Indiana 2025 Regular Session

Indiana Senate Bill SB0522 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. 522
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 5-10-8; IC 5-16-16; IC 11-8; IC 11-10-3.5;
7	7	IC 11-12-4-1; IC 12-15-5; IC 16-18-2; IC 16-35-12; IC 16-41-17.5;
8	8	IC 27-8; IC 27-13-7.
9	9	Synopsis: Maternal health matters. Prohibits step therapy protocol for
10	10	prescription drugs prescribed for the treatment of postpartum mental
11	11	health conditions. Requires a state employee health plan, a policy of
12	12	accident and sickness insurance, and a health maintenance organization
13	13	contract to provide coverage for: (1) postpartum mental health
14	14	conditions; (2) a tubal ligation procedure; and (3) a vasectomy
15	15	procedure; for certain individuals. Establishes a grant program to
16	16	promote the installation of lactation rooms in public buildings.
17	17	Requires the Indiana housing and community development authority
18	18	(IHCDA) to administer the grant program. Authorizes public agencies
19	19	to apply for grants. Establishes the Officer Breann Leath Memorial
20	20	Prison Nursery (nursery) within a correctional facility determined by
21	21	the commissioner of the department of correction (DOC). Specifies the
22	22	criteria for operation, design, and implementation of the nursery and
23	23	minimum standards that govern the nursery. Requires the DOC to
24	24	provide an annual report to the legislative council concerning the
25	25	nursery. Amends the statute requiring the DOC to adopt rules
26	26	governing minimum standards for county jails to include the provision
27	27	of menstrual discharge collection devices to inmates. Establishes the
28	28	incarcerated women's maternal health fund to provide funds to support
29	29	the nursery. Provides for Medicaid reimbursement for certified medical
30	30	interpretation services for Medicaid recipients who have limited
31	31	English proficiency when receiving Medicaid covered services from a
32	32	Medicaid provider. Requires Medicaid pregnancy services to include
33	33	reimbursement for doula services. Establishes the telephone assistance
34	34	line for mothers program for the purpose of providing a telephone
35	35	(Continued next page)
36	36	Effective: July 1, 2025.
37	37	Hunley, Yoder, Jackson L
38	38	January 16, 2025, read first time and referred to Committee on Health and Provider
39	39	Services.
40	40	2025 IN 522—LS 7371/DI 104 Digest Continued
41	41	assistance line for mothers who are experiencing behavioral health
42	42	issues to connect with health care practitioners to obtain behavioral
43	43	health resources. Establishes the stillbirth prevention through fetal
44	44	movement pilot program (program) for the purpose of providing
45	45	evidence based information on the importance of tracking fetal
46	46	movement in the third trimester of pregnancy to prevent stillbirths, to
47	47	be administered by the Indiana department of health (state department).
48	48	Allows the state department to award grants to increase education and
49	49	the distribution of materials on tracking fetal movement in the third
50	50	trimester of pregnancy. Requires grantees to report specified
51	51	information on a quarterly and annual basis. Creates a fund and
52	52	appropriates $250,000 for the program. Expires the program on
53	53	December 31, 2027. Appropriates $5,000,000 to the IHCDA for
54	54	deposit in the lactation room grant fund. Makes a continuing
55	55	appropriation.
56	56	2025 IN 522—LS 7371/DI 1042025 IN 522—LS 7371/DI 104 Introduced
57	57	First Regular Session of the 124th General Assembly (2025)
58	58	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
59	59	Constitution) is being amended, the text of the existing provision will appear in this style type,
60	60	additions will appear in this style type, and deletions will appear in this style type.
61	61	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
62	62	provision adopted), the text of the new provision will appear in this style type. Also, the
63	63	word NEW will appear in that style type in the introductory clause of each SECTION that adds
64	64	a new provision to the Indiana Code or the Indiana Constitution.
65	65	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
66	66	between statutes enacted by the 2024 Regular Session of the General Assembly.
67	67	SENATE BILL No. 522
68	68	A BILL FOR AN ACT to amend the Indiana Code concerning
69	69	health and to make an appropriation.
70	70	Be it enacted by the General Assembly of the State of Indiana:
71	71	1 SECTION 1. IC 5-10-8-17, AS AMENDED BY THE TECHNICAL
72	72	2 CORRECTIONS BILL OF THE 2025 GENERAL ASSEMBLY, IS
73	73	3 AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2025]:
74	74	4 Sec. 17. (a) As used in this section, "covered individual" means an
75	75	5 individual entitled to coverage under a state employee health plan.
76	76	6 (b) As used in this section, "preceding prescription drug" means a
77	77	7 prescription drug that, according to a step therapy protocol, must be:
78	78	8 (1) first used to treat a covered individual's condition; and
79	79	9 (2) as a result of the treatment under subdivision (1), determined
80	80	10 to be inappropriate to treat the covered individual's condition;
81	81	11 as a condition of coverage under a state employee health plan for
82	82	12 succeeding treatment with another prescription drug.
83	83	13 (c) As used in this section, "protocol exception" means a
84	84	14 determination by a state employee health plan that, based on a review
85	85	15 of a request for the determination and any supporting documentation:
86	86	2025 IN 522—LS 7371/DI 104 2
87	87	1 (1) a step therapy protocol is not medically appropriate for
88	88	2 treatment of a particular covered individual's condition; and
89	89	3 (2) the state employee health plan will:
90	90	4 (A) not require the covered individual's use of a preceding
91	91	5 prescription drug under the step therapy protocol; and
92	92	6 (B) provide immediate coverage for another prescription drug
93	93	7 that is prescribed for the covered individual.
94	94	8 (d) As used in this section, "state employee health plan" refers to the
95	95	9 following that provide coverage for prescription drugs:
96	96	10 (1) A self-insurance program established under section 7(b) of
97	97	11 this chapter.
98	98	12 (2) A contract with a prepaid health care delivery plan that is
99	99	13 entered into or renewed under section 7(c) of this chapter.
100	100	14 The term includes a person that administers prescription drug benefits
101	101	15 on behalf of a state employee health plan.
