50	50	8 (1) Improper Medicaid payments and expenditures.
51	51	9 (2) Federal and state recovered funds.
52	52	10 (3) Aggregate data concerning improper payments and
53	53	11 ineligible Medicaid recipients who received Medicaid services
54	54	12 as a percentage of those investigated or reviewed.
55	55	13 The report must be in an electronic format under IC 5-14-6.
56	56	14 SECTION 2. IC 6-8.1-7-1, AS AMENDED BY P.L.118-2024,
57	57	15 SECTION 21, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
58	58	16 JULY 1, 2025]: Sec. 1. (a) This subsection does not apply to the
59	59	17 disclosure of information concerning a conviction on a tax evasion
60	60	2025 IN 234—LS 6908/DI 104 2
61	61	1 charge. Unless in accordance with a judicial order or as otherwise
62	62	2 provided in this chapter, the department, its employees, former
63	63	3 employees, counsel, agents, or any other person may not divulge the
64	64	4 amount of tax paid by any taxpayer, terms of a settlement agreement
65	65	5 executed between a taxpayer and the department, investigation records,
66	66	6 investigation reports, or any other information disclosed by the reports
67	67	7 filed under the provisions of the law relating to any of the listed taxes,
68	68	8 including required information derived from a federal return, except to
69	69	9 any of the following when it is agreed that the information is to be
70	70	10 confidential and to be used solely for official purposes:
71	71	11 (1) Members and employees of the department.
72	72	12 (2) The governor.
73	73	13 (3) A member of the general assembly or an employee of the
74	74	14 house of representatives or the senate when acting on behalf of a
75	75	15 taxpayer located in the member's legislative district who has
76	76	16 provided sufficient information to the member or employee for
77	77	17 the department to determine that the member or employee is
78	78	18 acting on behalf of the taxpayer.
79	79	19 (4) An employee of the legislative services agency to carry out the
80	80	20 responsibilities of the legislative services agency under
81	81	21 IC 2-5-1.1-7 or another law.
82	82	22 (5) The attorney general or any other legal representative of the
83	83	23 state in any action in respect to the amount of tax due under the
84	84	24 provisions of the law relating to any of the listed taxes.
85	85	25 (6) Any authorized officers of the United States.
86	86	26 (b) The information described in subsection (a) may be revealed
87	87	27 upon the receipt of a certified request of any designated officer of the
88	88	28 state tax department of any other state, district, territory, or possession
89	89	29 of the United States when:
90	90	30 (1) the state, district, territory, or possession permits the exchange
91	91	31 of like information with the taxing officials of the state; and
92	92	32 (2) it is agreed that the information is to be confidential and to be
93	93	33 used solely for tax collection purposes.
94	94	34 (c) The information described in subsection (a) relating to a person
95	95	35 on public welfare or a person who has made application for public
96	96	36 welfare may be revealed to the office of the secretary of family and
97	97	37 social services for purposes of IC 12-15-1-24, the director of the
98	98	38 division of family resources, and to any director of a county office of
99	99	39 the division of family resources located in Indiana, upon receipt of a
100	100	40 written request from either director for the information. The
101	101	41 information shall be treated as confidential by the office and the
102	102	42 directors. In addition, the information described in subsection (a)
103	103	2025 IN 234—LS 6908/DI 104 3
104	104	1 relating to a person who has been designated as an absent parent by the
105	105	2 state Title IV-D agency shall be made available to the state Title IV-D
106	106	3 agency upon request. The information shall be subject to the
107	107	4 information safeguarding provisions of the state and federal Title IV-D
108	108	5 programs.
109	109	6 (d) The name, address, Social Security number, and place of
110	110	7 employment relating to any individual who is delinquent in paying
111	111	8 educational loans owed to a postsecondary educational institution may
112	112	9 be revealed to that institution if it provides proof to the department that
113	113	10 the individual is delinquent in paying for educational loans. This
114	114	11 information shall be provided free of charge to approved postsecondary
115	115	12 educational institutions (as defined by IC 21-7-13-6(a)). The
116	116	13 department shall establish fees that all other institutions must pay to the
117	117	14 department to obtain information under this subsection. However, these
118	118	15 fees may not exceed the department's administrative costs in providing
119	119	16 the information to the institution.
120	120	17 (e) The information described in subsection (a) relating to reports
121	121	18 submitted under IC 6-6-1.1-502 concerning the number of gallons of
122	122	19 gasoline sold by a distributor and IC 6-6-2.5 concerning the number of
123	123	20 gallons of special fuel sold by a supplier and the number of gallons of
124	124	21 special fuel exported by a licensed exporter or imported by a licensed
125	125	22 transporter may be released by the commissioner upon receipt of a
126	126	23 written request for the information.
127	127	24 (f) The information described in subsection (a) may be revealed
128	128	25 upon the receipt of a written request from the administrative head of a
129	129	26 state agency of Indiana when:
130	130	27 (1) the state agency shows an official need for the information;
131	131	28 and
132	132	29 (2) the administrative head of the state agency agrees that any
133	133	30 information released will be kept confidential and will be used
134	134	31 solely for official purposes.
135	135	32 (g) The information described in subsection (a) may be revealed
136	136	33 upon the receipt of a written request from the chief law enforcement
137	137	34 officer of a state or local law enforcement agency in Indiana when it is
138	138	35 agreed that the information is to be confidential and to be used solely
139	139	36 for official purposes.
140	140	37 (h) The name and address of retail merchants, including township,
141	141	38 as specified in IC 6-2.5-8-1(k) may be released solely for tax collection
142	142	39 purposes to township assessors and county assessors.
