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| 2 | 2 | | Introduced Version |
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| 3 | 3 | | SENATE BILL No. 493 |
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| 4 | 4 | | _____ |
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| 5 | 5 | | DIGEST OF INTRODUCED BILL |
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| 6 | 6 | | Citations Affected: IC 12-15-12-2.5. |
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| 7 | 7 | | Synopsis: Medicaid value based contracting. Allows a managed care |
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| 8 | 8 | | organization to enter into a value based contract with a Medicaid |
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| 9 | 9 | | provider to provide services under a risk based managed care program. |
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| 10 | 10 | | Effective: July 1, 2025. |
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| 11 | 11 | | Crider |
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| 12 | 12 | | January 14, 2025, read first time and referred to Committee on Health and Provider |
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| 13 | 13 | | Services. |
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| 14 | 14 | | 2025 IN 493—LS 7039/DI 104 Introduced |
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| 15 | 15 | | First Regular Session of the 124th General Assembly (2025) |
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| 16 | 16 | | PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana |
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| 17 | 17 | | Constitution) is being amended, the text of the existing provision will appear in this style type, |
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| 18 | 18 | | additions will appear in this style type, and deletions will appear in this style type. |
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| 19 | 19 | | Additions: Whenever a new statutory provision is being enacted (or a new constitutional |
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| 20 | 20 | | provision adopted), the text of the new provision will appear in this style type. Also, the |
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| 21 | 21 | | word NEW will appear in that style type in the introductory clause of each SECTION that adds |
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| 22 | 22 | | a new provision to the Indiana Code or the Indiana Constitution. |
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| 23 | 23 | | Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts |
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| 24 | 24 | | between statutes enacted by the 2024 Regular Session of the General Assembly. |
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| 25 | 25 | | SENATE BILL No. 493 |
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| 26 | 26 | | A BILL FOR AN ACT to amend the Indiana Code concerning |
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| 27 | 27 | | Medicaid. |
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| 28 | 28 | | Be it enacted by the General Assembly of the State of Indiana: |
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| 29 | 29 | | 1 SECTION 1. IC 12-15-12-2.5 IS ADDED TO THE INDIANA |
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| 30 | 30 | | 2 CODE AS A NEW SECTION TO READ AS FOLLOWS |
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| 31 | 31 | | 3 [EFFECTIVE JULY 1, 2025]: Sec. 2.5. (a) A managed care |
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| 32 | 32 | | 4 organization may enter into a value based contract with a |
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| 33 | 33 | | 5 Medicaid provider to provide services under a risk based managed |
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| 34 | 34 | | 6 care program. |
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| 35 | 35 | | 7 (b) A managed care organization: |
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| 36 | 36 | | 8 (1) is responsible for ensuring access to high quality care for |
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| 37 | 37 | | 9 Medicaid recipients; and |
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| 38 | 38 | | 10 (2) may use a value based model that includes any of the |
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| 39 | 39 | | 11 following if the Medicaid provider agrees and opts into the |
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| 40 | 40 | | 12 arrangement: |
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| 41 | 41 | | 13 (A) Case rates. |
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| 42 | 42 | | 14 (B) Total cost of care arrangements. |
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| 43 | 43 | | 15 (C) Pay for value bonuses. |
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| 44 | 44 | | 16 (D) Bundled payments. |
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| 45 | 45 | | 2025 IN 493—LS 7039/DI 104 |
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