102	102	16 (e) As used in this section, "step therapy protocol" means a protocol
103	103	17 that specifies, as a condition of coverage under a state employee health
104	104	18 plan, the order in which certain prescription drugs must be used to treat
105	105	19 a covered individual's condition.
106	106	20 (f) As used in this section, "urgent care situation" means a covered
107	107	21 individual's injury or condition about which the following apply:
108	108	22 (1) If medical care or treatment is not provided earlier than the
109	109	23 time frame generally considered by the medical profession to be
110	110	24 reasonable for a nonurgent situation, the injury or condition could
111	111	25 seriously jeopardize the covered individual's:
112	112	26 (A) life or health; or
113	113	27 (B) ability to regain maximum function;
114	114	28 based on a prudent layperson's judgment.
115	115	29 (2) If medical care or treatment is not provided earlier than the
116	116	30 time frame generally considered by the medical profession to be
117	117	31 reasonable for a nonurgent situation, the injury or condition could
118	118	32 subject the covered individual to severe pain that cannot be
119	119	33 adequately managed, based on the covered individual's treating
120	120	34 health care provider's judgment.
121	121	35 (g) A state employee health plan shall publish on the state employee
122	122	36 health plan's Internet web site, website, and provide to a covered
123	123	37 individual in writing, a procedure for the covered individual's use in
124	124	38 requesting a protocol exception. The procedure must include the
125	125	39 following provisions:
126	126	40 (1) A description of the manner in which a covered individual
127	127	41 may request a protocol exception.
128	128	42 (2) That the state employee health plan shall make a
129	129	2025 IN 522—LS 7371/DI 104 3
130	130	1 determination concerning a protocol exception request, or an
131	131	2 appeal of a denial of a protocol exception request, not more than:
132	132	3 (A) in an urgent care situation, one (1) business day after
133	133	4 receiving the request or appeal; or
134	134	5 (B) in a nonurgent care situation, three (3) business days after
135	135	6 receiving the request or appeal.
136	136	7 (3) That a protocol exception will be granted if any of the
137	137	8 following apply:
138	138	9 (A) A preceding prescription drug is contraindicated or will
139	139	10 likely cause an adverse reaction or physical or mental harm to
140	140	11 the covered individual.
141	141	12 (B) A preceding prescription drug is expected to be
142	142	13 ineffective, based on both of the following:
143	143	14 (i) The known clinical characteristics of the covered
144	144	15 individual.
145	145	16 (ii) Known characteristics of the preceding prescription
146	146	17 drug, as found in sound clinical evidence.
147	147	18 (C) The covered individual has previously received:
148	148	19 (i) a preceding prescription drug; or
149	149	20 (ii) another prescription drug that is in the same
150	150	21 pharmacologic class or has the same mechanism of action as
151	151	22 a preceding prescription drug;
152	152	23 and the prescription drug was discontinued due to lack of
153	153	24 efficacy or effectiveness, diminished effect, or an adverse
154	154	25 event.
155	155	26 (D) Based on clinical appropriateness, a preceding
156	156	27 prescription drug is not in the best interest of the covered
157	157	28 individual because the covered individual's use of the
158	158	29 preceding prescription drug is expected to:
159	159	30 (i) cause a significant barrier to the covered individual's
160	160	31 adherence to or compliance with the covered individual's
161	161	32 plan of care;
162	162	33 (ii) worsen a comorbid condition of the covered individual;
163	163	34 or
164	164	35 (iii) decrease the covered individual's ability to achieve or
165	165	36 maintain reasonable functional ability in performing daily
166	166	37 activities.
167	167	38 (4) That when a protocol exception is granted, the state employee
168	168	39 health plan shall notify the covered individual and the covered
169	169	40 individual's health care provider of the authorization for coverage
170	170	41 of the prescription drug that is the subject of the protocol
171	171	42 exception.
172	172	2025 IN 522—LS 7371/DI 104 4
173	173	1 (5) That if:
174	174	2 (A) a protocol exception request; or
175	175	3 (B) an appeal of a denied protocol exception request;
176	176	4 results in a denial of the protocol exception, the state employee
177	177	5 health plan shall provide to the covered individual and the
178	178	6 treating health care provider notice of the denial, including a
179	179	7 detailed, written explanation of the reason for the denial and the
180	180	8 clinical rationale that supports the denial.
181	181	9 (6) That the state employee health plan may request a copy of
182	182	10 relevant documentation from the covered individual's medical
183	183	11 record in support of a protocol exception.
184	184	12 (h) A state employee health plan may not require step therapy
185	185	13 protocol for a prescription drug that is prescribed for the
186	186	14 treatment of a postpartum mental health condition (as defined in
187	187	15 section 27 of this chapter).
188	188	16 SECTION 2. IC 5-10-8-27 IS ADDED TO THE INDIANA CODE
189	189	17 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
190	190	18 1, 2025]: Sec. 27. (a) This section applies to a state employee health
191	191	19 plan that is established, entered into, amended, or renewed after
192	192	20 June 30, 2025.
193	193	21 (b) As used in this section, "covered individual" means an
194	194	22 individual entitled to coverage under a state employee health plan.
195	195	23 (c) As used in this section, "postpartum mental health
196	196	24 condition" means a mental health condition that occurs:
197	197	25 (1) during pregnancy or after childbirth; and
198	198	26 (2) as a result of pregnancy or childbirth.
199	199	27 The term includes postpartum depression.
200	200	28 (d) As used in this section, "state employee health plan" means
201	201	29 the following:
202	202	30 (1) A self-insurance program established under section 7(b) of
203	203	31 this chapter.
204	204	32 (2) A contract for prepaid health care services entered into
205	205	33 under section 7(c) of this chapter.
206	206	34 (e) A state employee health plan must provide coverage for:
207	207	35 (1) a postpartum mental health condition screening for a
208	208	36 covered individual; and
209	209	37 (2) postpartum mental health condition treatment for a
210	210	38 covered individual, which includes prescription drugs used to
211	211	39 treat a postpartum mental health condition.
212	212	40 SECTION 3. IC 5-10-8-28 IS ADDED TO THE INDIANA CODE
213	213	41 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
214	214	42 1, 2025]: Sec. 28. (a) This section applies to a state employee health
215	215	2025 IN 522—LS 7371/DI 104 5
216	216	1 plan that is established, entered into, amended, or renewed after
217	217	2 June 30, 2025.