143	143	40 (i) The department shall notify the appropriate innkeeper's tax
144	144	41 board, bureau, or commission that a taxpayer is delinquent in remitting
145	145	42 innkeepers' taxes under IC 6-9.
146	146	2025 IN 234—LS 6908/DI 104 4
147	147	1 (j) All information relating to the delinquency or evasion of the
148	148	2 vehicle excise tax may be disclosed to the bureau of motor vehicles in
149	149	3 Indiana and may be disclosed to another state, if the information is
150	150	4 disclosed for the purpose of the enforcement and collection of the taxes
151	151	5 imposed by IC 6-6-5.
152	152	6 (k) All information relating to the delinquency or evasion of
153	153	7 commercial vehicle excise taxes payable to the bureau of motor
154	154	8 vehicles in Indiana may be disclosed to the bureau and may be
155	155	9 disclosed to another state, if the information is disclosed for the
156	156	10 purpose of the enforcement and collection of the taxes imposed by
157	157	11 IC 6-6-5.5.
158	158	12 (l) All information relating to the delinquency or evasion of
159	159	13 commercial vehicle excise taxes payable under the International
160	160	14 Registration Plan may be disclosed to another state, if the information
161	161	15 is disclosed for the purpose of the enforcement and collection of the
162	162	16 taxes imposed by IC 6-6-5.5.
163	163	17 (m) All information relating to the delinquency or evasion of the
164	164	18 excise taxes imposed on recreational vehicles and truck campers that
165	165	19 are payable to the bureau of motor vehicles in Indiana may be disclosed
166	166	20 to the bureau and may be disclosed to another state if the information
167	167	21 is disclosed for the purpose of the enforcement and collection of the
168	168	22 taxes imposed by IC 6-6-5.1.
169	169	23 (n) This section does not apply to:
170	170	24 (1) the beer excise tax, including brand and packaged type (IC
171	171	25 7.1-4-2);
172	172	26 (2) the liquor excise tax (IC 7.1-4-3);
173	173	27 (3) the wine excise tax (IC 7.1-4-4);
174	174	28 (4) the hard cider excise tax (IC 7.1-4-4.5);
175	175	29 (5) the vehicle excise tax (IC 6-6-5);
176	176	30 (6) the commercial vehicle excise tax (IC 6-6-5.5); and
177	177	31 (7) the fees under IC 13-23.
178	178	32 (o) The name and business address of retail merchants within each
179	179	33 county that sell tobacco products may be released to the division of
180	180	34 mental health and addiction and the alcohol and tobacco commission
181	181	35 solely for the purpose of the list prepared under IC 6-2.5-6-14.2.
182	182	36 (p) The name and business address of a person licensed by the
183	183	37 department under IC 6-6 or IC 6-7, or issued a registered retail
184	184	38 merchant's certificate under IC 6-2.5, may be released for the purpose
185	185	39 of reporting the status of the person's license or certificate.
186	186	40 (q) The department may release information concerning total
187	187	41 incremental tax amounts under:
188	188	42 (1) IC 5-28-26;
189	189	2025 IN 234—LS 6908/DI 104 5
190	190	1 (2) IC 36-7-13;
191	191	2 (3) IC 36-7-26;
192	192	3 (4) IC 36-7-27;
193	193	4 (5) IC 36-7-31;
194	194	5 (6) IC 36-7-31.3; or
195	195	6 (7) any other statute providing for the calculation of incremental
196	196	7 state taxes that will be distributed to or retained by a political
197	197	8 subdivision or other entity;
198	198	9 to the fiscal officer of the political subdivision or other entity that
199	199	10 established the district or area from which the incremental taxes were
200	200	11 received if that fiscal officer enters into an agreement with the
201	201	12 department specifying that the political subdivision or other entity will
202	202	13 use the information solely for official purposes.
203	203	14 (r) The department may release the information as required in
204	204	15 IC 6-8.1-3-7.1 concerning:
205	205	16 (1) an innkeeper's tax, a food and beverage tax, or an admissions
206	206	17 tax under IC 6-9;
207	207	18 (2) the supplemental auto rental excise tax under IC 6-6-9.7; and
208	208	19 (3) the covered taxes allocated to a professional sports
209	209	20 development area fund, sports and convention facilities operating
210	210	21 fund, or other fund under IC 36-7-31 and IC 36-7-31.3.
211	211	22 (s) Information concerning state gross retail tax exemption
212	212	23 certificates that relate to a person who is exempt from the state gross
213	213	24 retail tax under IC 6-2.5-4-5 may be disclosed to a power subsidiary (as
214	214	25 defined in IC 6-2.5-1-22.5) or a person selling the services or
215	215	26 commodities listed in IC 6-2.5-4-5 for the purpose of enforcing and
216	216	27 collecting the state gross retail and use taxes under IC 6-2.5.
217	217	28 (t) The department may release a statement of tax withholding or
218	218	29 other tax information statement provided on behalf of a taxpayer to the
219	219	30 department to:
220	220	31 (1) the taxpayer on whose behalf the tax withholding or other tax
221	221	32 information statement was provided to the department;
222	222	33 (2) the taxpayer's spouse, if:
223	223	34 (A) the taxpayer is deceased or incapacitated; and
224	224	35 (B) the taxpayer's spouse is filing a joint income tax return
225	225	36 with the taxpayer; or
226	226	37 (3) an administrator, executor, trustee, or other fiduciary acting on
227	227	38 behalf of the taxpayer if the taxpayer is deceased.
