Introduced Version
SENATE BILL No. 471
_____
DIGEST OF INTRODUCED BILL
Citations Affected: Noncode.
Synopsis: Medicaid study. Requires the office of the secretary of
family and social services and the legislative services agency to
conduct a feasibility study of transitioning Indiana's Medicaid program
administration to a nonprofit health insurance entity. Sets forth
parameters of the study.
Effective: Upon passage.
Qaddoura
January 13, 2025, read first time and referred to Committee on Health and Provider
Services.
2025 IN 471—LS 6501/DI 104 Introduced
First Regular Session of the 124th General Assembly (2025)
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 2024 Regular Session of the General Assembly.
SENATE BILL No. 471
A BILL FOR AN ACT concerning Medicaid.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. [EFFECTIVE UPON PASSAGE] (a) As used in this
2 SECTION, "office" refers to the office of the secretary of family
3 and social services established by IC 12-8-1.5-1.
4 (b) During the 2025 interim, the office and the legislative
5 services agency shall study the feasibility of the following for
6 implementation by Medicaid before state fiscal year 2029:
7 (1) Creating a state or quasi-state nonprofit health insurance
8 entity to administer and manage the health care and
9 pharmaceutical needs of the entire Indiana Medicaid
10 population within all Medicaid programs and waivers. The
11 entity must meet the following:
12 (A) Operate without any net profit and operational
13 reserves not to exceed twenty percent (20%) of the annual
14 operating budget.
15 (B) Provide limited executive and employee pay that does
16 not exceed one million dollars ($1,000,000).
17 (C) Operate through a state appointed board.
18 (2) Expanding the current Indiana nonprofit health insurance
2025 IN 471—LS 6501/DI 104 2
1 market to existing nonprofit health insurance entities that are
2 able to meet the following:
3 (A) Operate without any net profit and operational
4 reserves not to exceed twenty percent (20%) of the annual
5 operating budget.
6 (B) Provide limited executive and employee pay that does
7 not exceed one million dollars ($1,000,000).
8 (C) Have a credible history as a nonprofit entity.
9 (c) Before July 1, 2025, the following information must be
10 provided:
11 (1) The office shall share with and provide access to the
12 necessary data to perform this study with the legislative
13 services agency.
14 (2) A managed care organization that has contracted with the
15 office to provide managed care services for the Medicaid
16 program shall provide data necessary for the office and the
17 legislative services agency to meet the requirements of this
18 SECTION, as prescribed by the office and the legislative
19 services agency.
20 (d) The study must include whether either of the models
21 described in subsection (b) would result in a savings of at least
22 three percent (3%) to the Medicaid program from current
23 Medicaid spending.
24 (e) If the study required by this SECTION results in the savings
25 described in subsection (d), the following actions must occur:
26 (1) The general assembly is encouraged to move forward with
27 legislation necessary for the implementation of the model with
28 the savings described in subsection (d) during the 2026
29 regular session of the general assembly.
30 (2) Not later than November 1, 2025, the office shall submit to
31 the general assembly in an electronic format under IC 5-14-6
32 a full implementation plan for the general assembly to
33 consider in the implementation described in subdivision (1).
34 (f) Not later than October 1, 2025, the office and the legislative
35 services agency shall report the findings of this study to the
36 legislative council in an electronic format under IC 5-14-6.
37 (g) This SECTION expires December 31, 2026.
38 SECTION 2. An emergency is declared for this act.
2025 IN 471—LS 6501/DI 104