218	218	3 (b) As used in this section, "covered individual" means an
219	219	4 individual entitled to coverage under a state employee health plan.
220	220	5 (c) As used in this section, "state employee health plan" means
221	221	6 the following:
222	222	7 (1) A self-insurance program established under section 7(b) of
223	223	8 this chapter.
224	224	9 (2) A contract for prepaid health care services entered into
225	225	10 under section 7(c) of this chapter.
226	226	11 (d) As used in this section, "tubal ligation procedure" means a
227	227	12 surgical procedure that involves severing and tying the fallopian
228	228	13 tubes.
229	229	14 (e) As used in this section, "vasectomy procedure" means a
230	230	15 surgical procedure that involves cutting and sealing part of each
231	231	16 vas deferens.
232	232	17 (f) A state employee health plan shall provide coverage for a
233	233	18 tubal ligation procedure for a covered individual.
234	234	19 (g) A state employee health plan shall provide coverage for a
235	235	20 vasectomy procedure for a covered individual.
236	236	21 SECTION 4. IC 5-16-16 IS ADDED TO THE INDIANA CODE AS
237	237	22 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
238	238	23 1, 2025]:
239	239	24 Chapter 16. Grant Program for the Installation of Lactation
240	240	25 Rooms in Public Buildings
241	241	26 Sec. 1. This chapter applies to a public agency.
242	242	27 Sec. 2. As used in this chapter, "authority" refers to the Indiana
243	243	28 housing and community development authority created by
244	244	29 IC 5-20-1-3.
245	245	30 Sec. 3. As used in this chapter, "fund" refers to the lactation
246	246	31 room grant fund established by section 10 of this chapter.
247	247	32 Sec. 4. As used in this chapter, "grant program" refers to the
248	248	33 grant program for the installation of lactation rooms established
249	249	34 by section 7 of this chapter.
250	250	35 Sec. 5. As used in this chapter, "lactation room" means a room
251	251	36 designated and equipped for the purpose of allowing mothers to
252	252	37 nurse or express breast milk in a clean and private setting within
253	253	38 a public building.
254	254	39 Sec. 6. As used in this chapter, "public agency" has the meaning
255	255	40 set forth in IC 5-30-1-11.
256	256	41 Sec. 7. The grant program for the installation of lactation rooms
257	257	42 is established to provide grants to public agencies to offset costs
258	258	2025 IN 522—LS 7371/DI 104 6
259	259	1 incurred in the installation of lactation rooms when constructing
260	260	2 or renovating public buildings.
261	261	3 Sec. 8. (a) The authority shall administer the grant program.
262	262	4 The authority shall do the following:
263	263	5 (1) Adopt guidelines to determine standards for awarding
264	264	6 grants under this chapter, including standards for
265	265	7 determining whether a lactation room complies with section
266	266	8 9 of this chapter and any other applicable governmental or
267	267	9 other nationally recognized standards that apply to the
268	268	10 provision of lactation rooms in public buildings.
269	269	11 (2) Prepare and supervise the issuance of public information
270	270	12 concerning the grant program.
271	271	13 (3) Prescribe the form for and regulate the submission of
272	272	14 applications for grants under this chapter.
273	273	15 (b) A public agency may apply in the manner prescribed by the
274	274	16 authority for a grant under this chapter to offset costs incurred in
275	275	17 the installation of a lactation room in a public building managed by
276	276	18 the public agency.
277	277	19 Sec. 9. A lactation room installed by a public agency that
278	278	20 receives a grant under this chapter must meet the following
279	279	21 standards:
280	280	22 (1) The space must be shielded from view and free from
281	281	23 intrusion of others.
282	282	24 (2) The room must be functional, with a private space with a
283	283	25 place to sit and a flat surface, other than the floor, on which
284	284	26 to place a breast pump and other supplies.
285	285	27 (3) The room must provide the following:
286	286	28 (A) Access to electricity for the use of a breast pump.
287	287	29 (B) Good lighting.
288	288	30 (C) A comfortable temperature.
289	289	31 (D) Proper ventilation.
290	290	32 Sec. 10. (a) The lactation room grant fund is established to
291	291	33 provide grants under this chapter. The authority shall administer
292	292	34 the fund.
293	293	35 (b) The fund consists of:
294	294	36 (1) money appropriated to the fund by the general assembly;
295	295	37 (2) money received from state or federal grants or programs
296	296	38 for the purposes of this chapter; and
297	297	39 (3) donations, gifts, and money received from any other
298	298	40 source, including transfers from other funds or accounts.
299	299	41 (c) The treasurer of state shall invest the money in the fund not
300	300	42 currently needed to meet the obligations of the fund in the same
301	301	2025 IN 522—LS 7371/DI 104 7
302	302	1 manner as other public funds may be invested.
303	303	2 (d) Money in the fund at the end of a state fiscal year does not
304	304	3 revert to the state general fund but remains in the fund to be used
305	305	4 exclusively for purposes of this chapter.
306	306	5 (e) Money in the fund is continuously appropriated for the
307	307	6 purposes of this chapter.
308	308	7 SECTION 5. IC 11-8-1-8.9 IS ADDED TO THE INDIANA
309	309	8 CODE AS A NEW SECTION TO READ AS FOLLOWS
310	310	9 [EFFECTIVE JULY 1, 2025]: Sec. 8.9. "Nursery" has the meaning
311	311	10 set forth in IC 11-10-3.5-1.
312	312	11 SECTION 6. IC 11-8-2-16 IS ADDED TO THE INDIANA CODE
313	313	12 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
314	314	13 1, 2025]: Sec. 16. (a) As used in this section, "fund" refers to the
315	315	14 incarcerated women's maternal health fund established by
316	316	15 subsection (b).
317	317	16 (b) The incarcerated women's maternal health fund is
318	318	17 established to provide funds to support the Officer Breann Leath
319	319	18 Memorial Prison Nursery established by IC 11-10-3.5-5.
320	320	19 (c) The fund consists of the following:
321	321	20 (1) Appropriations made by the general assembly.
322	322	21 (2) Gifts, bequests, donations, contributions, and grants from
323	323	22 any public or private source.