228	228	39 (u) Information related to a listed tax regarding a taxpayer may be
229	229	40 disclosed to an individual without a power of attorney under
230	230	41 IC 6-8.1-3-8(a)(2) if:
231	231	42 (1) the individual is authorized to file returns and remit payments
232	232	2025 IN 234—LS 6908/DI 104 6
233	233	1 for one (1) or more listed taxes on behalf of the taxpayer through
234	234	2 the department's online tax system before September 8, 2020;
235	235	3 (2) the information relates to a listed tax described in subdivision
236	236	4 (1) for which the individual is authorized to file returns and remit
237	237	5 payments;
238	238	6 (3) the taxpayer has been notified by the department of the
239	239	7 individual's ability to access the taxpayer's information for the
240	240	8 listed taxes described in subdivision (1) and the taxpayer has not
241	241	9 objected to the individual's access;
242	242	10 (4) the individual's authorization or right to access the taxpayer's
243	243	11 information for a listed tax described in subdivision (1) has not
244	244	12 been withdrawn by the taxpayer; and
245	245	13 (5) disclosure of the information to the individual is not
246	246	14 prohibited by federal law.
247	247	15 Except as otherwise provided by this article, this subsection does not
248	248	16 authorize the disclosure of any correspondence from the department
249	249	17 that is mailed or otherwise delivered to the taxpayer relating to the
250	250	18 specified listed taxes for which the individual was given authorization
251	251	19 by the taxpayer. The department shall establish a date, which may be
252	252	20 earlier but not later than September 1, 2023, after which a taxpayer's
253	253	21 information concerning returns and remittances for a listed tax may not
254	254	22 be disclosed to an individual without a power of attorney under
255	255	23 IC 6-8.1-3-8(a)(2) by providing notice to the affected taxpayers and
256	256	24 previously authorized individuals, including notification published on
257	257	25 the department's website. After the earlier of the date established by the
258	258	26 department or September 1, 2023, the department may not disclose a
259	259	27 taxpayer's information concerning returns and remittances for a listed
260	260	28 tax to an individual unless the individual has a power of attorney under
261	261	29 IC 6-8.1-3-8(a)(2) or the disclosure is otherwise allowed under this
262	262	30 article.
263	263	31 (v) The department may publish a list of persons, corporations, or
264	264	32 other entities that qualify or have qualified for an exemption for sales
265	265	33 tax under IC 6-2.5-5-16, IC 6-2.5-5-25, or IC 6-2.5-5-26, or otherwise
266	266	34 provide information regarding a person's, corporation's, or entity's
267	267	35 exemption status under IC 6-2.5-5-16, IC 6-2.5-5-25, or IC 6-2.5-5-26.
268	268	36 For purposes of this subsection, information that may be disclosed
269	269	37 includes:
270	270	38 (1) any federal identification number or other identification
271	271	39 number for the entity assigned by the department;
272	272	40 (2) any expiration date of an exemption under IC 6-2.5-5-25;
273	273	41 (3) whether any sales tax exemption has expired or has been
274	274	42 revoked by the department; and
275	275	2025 IN 234—LS 6908/DI 104 7
276	276	1 (4) any other information reasonably necessary for a recipient of
277	277	2 an exemption certificate to determine if an exemption certificate
278	278	3 is valid.
279	279	4 (w) The department may share a taxpayer's name and other personal
280	280	5 identification information with a tax preparer or tax preparation
281	281	6 software provider in cases where the department suspects that a
282	282	7 fraudulent return has been filed on behalf of a taxpayer and the
283	283	8 department suspects that the system of a taxpayer's previous year tax
284	284	9 preparer or tax preparation software provider has been breached.
285	285	10 SECTION 3. IC 12-15-1-24 IS ADDED TO THE INDIANA CODE
286	286	11 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
287	287	12 1, 2025]: Sec. 24. (a) Except as required under federal law, the
288	288	13 office of the secretary may not accept self-attestation of any of the
289	289	14 following in the administration of the Medicaid program:
290	290	15 (1) Income.
291	291	16 (2) Residency.
292	292	17 (3) Age.
293	293	18 (4) Household composition.
294	294	19 (5) Caretaker or relative status.
295	295	20 (6) Receipt of other coverage without verification before
296	296	21 enrollment.
297	297	22 (b) The office of the secretary shall enter into a data matching
298	298	23 agreement with:
299	299	24 (1) the state lottery commission; and
300	300	25 (2) the Indiana gaming commission;
301	301	26 to, on at least a monthly basis, identify individuals receiving
302	302	27 Medicaid assistance with lottery and gambling winnings of at least
303	303	28 three thousand dollars ($3,000). Upon verification of any winnings
304	304	29 resulting in the individual no longer being eligible for Medicaid,
305	305	30 the office of the secretary shall terminate the individual's
306	306	31 enrollment.
307	307	32 (c) On at least a monthly basis, the office of the secretary shall
308	308	33 review vital statistics information provided by the Indiana
309	309	34 department of health under IC 16-19-3-19 to determine removal of
310	310	35 deceased individuals from Medicaid enrollment.
311	311	36 (d) On at least a quarterly basis, the office of the secretary shall
312	312	37 receive and review information from the department of state
313	313	38 revenue and the department of workforce development concerning
314	314	39 Medicaid recipients that indicates a change in circumstances that
315	315	40 may affect eligibility, including changes to employment or wages.
316	316	41 (e) On at least an annual basis, the office of the secretary shall
317	317	42 receive and review information from the department of state
318	318	2025 IN 234—LS 6908/DI 104 8
319	319	1 revenue concerning Medicaid recipients that indicates a change in
320	320	2 circumstances that may affect Medicaid eligibility.
321	321	3 (f) On at least a monthly basis, the office of the secretary shall
322	322	4 review information concerning Medicaid recipients who also
323	323	5 receive SNAP to determine whether there has been any change in
324	324	6 circumstances that may affect Medicaid eligibility, including a
325	325	7 change in residency as may be identified through electronic benefit
326	326	8 transfer program transactions.
327	327	9 (g) On at least a monthly basis, the office of the secretary shall
328	328	10 receive and review information from the department of correction
329	329	11 concerning Medicaid recipients that may indicate a change in
330	330	12 circumstances that may affect Medicaid eligibility.
331	331	13 SECTION 4. IC 12-15-1-25 IS ADDED TO THE INDIANA CODE
332	332	14 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
333	333	15 1, 2025]: Sec. 25. (a) Unless prohibited by federal law and on at
334	334	16 least a monthly basis, the office of the secretary shall review the
335	335	17 following to assess continuous eligibility of Medicaid recipients:
336	336	18 (1) The following information maintained by the United States
337	337	19 Social Security Administration:
338	338	20 (A) Earned income information.
339	339	21 (B) Death register information.
340	340	22 (C) Incarceration records.
341	341	23 (D) Supplemental security income information.
342	342	24 (E) Beneficiary records.
343	343	25 (F) Earnings information.
344	344	26 (G) Pension information.
345	345	27 (2) The following information maintained by the United States
346	346	28 Department of Health and Human Services:
347	347	29 (A) Income and employment information maintained in the
348	348	30 national directory of new hires data base.
349	349	31 (B) Child support enforcement data.
350	350	32 (3) Change of address information maintained by the United
351	351	33 States Postal Service.
352	352	34 (4) Payment and earnings information maintained by the
353	353	35 United States Department of Housing and Urban
354	354	36 Development.
355	355	37 (5) National fleeing felon information maintained by the
356	356	38 United States Federal Bureau of Investigation.
357	357	39 (6) Tax filing information maintained by the United States
358	358	40 Department of the Treasury.
359	359	41 (b) The office of the secretary may contract with an independent
360	360	42 third party for additional data base searches that may contain
361	361	2025 IN 234—LS 6908/DI 104 9
362	362	1 information that indicates a change in circumstances that may
363	363	2 affect Medicaid applicant or recipient eligibility.
364	364	3 SECTION 5. IC 12-15-1.3-4.3 IS ADDED TO THE INDIANA
365	365	4 CODE AS A NEW SECTION TO READ AS FOLLOWS
366	366	5 [EFFECTIVE UPON PASSAGE]: Sec. 4.3. (a) Before July 1, 2025,
367	367	6 the office of the secretary shall apply to the United States
368	368	7 Department of Health and Human Services for an amendment to
369	369	8 the state Medicaid plan that removes references to coverage under
370	370	9 the state Medicaid plan of the population described in 42 CFR
371	371	10 435.119.
372	372	11 (b) The office of the secretary may delay the effective date of a
373	373	12 state plan amendment described in subsection (a) during the time
374	374	13 that the office of the secretary is negotiating with the United States
375	375	14 Department of Health and Human Services for a state Medicaid
376	376	15 waiver covering the population described in subsection (a).
377	377	16 However, the office of the secretary may not delay later than June
378	378	17 30, 2026, the implementation of a state plan amendment requested
379	379	18 under this section and authorized by the United States Department
380	380	19 of Health and Human Services.
381	381	20 SECTION 6. IC 12-15-4-1.5 IS ADDED TO THE INDIANA CODE
382	382	21 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
383	383	22 1, 2025]: Sec. 1.5. (a) The office of the secretary shall establish the
384	384	23 following:
385	385	24 (1) Performance standards for hospitals to use in making
386	386	25 presumptive eligibility determinations.
387	387	26 (2) An appeals process for a hospital that disputes a
388	388	27 determination that a presumptive eligibility was violated
389	389	28 beginning after the second finding of a presumptive eligibility
390	390	29 violation by the office of the secretary for the hospital within
391	391	30 a twelve (12) month period.
392	392	31 (b) A hospital shall do the following when making a presumptive
393	393	32 eligibility determination:
394	394	33 (1) Notify the office of the secretary of each presumptive
395	395	34 eligibility determination not later than five (5) business days
396	396	35 after the date of the determination.
397	397	36 (2) Assist individuals whom the hospital determines are
398	398	37 presumptively eligible with completing and submitting a full
399	399	38 Medicaid application.
400	400	39 (3) Notify the applicant in writing and on all relevant forms
401	401	40 with plain language and large print that if the applicant:
402	402	41 (A) does not file a full Medicaid application with the office
403	403	42 of the secretary before the last day of the following month,
404	404	2025 IN 234—LS 6908/DI 104 10
405	405	1 presumptive eligibility will end on that last day; and
406	406	2 (B) files a full Medicaid application with the office of the
407	407	3 secretary before the last day of the following month,
408	408	4 presumptive eligibility will continue until an eligibility
409	409	5 determination is made concerning the application.
410	410	6 (c) The office of the secretary shall use the following
411	411	7 performance standards to establish and ensure accurate
412	412	8 presumptive eligibility determinations by a qualified hospital:
413	413	9 (1) Determine whether the presumptive eligibility received
414	414	10 from the hospital complied with the time requirement set
415	415	11 forth in subsection (b)(1).
416	416	12 (2) Determine whether the office of the secretary received
417	417	13 before the expiration of the presumptive eligibility period the
418	418	14 full application from the individual determined by the
419	419	15 hospital to be presumptively eligible.
420	420	16 (3) Determine whether the applicant who was determined by
421	421	17 the hospital to be presumptively eligible by the hospital was
422	422	18 determined to be eligible for Medicaid after the full
423	423	19 application was received.