324	324	23 (d) The department shall administer the fund.
325	325	24 (e) The expenses of administering the fund shall be paid from
326	326	25 money in the fund.
327	327	26 (f) The treasurer of state shall invest the money in the fund not
328	328	27 currently needed to meet the obligations of the fund in the same
329	329	28 manner as other public money may be invested. Interest that
330	330	29 accrues from these investments shall be deposited in the fund.
331	331	30 (g) Money in the fund at the end of a state fiscal year does not
332	332	31 revert to the state general fund.
333	333	32 (h) Money in the fund is continuously appropriated to carry out
334	334	33 the purposes of the fund.
335	335	34 SECTION 7. IC 11-10-3.5-1, AS ADDED BY P.L.78-2022,
336	336	35 SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
337	337	36 JULY 1, 2025]: Sec. 1. The following definitions apply throughout this
338	338	37 chapter:
339	339	38 (1) "Correctional facility" has the meaning set forth in
340	340	39 IC 5-1.2-2-11.
341	341	40 (2) "Nursery" means the Officer Breann Leath Memorial
342	342	41 Prison Nursery established by section 5 of this chapter.
343	343	42 (2) (3) "Pregnant inmate" means a confined person who is
344	344	2025 IN 522—LS 7371/DI 104 8
345	345	1 pregnant.
346	346	2 (3) (4) "Restraints" means any mechanical device used to control
347	347	3 the movement of a pregnant inmate's body or limbs, including
348	348	4 handcuffs, leg shackles, and belly chains.
349	349	5 SECTION 8. IC 11-10-3.5-5 IS ADDED TO THE INDIANA CODE
350	350	6 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
351	351	7 1, 2025]: Sec. 5. (a) The Officer Breann Leath Memorial Prison
352	352	8 Nursery is established within a correctional facility determined by
353	353	9 the commissioner.
354	354	10 (b) The department shall operate the nursery and shall ensure
355	355	11 that the operation, design, and implementation of the nursery is
356	356	12 undertaken with the consultation and guidance of subject matter
357	357	13 experts, who are not employed by the department or a vendor of
358	358	14 the department, from the following fields:
359	359	15 (1) Maternal health.
360	360	16 (2) Public health.
361	361	17 (3) Pediatrics.
362	362	18 (4) Child development.
363	363	19 (c) To implement this section, the department shall adopt rules
364	364	20 under IC 4-22-2 that contain the following minimum standards:
365	365	21 (1) Policies and procedures to augment the operation, design,
366	366	22 and implementation criteria established with subject matter
367	367	23 experts under subsection (a).
368	368	24 (2) Policies and procedures that require the nursery to be
369	369	25 made available to appropriate inmates to facilitate the care of
370	370	26 an inmate's child up to the age of thirty (30) months.
371	371	27 (3) Policies and procedures that prohibit the use of an
372	372	28 incarcerated mother's parenting style as grounds for
373	373	29 punishment or discipline. This subdivision does not prohibit
374	374	30 the imposition of discipline or punishment if an incarcerated
375	375	31 mother's conduct is reasonably likely to:
376	376	32 (A) cause harm or injury to the child; or
377	377	33 (B) pose a threat to or endanger the well-being of the child.
378	378	34 (d) Before September 30 of each year, the department shall
379	379	35 report to the legislative council, in an electronic format under
380	380	36 IC 5-14-6, the following information for the preceding state fiscal
381	381	37 year:
382	382	38 (1) The number of pregnant inmates in custody of the
383	383	39 department.
384	384	40 (2) The number of inmates considered for placement, and the
385	385	41 number of inmates actually placed, in the nursery.
386	386	42 SECTION 9. IC 11-12-4-1, AS AMENDED BY P.L.56-2023,
387	387	2025 IN 522—LS 7371/DI 104 9
388	388	1 SECTION 82, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
389	389	2 JULY 1, 2025]: Sec. 1. (a) As used in this section, "menstrual
390	390	3 discharge collection devices" means:
391	391	4 (1) tampons;
392	392	5 (2) panty liners;
393	393	6 (3) menstrual cups;
394	394	7 (4) sanitary napkins; and
395	395	8 (5) other similar tangible personal property designed to
396	396	9 promote hygiene in connection with the human menstrual
397	397	10 cycle.
398	398	11 (b) The department shall adopt under IC 4-22-2 minimum standards
399	399	12 for county jails governing the following:
400	400	13 (1) General physical and environmental conditions.
401	401	14 (2) Services and programs to be provided to confined persons.
402	402	15 (3) Procedures for the care and control of confined persons that
403	403	16 are necessary to ensure the health and safety of confined persons,
404	404	17 the security of the jail, and public safety. and
405	405	18 (4) The restraint of pregnant inmates. Rules adopted under this
406	406	19 subdivision must be consistent with IC 11-10-3.5.
407	407	20 (5) The provision of menstrual discharge collection devices to
408	408	21 inmates who menstruate. Rules adopted under this
409	409	22 subdivision must require the provision of menstrual discharge
410	410	23 collection devices, in an appropriate quantity and at no cost,
411	411	24 to an inmate that seeks a menstrual discharge collection
412	412	25 device.
413	413	26 However, the department may not adopt any standard that prohibits the
414	414	27 placement of more than one (1) prisoner in a prisoner cell that has
415	415	28 thirty-five (35) square feet or more of floor space per prisoner.
416	416	29 (b) (c) The standards must be sufficiently flexible to foster the
417	417	30 development of new and improved practices and to accommodate local
418	418	31 needs and circumstances. The standards must be consistent with the
419	419	32 laws of Indiana and the rules of the Indiana department of health and
420	420	33 the fire prevention and building safety commission.
421	421	34 (c) (d) The commissioner shall select a committee of not less than
422	422	35 five (5) county sheriffs to consult with the department before and
423	423	36 during the drafting of the proposed minimum standards. County
424	424	37 sheriffs shall be selected from the various classes of counties to ensure
425	425	38 that densely, moderately, and sparsely populated counties are
426	426	39 represented. Each county sheriff is entitled to the minimum salary per
427	427	40 diem as provided in IC 4-10-11-2.1 for each day engaged in the official
428	428	41 business of the committee and to reimbursement for traveling and other
429	429	42 expenses, as provided in the state travel policies and procedures
430	430	2025 IN 522—LS 7371/DI 104 10
431	431	1 established by the Indiana department of administration and approved
432	432	2 by the budget agency.