424	424	20 (d) If a hospital fails for the first time to meet any of the
425	425	21 presumptive eligibility standards under this section for a
426	426	22 presumptive eligibility determination in a calendar year, the office
427	427	23 of the secretary shall notify the hospital in writing not later than
428	428	24 five (5) days after the determination of a violation is made. The
429	429	25 notice must include the following:
430	430	26 (1) A description of the standard that was not met and an
431	431	27 explanation of why the hospital did not meet the standard.
432	432	28 (2) Notice that a second finding on noncompliance with a
433	433	29 standard will result in a requirement that the hospital's
434	434	30 applicable staff participate in mandatory training on hospital
435	435	31 presumptive eligibility rules and standards that is performed
436	436	32 by the office of the secretary.
437	437	33 (e) If the office of the secretary determines that a hospital has
438	438	34 failed to meet any of the presumptive eligibility standards under
439	439	35 this section in any presumptive eligibility determination by the
440	440	36 hospital for a second time within a twelve (12) month period of a
441	441	37 first violation, the office of the secretary shall notify the hospital in
442	442	38 writing not later than five (5) days after the determination that a
443	443	39 second violation has occurred. The written notice must include the
444	444	40 following:
445	445	41 (1) A description of the standard that was not met and an
446	446	42 explanation of why the hospital did not meet the standard.
447	447	2025 IN 234—LS 6908/DI 104 11
448	448	1 (2) Notice that the hospital's applicable staff must participate
449	449	2 in mandatory training on hospital presumptive eligibility
450	450	3 rules and standards that is performed by the office of the
451	451	4 secretary, and information concerning the date, time, and
452	452	5 location of the training by the office.
453	453	6 (3) A description of the available appeal procedures that the
454	454	7 hospital may use to dispute the finding of a violation of
455	455	8 presumptive eligibility standards.
456	456	9 (4) Notice that a third violation by the hospital of a
457	457	10 presumptive eligibility standard within a twelve (12) month
458	458	11 period from the second violation will result in the hospital no
459	459	12 longer being qualified to make presumptive eligibility
460	460	13 determinations.
461	461	14 If a hospital appeals a finding of a violation of presumptive
462	462	15 eligibility standards described in this subsection, the hospital must
463	463	16 provide clear and convincing evidence during the appeals process
464	464	17 that the standard was met by the hospital.
465	465	18 (f) If the office of the secretary determines that a hospital has
466	466	19 failed to meet any of the presumptive eligibility standards under
467	467	20 this section in any presumptive eligibility determination by the
468	468	21 hospital for a third time within a twelve (12) month period of the
469	469	22 second violation by the hospital, the office of the secretary shall
470	470	23 notify the hospital in writing not later than five (5) days from a
471	471	24 determination that a presumptive eligibility standard was violated
472	472	25 by the hospital for the third time. The written notice must include
473	473	26 the following:
474	474	27 (1) A description of the standard that was not met and an
475	475	28 explanation of why the hospital did not meet the standard.
476	476	29 (2) A description of the available appeal procedures that the
477	477	30 hospital may use to dispute the finding of a violation of
478	478	31 presumptive eligibility standards.
479	479	32 (3) Notice that, effective immediately from receipt of the
480	480	33 notice, the hospital is no longer qualified to make presumptive
481	481	34 eligibility determinations for the Medicaid program.
482	482	35 If a hospital appeals a finding of a violation of presumptive
483	483	36 eligibility standards described in this subsection, the hospital must
484	484	37 provide clear and convincing evidence during the appeals process
485	485	38 that the standard was met by the hospital.
486	486	39 SECTION 7. IC 12-15-44.5-3, AS AMENDED BY P.L.241-2023,
487	487	40 SECTION 16, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
488	488	41 JULY 1, 2025]: Sec. 3. (a) The healthy Indiana plan is established.
489	489	42 (b) The office shall administer the plan.
490	490	2025 IN 234—LS 6908/DI 104 12
491	491	1 (c) Subject to section 4 of this chapter, the following individuals
492	492	2 are may be eligible for the plan:
493	493	3 (1) The adult group described in 42 CFR 435.119
494	494	4 (2) Parents and caretaker relatives eligible under 42 CFR 435.110.
495	495	5 (3) Low income individuals who are:
496	496	6 (A) at least nineteen (19) years of age; and
497	497	7 (B) less than twenty-one (21) years of age;
498	498	8 and eligible under 42 CFR 435.222.
499	499	9 (4) Individuals, for purposes of receiving transitional medical
500	500	10 assistance.
501	501	11 if an individual meets the following requirements:
502	502	12 (A) Meets at least one (1) of the following:
503	503	13 (i) Is working at least twenty (20) hours per week on a
504	504	14 monthly average.
505	505	15 (ii) Is participating in and complying with the
506	506	16 requirements of a work program for at least twenty (20)
507	507	17 hours per week, as determined by the office.
508	508	18 (iii) Is volunteering at least twenty (20) hours per week,
509	509	19 as determined by the office.
510	510	20 (iv) Undertakes the activities described in items (i) and
511	511	21 (ii) for a combined total of at least twenty (20) hours per
512	512	22 week, as determined by the office.
513	513	23 (v) Participates in and complies with the requirements of
514	514	24 a workfare program, as determined by the office.
515	515	25 (vi) Receives unemployment compensation and complies
516	516	26 with federal and state work requirements under the
517	517	27 unemployment compensation system.
518	518	28 (vii) Participates in a substance use treatment and
519	519	29 rehabilitation program.
520	520	30 (viii) Is medically certified as physically or mentally unfit
521	521	31 for employment.
522	522	32 (ix) Is a parent or caretaker responsible for the care of a
523	523	33 dependent child less than six (6) years of age.
524	524	34 (x) Is a parent or caretaker personally providing the care
525	525	35 for a dependent child with a serious medical condition or
526	526	36 disability.
527	527	37 (B) Has received not more than thirty-six (36) months of
528	528	38 coverage under the plan.
529	529	39 (C) Was eligible for and enrolled in the plan on the date
530	530	40 the plan becomes effective after approval by the United
531	531	41 States Department of Health and Human Services.
532	532	42 (2) Is either less than nineteen (19) years of age or more than
533	533	2025 IN 234—LS 6908/DI 104 13
534	534	1 sixty-four (64) years of age and meets the following:
535	535	2 (A) Has received not more than thirty-six (36) months of
536	536	3 coverage under the plan.
537	537	4 (B) Was eligible for and enrolled in the plan on the date the
538	538	5 plan becomes effective after approval by the United States
539	539	6 Department of Health and Human Services.
540	540	7 (3) Is pregnant and meets the following:
541	541	8 (A) Has received not more than thirty-six (36) months of
542	542	9 coverage under the plan.
543	543	10 (B) Was eligible for and enrolled in the plan on the date the
544	544	11 plan becomes effective after approval by the United States
545	545	12 Department of Health and Human Services.
546	546	13 An individual must meet the Medicaid residency requirements under
547	547	14 IC 12-15-4-4 and this article to be eligible for the plan.
548	548	15 (d) The following individuals are not eligible for the plan:
549	549	16 (1) An individual who participates in the federal Medicare
550	550	17 program (42 U.S.C. 1395 et seq.).
551	551	18 (2) An individual who is otherwise eligible and enrolled for
552	552	19 medical assistance.
553	553	20 (e) The department of insurance and the office of the secretary shall
554	554	21 provide oversight of the marketing practices of the plan.
555	555	22 (f) The office shall promote the plan and provide information to
556	556	23 potential eligible individuals who live in medically underserved rural
557	557	24 areas of Indiana.
558	558	25 (g) The office shall, to the extent possible, ensure that enrollment in
559	559	26 the plan is distributed throughout Indiana in proportion to the number
560	560	27 of individuals throughout Indiana who are eligible for participation in
561	561	28 the plan.
562	562	29 (h) The office shall establish standards for consumer protection,
563	563	30 including the following:
564	564	31 (1) Quality of care standards.
565	565	32 (2) A uniform process for participant grievances and appeals.
566	566	33 (3) Standardized reporting concerning provider performance,
567	567	34 consumer experience, and cost.
568	568	35 (i) A health care provider that provides care to an individual who
569	569	36 receives health coverage under the plan shall also participate in the
570	570	37 Medicaid program under this article.
571	571	38 (j) The following do not apply to the plan:
572	572	39 (1) IC 12-15-12.
573	573	40 (2) IC 12-15-13.
574	574	41 (3) IC 12-15-14.
575	575	42 (4) IC 12-15-15.
576	576	2025 IN 234—LS 6908/DI 104 14
577	577	1 (5) IC 12-15-21.
578	578	2 (6) IC 12-15-26.
579	579	3 (7) IC 12-15-31.1.
580	580	4 (8) IC 12-15-34.
581	581	5 (9) IC 12-15-35.
582	582	6 (10) IC 16-42-22-10.
583	583	7 SECTION 8. IC 12-15-44.5-4, AS AMENDED BY P.L.30-2016,
584	584	8 SECTION 29, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
585	585	9 JULY 1, 2025]: Sec. 4. (a) The plan:
586	586	10 (1) is not an entitlement program; and
587	587	11 (2) serves as an alternative to health care coverage under Title
588	588	12 XIX of the federal Social Security Act (42 U.S.C. 1396 et seq.);
589	589	13 (3) may not grant eligibility under the state Medicaid plan for
590	590	14 medical assistance under 42 U.S.C. 1396a; and
591	591	15 (4) must grant eligibility for the plan through an approved
592	592	16 demonstration project under 42 U.S.C. 1315.
593	593	17 (b) If either any of the following occurs, the office shall terminate
594	594	18 the plan in accordance with section 6(b) of this chapter:
595	595	19 (1) The:
596	596	20 (A) percentages of federal medical assistance available to the
597	597	21 plan for coverage of plan participants described in Section
598	598	22 1902(a)(10)(A)(i)(VIII) of the federal Social Security Act are
599	599	23 less than the percentages provided for in Section
600	600	24 2001(a)(3)(B) of the federal Patient Protection and Affordable
601	601	25 Care Act; and
602	602	26 (B) hospital assessment committee (IC 16-21-10), after
603	603	27 considering the modification and the reduction in available
604	604	28 funding, does not alter the formula established under
605	605	29 IC 16-21-10-13.3(b)(1) to cover the amount of the reduction
606	606	30 in federal medical assistance.
607	607	31 For purposes of this subdivision, "coverage of plan participants"
608	608	32 includes payments, contributions, and amounts referred to in
609	609	33 IC 16-21-10-13.3(b)(1)(A), IC 16-21-10-13.3(b)(1)(C), and
610	610	34 IC 16-21-10-13.3(b)(1)(D), including payments, contributions,
611	611	35 and amounts incurred during a phase out period of the plan.
612	612	36 (2) The:
613	613	37 (A) methodology of calculating the incremental fee set forth in
614	614	38 IC 16-21-10-13.3 is modified in any way that results in a
615	615	39 reduction in available funding;
616	616	40 (B) hospital assessment fee committee (IC 16-21-10), after
617	617	41 considering the modification and reduction in available
618	618	42 funding, does not alter the formula established under
619	619	2025 IN 234—LS 6908/DI 104 15
620	620	1 IC 16-21-10-13.3(b)(1) to cover the amount of the reduction
621	621	2 in fees; and
622	622	3 (C) office does not use alternative financial support to cover
623	623	4 the amount of the reduction in fees.