433	433	3 (d) (e) At least sixty (60) days before setting the date for a public
434	434	4 hearing under IC 4-22-2, the department shall forward copies of the
435	435	5 proposed minimum standards to each county sheriff and each board of
436	436	6 county commissioners and shall solicit their views and suggestions.
437	437	7 SECTION 10. IC 12-15-5-7, AS ADDED BY P.L.35-2019,
438	438	8 SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
439	439	9 JULY 1, 2025]: Sec. 7. (a) Pregnancy services provided under this
440	440	10 article may shall include reimbursement for doula services.
441	441	11 (b) The office may shall apply for any state plan amendment or
442	442	12 waiver necessary to implement this section.
443	443	13 (c) The office may shall adopt rules under IC 4-22-2 to implement
444	444	14 this section.
445	445	15 SECTION 11. IC 12-15-5-16.5 IS ADDED TO THE INDIANA
446	446	16 CODE AS A NEW SECTION TO READ AS FOLLOWS
447	447	17 [EFFECTIVE JULY 1, 2025]: Sec. 16.5. (a) As used in this section,
448	448	18 "certified medical interpretation services" does not include sign
449	449	19 language interpretation services.
450	450	20 (b) Subject to the approval under subsection (e), the office of the
451	451	21 secretary shall reimburse for the provision of certified medical
452	452	22 interpretation services for Medicaid recipients who have limited
453	453	23 English proficiency when receiving Medicaid covered services from
454	454	24 a Medicaid provider.
455	455	25 (c) The office of the secretary shall ensure that any contract for
456	456	26 the provision of certified medical interpretation services allows a
457	457	27 Medicaid provider to access scheduling for the service.
458	458	28 (d) The office of the secretary shall establish a community
459	459	29 advisory committee to advise on the provision of certified medical
460	460	30 interpretation services. The advisory committee must consist of
461	461	31 stakeholders and Medicaid health care providers.
462	462	32 (e) The office of the secretary shall apply to the United States
463	463	33 Department of Health and Human Services for any state plan
464	464	34 amendment or waiver necessary to implement this section.
465	465	35 SECTION 12. IC 16-18-2-294.5, AS AMENDED BY P.L.208-2015,
466	466	36 SECTION 4, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
467	467	37 JULY 1, 2025]: Sec. 294.5. (a) "Program", for purposes of
468	468	38 IC 16-35-12, has the meaning set forth in IC 16-35-12-1.
469	469	39 (a) (b) "Program", for purposes of IC 16-40-4, has the meaning set
470	470	40 forth in IC 16-40-4-3.
471	471	41 (b) (c) "Program", for purposes of IC 16-41-7.5, has the meaning set
472	472	42 forth in IC 16-41-7.5-2.
473	473	2025 IN 522—LS 7371/DI 104 11
474	474	1 (d) "Program", for purposes of IC 16-41-17.5, has the meaning
475	475	2 set forth in IC 16-41-17.5-1.
476	476	3 (c) (e) "Program", for purposes of IC 16-47-1, has the meaning set
477	477	4 forth in IC 16-47-1-3.
478	478	5 SECTION 13. IC 16-18-2-341, AS AMENDED BY P.L.31-2019,
479	479	6 SECTION 4, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
480	480	7 JULY 1, 2025]: Sec. 341. "Stillbirth", for purposes of IC 16-37,
481	481	8 IC 16-41-17.5, and IC 16-49-6, means a birth after twenty (20) weeks
482	482	9 of gestation that is not a live birth.
483	483	10 SECTION 14. IC 16-35-12 IS ADDED TO THE INDIANA CODE
484	484	11 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
485	485	12 JULY 1, 2025]:
486	486	13 Chapter 12. Telephone Assistance Line for Mothers
487	487	14 Sec. 1. As used in this chapter, "program" refers to the
488	488	15 telephone assistance line for mothers program established under
489	489	16 section 2 of this chapter.
490	490	17 Sec. 2. (a) The state department shall establish and administer
491	491	18 the telephone assistance line for mothers program for the purpose
492	492	19 of helping mothers who are experiencing behavioral health issues
493	493	20 to connect with health care providers to obtain behavioral health
494	494	21 resources.
495	495	22 (b) The state department shall employ at least the following for
496	496	23 the program:
497	497	24 (1) A psychiatrist licensed under IC 25-22.5.
498	498	25 (2) A psychologist licensed under IC 25-33.
499	499	26 Sec. 3. The program must include the operation of a dedicated
500	500	27 telephone number Monday through Friday from at least 8 a.m.
501	501	28 until 5 p.m. that serves as the entry point to the program for health
502	502	29 care providers to be able to connect available services to a mother
503	503	30 with behavioral health concerns. Services must include the
504	504	31 following:
505	505	32 (1) An immediate clinical consultation over the telephone.
506	506	33 (2) An expedited face-to-face behavioral health consultation.
507	507	34 (3) Care coordination for assistance with referrals to
508	508	35 community behavioral health services.
509	509	36 Sec. 4. The state department shall provide professional
510	510	37 continuing education on behavioral health matters for health care
511	511	38 providers employed by the program.
512	512	39 SECTION 15. IC 16-41-17.5 IS ADDED TO THE INDIANA
513	513	40 CODE AS A NEW CHAPTER TO READ AS FOLLOWS
514	514	41 [EFFECTIVE JULY 1, 2025]:
515	515	42 Chapter 17.5. Prevention and Treatment Programs: Stillbirth
516	516	2025 IN 522—LS 7371/DI 104 12
517	517	1 Prevention Through Fetal Movement Pilot Program
518	518	2 Sec. 1. As used in this chapter, "program" refers to the stillbirth
519	519	3 prevention through fetal movement pilot program established by
520	520	4 section 2 of this chapter.
521	521	5 Sec. 2. The stillbirth prevention through fetal movement pilot
522	522	6 program is established for the purpose of providing evidence based
523	523	7 information on the importance of tracking fetal movement in the
524	524	8 third trimester of pregnancy to prevent stillbirths in Indiana.