624	624	5 (3) The Medicaid waiver approving the plan is revoked,
625	625	6 rescinded, vacated, or otherwise altered in a manner such that
626	626	7 the state cannot comply with the requirements of this chapter.
627	627	8 (c) If the plan is terminated under subsection (b), the secretary may
628	628	9 implement a plan for coverage of the affected population in a manner
629	629	10 consistent with the healthy Indiana plan (IC 12-15-44.2 (before its
630	630	11 repeal)) in effect on January 1, 2014:
631	631	12 (1) subject to prior approval of the United States Department of
632	632	13 Health and Human Services; and
633	633	14 (2) without funding from the incremental fee set forth in
634	634	15 IC 16-21-10-13.3.
635	635	16 (d) The office may not operate the plan in a manner that would
636	636	17 obligate the state to financial participation beyond the level of state
637	637	18 appropriations or funding otherwise authorized for the plan.
638	638	19 (e) The office of the secretary shall submit annually to the budget
639	639	20 committee an actuarial analysis of the plan that reflects a determination
640	640	21 that sufficient funding is reasonably estimated to be available to
641	641	22 operate the plan.
642	642	23 SECTION 9. IC 12-15-44.5-10, AS AMENDED BY P.L.30-2016,
643	643	24 SECTION 35, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
644	644	25 JULY 1, 2025]: Sec. 10. (a) The secretary has the authority to provide
645	645	26 benefits to individuals eligible under the adult group described in 42
646	646	27 CFR 435.119 only in accordance with this chapter.
647	647	28 (b) The secretary shall limit enrollment in the plan to the lesser
648	648	29 of:
649	649	30 (1) the number individuals that ensures that financial
650	650	31 participation does not exceed the level of state appropriations
651	651	32 or other funding for the plan; or
652	652	33 (2) five hundred thousand (500,000) individuals.
653	653	34 (b) (c) The secretary may negotiate and make changes to the plan,
654	654	35 except that the secretary may not negotiate or change the plan in a way
655	655	36 that would do the following:
656	656	37 (1) Reduce the following:
657	657	38 (A) Contribution amounts below the minimum levels set forth
658	658	39 in section 4.7 of this chapter.
659	659	40 (B) Deductible amounts below the minimum amount
660	660	41 established in section 4.5(c) of this chapter.
661	661	42 (C) The number of hours required to satisfy the work
662	662	2025 IN 234—LS 6908/DI 104 16
663	663	1 requirements specified in section 3(c)(1)(A) of this chapter.
664	664	2 (2) Remove or reduce the penalties for nonpayment set forth in
665	665	3 section 4.7 of this chapter.
666	666	4 (3) Revise the use of the health care account requirement set forth
667	667	5 in section 4.5 of this chapter.
668	668	6 (4) Include noncommercial benefits or add additional plan
669	669	7 benefits in a manner inconsistent with section 3.5 of this chapter.
670	670	8 (5) Allow services to begin:
671	671	9 (A) without the payment established or required by; or
672	672	10 (B) earlier than the time frames otherwise established by;
673	673	11 section 4.7 of this chapter.
674	674	12 (6) Reduce financial penalties for the inappropriate use of the
675	675	13 emergency room below the minimum levels set forth in section
676	676	14 5.7 of this chapter.
677	677	15 (7) Permit members to change health plans without cause in a
678	678	16 manner inconsistent with section 4.7(g) of this chapter.
679	679	17 (8) Operate the plan in a manner that would obligate the state to
680	680	18 financial participation beyond the level of state appropriations or
681	681	19 funding otherwise authorized for the plan.
682	682	20 (9) Increase the maximum duration of benefits beyond the
683	683	21 limitations specified in section 3(c)(1)(B) of this chapter.
684	684	22 (10) Extend eligibility to individuals beyond those specified in
685	685	23 section 3(c) of this chapter.
686	686	24 (c) (d) The secretary may make changes to the plan under this
687	687	25 chapter if the changes are required by federal law or regulation.
688	688	26 SECTION 10. IC 16-19-3-19, AS AMENDED BY P.L.128-2015,
689	689	27 SECTION 237, IS AMENDED TO READ AS FOLLOWS
690	690	28 [EFFECTIVE JULY 1, 2025]: Sec. 19. (a) The state department shall
691	691	29 study the vital statistics and endeavor to make intelligent and profitable
692	692	30 use of the collected records of death and sickness among the people.
693	693	31 (b) As required under 52 U.S.C. 21083, after January 1, 2006, the
694	694	32 department shall provide information to the following:
695	695	33 (1) The election division to coordinate the computerized list of
696	696	34 voters maintained under IC 3-7-26.3 with the department records
697	697	35 concerning individuals identified as deceased under IC 3-7-45.
698	698	36 (2) The office of the secretary of family and social services to
699	699	37 determine whether a Medicaid recipient is identified as
700	700	38 deceased for purposes of IC 12-15-1-24(c).
701	701	39 SECTION 11. IC 22-4-19-6, AS AMENDED BY P.L.122-2019,
702	702	40 SECTION 32, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
703	703	41 JULY 1, 2025]: Sec. 6. (a) Each employing unit shall keep true and
704	704	42 accurate records containing information the department considers
705	705	2025 IN 234—LS 6908/DI 104 17
706	706	1 necessary. These records are:
707	707	2 (1) open to inspection; and
708	708	3 (2) subject to being copied;
709	709	4 by an authorized representative of the department at any reasonable
710	710	5 time and as often as may be necessary. The department, the review
711	711	6 board, or an administrative law judge may require from any employing
712	712	7 unit any verified or unverified report, with respect to persons employed
713	713	8 by it, which is considered necessary for the effective administration of
714	714	9 this article.