525	525	9 Sec. 3. (a) The state department shall establish a grant as part
526	526	10 of the program. The state department may award a grant to be
527	527	11 used for the following:
528	528	12 (1) Developing and distributing evidence based education
529	529	13 materials about the importance of tracking fetal movement in
530	530	14 the third trimester of pregnancy to the following that provide
531	531	15 education to maternal health providers:
532	532	16 (A) Community organizations.
533	533	17 (B) Hospitals.
534	534	18 (C) Birthing centers.
535	535	19 (D) Maternal health providers.
536	536	20 (E) State educational institutions that educate maternal
537	537	21 health providers.
538	538	22 (2) Providing maternal health providers and expectant
539	539	23 parents in Indiana with access to free evidence based
540	540	24 educational materials on fetal movement tracking, including
541	541	25 brochures, posters, continuing education materials, and
542	542	26 digital resources.
543	543	27 (3) Assisting in raising awareness with health care providers
544	544	28 concerning the following:
545	545	29 (A) Materials described in subdivisions (1) and (2).
546	546	30 (B) The importance of tracking fetal movement in the third
547	547	31 trimester of pregnancy through an education campaign
548	548	32 and by offering at least three (3) webinars or conferences
549	549	33 per year.
550	550	34 (C) The availability of free education materials described
551	551	35 in this subsection.
552	552	36 (b) A grant recipient shall provide the state department with the
553	553	37 following information on at least a quarterly basis:
554	554	38 (1) The number of educational materials distributed by the
555	555	39 grantee, broken down by ZIP code and type of facility or
556	556	40 organization that received the materials within Indiana.
557	557	41 (2) The number of fetal movement tracking application
558	558	42 downloads attributed to the program, broken down by ZIP
559	559	2025 IN 522—LS 7371/DI 104 13
560	560	1 code within Indiana.
561	561	2 (3) The number of health care providers that participated in
562	562	3 any training program, webinar, conference, or other
563	563	4 awareness events provided by the grantee.
564	564	5 (c) A grant recipient shall provide the state department with the
565	565	6 following information on an annual basis concerning how the pilot
566	566	7 program has affected the fetal death rates in Indiana, dividing the
567	567	8 information of the rates by race and ZIP code within Indiana.
568	568	9 Sec. 4. (a) The stillbirth prevention through fetal movement
569	569	10 pilot program fund is established for the purpose of providing
570	570	11 evidence based information on the importance of tracking fetal
571	571	12 movement in the third trimester of pregnancy to prevent stillbirths
572	572	13 in Indiana. The fund shall be administered by the state department.
573	573	14 (b) The expenses of administering the fund shall be paid from
574	574	15 money in the fund.
575	575	16 (c) The treasurer of state shall invest money in the fund not
576	576	17 currently needed to meet the obligations of the fund in the same
577	577	18 manner as other public money may be invested. Interest that
578	578	19 accrues from these investments shall be deposited in the fund.
579	579	20 (d) Money in the fund consists of appropriations, gifts, grants,
580	580	21 and donations from public or private sources. Money in the fund
581	581	22 at the end of a state fiscal year does not revert to the state general
582	582	23 fund.
583	583	24 Sec. 5. This chapter expires December 31, 2027.
584	584	25 SECTION 16. IC 27-8-5-30, AS ADDED BY P.L.19-2016,
585	585	26 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
586	586	27 JULY 1, 2025]: Sec. 30. (a) As used in this section, "insured" means an
587	587	28 individual who is entitled to coverage under a policy of accident and
588	588	29 sickness insurance.
589	589	30 (b) As used in this section, "insurer" refers to an insurer that issues
590	590	31 a policy of accident and sickness insurance. The term includes a person
591	591	32 that administers prescription drug benefits on behalf of an insurer.
592	592	33 (c) As used in this section, "policy of accident and sickness
593	593	34 insurance" means a policy of accident and sickness insurance that
594	594	35 provides coverage for prescription drugs.
595	595	36 (d) As used in this section, "preceding prescription drug" means a
596	596	37 prescription drug that, according to a step therapy protocol, must be:
597	597	38 (1) first used to treat an insured's condition; and
598	598	39 (2) as a result of the treatment under subdivision (1), determined
599	599	40 to be inappropriate to treat the insured's condition;
600	600	41 as a condition of coverage under a policy of accident and sickness
601	601	42 insurance for succeeding treatment with another prescription drug.
602	602	2025 IN 522—LS 7371/DI 104 14
603	603	1 (e) As used in this section, "protocol exception" means a
604	604	2 determination by an insurer that, based on a review of a request for the
605	605	3 determination and any supporting documentation:
606	606	4 (1) a step therapy protocol is not medically appropriate for
607	607	5 treatment of a particular insured's condition; and
608	608	6 (2) the insurer will:
609	609	7 (A) not require the insured's use of a preceding prescription
610	610	8 drug under the step therapy protocol; and
611	611	9 (B) provide immediate coverage for another prescription drug
612	612	10 that is prescribed for the insured.
613	613	11 (f) As used in this section, "step therapy protocol" means a protocol
614	614	12 that specifies, as a condition of coverage under a policy of accident and
615	615	13 sickness insurance, the order in which certain prescription drugs must
616	616	14 be used to treat an insured's condition.
617	617	15 (g) As used in this section, "urgent care situation" means an
618	618	16 insured's injury or condition about which the following apply:
619	619	17 (1) If medical care or treatment is not provided earlier than the
620	620	18 time frame generally considered by the medical profession to be
621	621	19 reasonable for a nonurgent situation, the injury or condition could
622	622	20 seriously jeopardize the insured's:
623	623	21 (A) life or health; or
624	624	22 (B) ability to regain maximum function;
625	625	23 based on a prudent layperson's judgment.
626	626	24 (2) If medical care or treatment is not provided earlier than the
627	627	25 time frame generally considered by the medical profession to be
628	628	26 reasonable for a nonurgent situation, the injury or condition could
629	629	27 subject the insured to severe pain that cannot be adequately
630	630	28 managed, based on the insured's treating health care provider's
631	631	29 judgment.
632	632	30 (h) An insurer shall publish on the insurer's Internet web site,
633	633	31 website, and provide to an insured in writing, a procedure for the
634	634	32 insured's use in requesting a protocol exception. The procedure must
635	635	33 include the following provisions:
636	636	34 (1) A description of the manner in which an insured may request
637	637	35 a protocol exception.
638	638	36 (2) That the insurer shall make a determination concerning a
639	639	37 protocol exception request, or an appeal of a denial of a protocol
640	640	38 exception request, not more than:
641	641	39 (A) in an urgent care situation, one (1) business day after
642	642	40 receiving the request or appeal; or
643	643	41 (B) in a nonurgent care situation, three (3) business days after
644	644	42 receiving the request or appeal.
645	645	2025 IN 522—LS 7371/DI 104 15
646	646	1 (3) That a protocol exception will be granted if any of the
647	647	2 following apply:
648	648	3 (A) A preceding prescription drug is contraindicated or will
649	649	4 likely cause an adverse reaction or physical or mental harm to
650	650	5 the insured.
651	651	6 (B) A preceding prescription drug is expected to be
652	652	7 ineffective, based on both of the following:
653	653	8 (i) The known clinical characteristics of the insured.
654	654	9 (ii) Known characteristics of the preceding prescription
655	655	10 drug, as found in sound clinical evidence.
656	656	11 (C) The insured has previously received:
657	657	12 (i) a preceding prescription drug; or
658	658	13 (ii) another prescription drug that is in the same
659	659	14 pharmacologic class or has the same mechanism of action as
660	660	15 a preceding prescription drug;
661	661	16 and the prescription drug was discontinued due to lack of
662	662	17 efficacy or effectiveness, diminished effect, or an adverse
663	663	18 event.
664	664	19 (D) Based on clinical appropriateness, a preceding
665	665	20 prescription drug is not in the best interest of the insured
666	666	21 because the insured's use of the preceding prescription drug is
667	667	22 expected to:
668	668	23 (i) cause a significant barrier to the insured's adherence to or
669	669	24 compliance with the insured's plan of care;
670	670	25 (ii) worsen a comorbid condition of the insured; or
671	671	26 (iii) decrease the insured's ability to achieve or maintain
672	672	27 reasonable functional ability in performing daily activities.
673	673	28 (4) That when a protocol exception is granted, the insurer shall
674	674	29 notify the insured and the insured's health care provider of the
675	675	30 authorization for coverage of the prescription drug that is the
676	676	31 subject of the protocol exception.
677	677	32 (5) That if:
678	678	33 (A) a protocol exception request; or
679	679	34 (B) an appeal of a denied protocol exception request;
680	680	35 results in a denial of the protocol exception, the insurer shall
681	681	36 provide to the insured and the treating health care provider notice
682	682	37 of the denial, including a detailed, written explanation of the
683	683	38 reason for the denial and the clinical rationale that supports the
684	684	39 denial.
685	685	40 (6) That the insurer may request a copy of relevant documentation
686	686	41 from the insured's medical record in support of a protocol
687	687	42 exception.
688	688	2025 IN 522—LS 7371/DI 104 16
689	689	1 (i) An insurer may not require step therapy protocol for a
690	690	2 prescription drug that is prescribed for the treatment of a
691	691	3 postpartum mental health condition (as defined in IC 27-8-41-4).
692	692	4 SECTION 17. IC 27-8-40 IS ADDED TO THE INDIANA CODE
693	693	5 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
694	694	6 JULY 1, 2025]:
695	695	7 Chapter 40. Coverage for Tubal Ligation and Vasectomy
696	696	8 Procedures
697	697	9 Sec. 1. This chapter applies to a policy of accident and sickness
698	698	10 insurance that is issued, delivered, amended, or renewed after June
699	699	11 30, 2025.
700	700	12 Sec. 2. As used in this chapter, "insured" means an individual
701	701	13 entitled to coverage under a policy of accident and sickness
702	702	14 insurance.
703	703	15 Sec. 3. As used in this chapter, "policy of accident and sickness
704	704	16 insurance" has the meaning set forth in IC 27-8-5-1.
705	705	17 Sec. 4. As used in this chapter, "tubal ligation procedure"
706	706	18 means a surgical procedure that involves severing and tying the
707	707	19 fallopian tubes.
708	708	20 Sec. 5. As used in this chapter, "vasectomy procedure" means
709	709	21 a surgical procedure that involves cutting and sealing part of each
710	710	22 vas deferens.
711	711	23 Sec. 6. A policy of accident and sickness insurance shall provide
712	712	24 coverage for a tubal ligation procedure for an insured.
713	713	25 Sec. 7. A policy of accident and sickness insurance shall provide
714	714	26 coverage for a vasectomy procedure for an insured.
715	715	27 SECTION 18. IC 27-8-41 IS ADDED TO THE INDIANA CODE
716	716	28 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
717	717	29 JULY 1, 2025]:
718	718	30 Chapter 41. Coverage for Postpartum Mental Health Condition
719	719	31 Screening and Treatment
720	720	32 Sec. 1. This chapter applies to a policy of accident and sickness
721	721	33 insurance that is issued, delivered, amended, or renewed after June
722	722	34 30, 2025.
723	723	35 Sec. 2. As used in this chapter, "insured" means an individual
724	724	36 entitled to coverage under a policy of accident and sickness
725	725	37 insurance.
726	726	38 Sec. 3. As used in this chapter, "policy of accident and sickness
727	727	39 insurance" has the meaning set forth in IC 27-8-5-1.
728	728	40 Sec. 4. As used in this chapter, "postpartum mental health
729	729	41 condition" means a mental health condition that occurs:
730	730	42 (1) during pregnancy or after childbirth; and
731	731	2025 IN 522—LS 7371/DI 104 17
732	732	1 (2) as a result of pregnancy or childbirth.
733	733	2 The term includes postpartum depression.
734	734	3 Sec. 5. A policy of accident and sickness insurance must provide
735	735	4 coverage for:
736	736	5 (1) a postpartum mental health condition screening for an
737	737	6 insured; and
738	738	7 (2) postpartum mental health condition treatment for an
739	739	8 insured, which includes prescription drugs used to treat a
740	740	9 postpartum mental health condition.