715	715	10 (b) Except as provided in this section, information obtained or
716	716	11 obtained from any person in the administration of this article and the
717	717	12 records of the department relating to the unemployment tax or the
718	718	13 payment of benefits is confidential and may not be published or be
719	719	14 open to public inspection in any manner revealing the individual's or
720	720	15 the employing unit's identity, except in obedience to an order of a court
721	721	16 or as provided in this section.
722	722	17 (c) A claimant or an employer at a hearing before an administrative
723	723	18 law judge or the review board shall be supplied with information from
724	724	19 the records referred to in this section to the extent necessary for the
725	725	20 proper presentation of the subject matter of the appearance.
726	726	21 (d) The department may release the following information:
727	727	22 (1) Summary statistical data may be released to the public.
728	728	23 (2) Employer specific information known as Quarterly Census of
729	729	24 Employment and Wages data and data resulting from
730	730	25 enhancements made through the business establishment list
731	731	26 improvement project may be released to the Indiana economic
732	732	27 development corporation only for the following purposes:
733	733	28 (A) The purpose of conducting a survey.
734	734	29 (B) The purpose of aiding the officers or employees of the
735	735	30 Indiana economic development corporation in providing
736	736	31 economic development assistance through program
737	737	32 development, research, or other methods.
738	738	33 (C) Other purposes consistent with the goals of the Indiana
739	739	34 economic development corporation and not inconsistent with
740	740	35 those of the department, including the purposes of IC 5-28-6-7.
741	741	36 (3) Employer specific information known as Quarterly Census of
742	742	37 Employment and Wages data and data resulting from
743	743	38 enhancements made through the business establishment list
744	744	39 improvement project may be released to:
745	745	40 (A) the budget agency and the legislative services agency only
746	746	41 for aiding the employees of the budget agency or the
747	747	42 legislative services agency in forecasting tax revenues; and
748	748	2025 IN 234—LS 6908/DI 104 18
749	749	1 (B) the Indiana department of labor for the purpose of
750	750	2 conducting a survey and reporting to the United States
751	751	3 Department of Labor or the federal Bureau of Labor Statistics.
752	752	4 (4) Wages data to the office of the secretary of family and
753	753	5 social services for the purposes specified in IC 12-15-1-24(d).
754	754	6 (e) The department may make information available under
755	755	7 subsection (d) only:
756	756	8 (1) if:
757	757	9 (A) under subsection (d)(1), data provided in summary form
758	758	10 cannot be used to identify information relating to a specific
759	759	11 employer or specific employee; or
760	760	12 (B) under subsection (d)(2) and (d)(3), there is an agreement
761	761	13 that the employer specific information released will be treated
762	762	14 as confidential and will be released only in summary form that
763	763	15 cannot be used to identify information relating to a specific
764	764	16 employer or a specific employee; and
765	765	17 (2) after the cost of making the information available to the
766	766	18 person requesting the information is paid under IC 5-14-3.
767	767	19 (f) The department may disclose confidential information:
768	768	20 (1) to an individual or employer as provided in 20 CFR 603.5(c),
769	769	21 upon request and proper identification of the individual or
770	770	22 employer;
771	771	23 (2) through informed consent of a party as provided in 20 CFR
772	772	24 603.5(d);
773	773	25 (3) to a public official as provided in 20 CFR 603.5(e);
774	774	26 (4) to an agent or contractor of a public official as provided in 20
775	775	27 CFR 603.5(f); or
776	776	28 (5) to the Bureau of Labor Statistics as provided in 20 CFR
777	777	29 603.5(g);
778	778	30 after the cost of making the information available to the party
779	779	31 requesting the information is paid under IC 5-14-3.
780	780	32 (g) In addition to the confidentiality provisions of subsection (b), the
781	781	33 fact that a claim has been made under IC 22-4-15-1(c)(8) and any
782	782	34 information furnished by the claimant or an agent to the department to
783	783	35 verify a claim of domestic or family violence are confidential.
784	784	36 Information concerning the claimant's current address or physical
785	785	37 location shall not be disclosed to the employer or any other person.
786	786	38 Disclosure is subject to the following additional restrictions:
787	787	39 (1) The claimant must be notified before any release of
788	788	40 information.
789	789	41 (2) Any disclosure is subject to redaction of unnecessary
790	790	42 identifying information, including the claimant's address.
791	791	2025 IN 234—LS 6908/DI 104 19
792	792	1 (h) An employee:
793	793	2 (1) of the department who recklessly violates subsection (a), (c),
794	794	3 (d), (e), (f), or (g); or
795	795	4 (2) of any governmental entity listed in subsection (f) who
796	796	5 recklessly violates subsection (f);
797	797	6 commits a Class B misdemeanor.
798	798	7 (i) An employee of the Indiana economic development corporation,
799	799	8 the budget agency, or the legislative services agency who violates
800	800	9 subsection (d), (e), or (f) commits a Class B misdemeanor.
801	801	10 (j) An employer or agent of an employer that becomes aware that a
802	802	11 claim has been made under IC 22-4-15-1(c)(8) shall maintain that
803	803	12 information as confidential.
804	804	13 (k) The department may charge a reasonable processing fee not to
805	805	14 exceed two dollars ($2) for each record that provides information about
806	806	15 an individual's last known employer released in compliance with a
807	807	16 court order under subsection (b).
808	808	17 SECTION 12. An emergency is declared for this act.
809	809	2025 IN 234—LS 6908/DI 104