741	741	10 SECTION 19. IC 27-13-7-23, AS ADDED BY P.L.19-2016,
742	742	11 SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
743	743	12 JULY 1, 2025]: Sec. 23. (a) As used in this section, "group contract"
744	744	13 refers to a group contract that provides coverage for prescription drugs.
745	745	14 (b) As used in this section, "health maintenance organization" refers
746	746	15 to a health maintenance organization that provides coverage for
747	747	16 prescription drugs. The term includes the following:
748	748	17 (1) A limited service health maintenance organization.
749	749	18 (2) A person that administers prescription drug benefits on behalf
750	750	19 of a health maintenance organization or a limited service health
751	751	20 maintenance organization.
752	752	21 (c) As used in this section, "individual contract" refers to an
753	753	22 individual contract that provides coverage for prescription drugs.
754	754	23 (d) As used in this section, "preceding prescription drug" means a
755	755	24 prescription drug that, according to a step therapy protocol, must be:
756	756	25 (1) first used to treat an enrollee's condition; and
757	757	26 (2) as a result of the treatment under subdivision (1), determined
758	758	27 to be inappropriate to treat the enrollee's condition;
759	759	28 as a condition of coverage under an individual contract or a group
760	760	29 contract for succeeding treatment with another prescription drug.
761	761	30 (e) As used in this section, "protocol exception" means a
762	762	31 determination by a health maintenance organization that, based on a
763	763	32 review of a request for the determination and any supporting
764	764	33 documentation:
765	765	34 (1) a step therapy protocol is not medically appropriate for
766	766	35 treatment of a particular enrollee's condition; and
767	767	36 (2) the health maintenance organization will:
768	768	37 (A) not require the enrollee's use of a preceding prescription
769	769	38 drug under the step therapy protocol; and
770	770	39 (B) provide immediate coverage for another prescription drug
771	771	40 that is prescribed for the enrollee.
772	772	41 (f) As used in this section, "step therapy protocol" means a protocol
773	773	42 that specifies, as a condition of coverage under an individual contract
774	774	2025 IN 522—LS 7371/DI 104 18
775	775	1 or a group contract, the order in which certain prescription drugs must
776	776	2 be used to treat an enrollee's condition.
777	777	3 (g) As used in this section, "urgent care situation" means an
778	778	4 enrollee's injury or condition about which the following apply:
779	779	5 (1) If medical care or treatment is not provided earlier than the
780	780	6 time frame generally considered by the medical profession to be
781	781	7 reasonable for a nonurgent situation, the injury or condition could
782	782	8 seriously jeopardize the enrollee's:
783	783	9 (A) life or health; or
784	784	10 (B) ability to regain maximum function;
785	785	11 based on a prudent layperson's judgment.
786	786	12 (2) If medical care or treatment is not provided earlier than the
787	787	13 time frame generally considered by the medical profession to be
788	788	14 reasonable for a nonurgent situation, the injury or condition could
789	789	15 subject the enrollee to severe pain that cannot be adequately
790	790	16 managed, based on the enrollee's treating health care provider's
791	791	17 judgment.
792	792	18 (h) A health maintenance organization shall publish on the health
793	793	19 maintenance organization's Internet web site, website, and provide to
794	794	20 an enrollee in writing, a procedure for the enrollee's use in requesting
795	795	21 a protocol exception. The procedure must include the following
796	796	22 provisions:
797	797	23 (1) A description of the manner in which an enrollee may request
798	798	24 a protocol exception.
799	799	25 (2) That the health maintenance organization shall make a
800	800	26 determination concerning a protocol exception request, or an
801	801	27 appeal of a denial of a protocol exception request, not more than:
802	802	28 (A) in an urgent care situation, one (1) business day after
803	803	29 receiving the request or appeal; or
804	804	30 (B) in a nonurgent care situation, three (3) business days after
805	805	31 receiving the request or appeal.
806	806	32 (3) That a protocol exception will be granted if any of the
807	807	33 following apply:
808	808	34 (A) A preceding prescription drug is contraindicated or will
809	809	35 likely cause an adverse reaction or physical or mental harm to
810	810	36 the enrollee.
811	811	37 (B) A preceding prescription drug is expected to be
812	812	38 ineffective, based on both of the following:
813	813	39 (i) The known clinical characteristics of the enrollee.
814	814	40 (ii) Known characteristics of the preceding prescription
815	815	41 drug, as found in sound clinical evidence.
816	816	42 (C) The enrollee has previously received:
817	817	2025 IN 522—LS 7371/DI 104 19
818	818	1 (i) a preceding prescription drug; or
819	819	2 (ii) another prescription drug that is in the same
820	820	3 pharmacologic class or has the same mechanism of action as
821	821	4 a preceding prescription drug;
822	822	5 and the prescription drug was discontinued due to lack of
823	823	6 efficacy or effectiveness, diminished effect, or an adverse
824	824	7 event.
825	825	8 (D) Based on clinical appropriateness, a preceding
826	826	9 prescription drug is not in the best interest of the enrollee
827	827	10 because the enrollee's use of the preceding prescription drug
828	828	11 is expected to:
829	829	12 (i) cause a significant barrier to the enrollee's adherence to
830	830	13 or compliance with the enrollee's plan of care;
831	831	14 (ii) worsen a comorbid condition of the enrollee; or
832	832	15 (iii) decrease the enrollee's ability to achieve or maintain
833	833	16 reasonable functional ability in performing daily activities.
834	834	17 (4) That when a protocol exception is granted, the health
835	835	18 maintenance organization shall notify the enrollee and the
836	836	19 enrollee's health care provider of the authorization for coverage
837	837	20 of the prescription drug that is the subject of the protocol
838	838	21 exception.
839	839	22 (5) That if:
840	840	23 (A) a protocol exception request; or
841	841	24 (B) an appeal of a denied protocol exception request;
842	842	25 results in a denial of the protocol exception, the health
843	843	26 maintenance organization shall provide to the enrollee and the
844	844	27 treating health care provider notice of the denial, including a
845	845	28 detailed, written explanation of the reason for the denial and the
846	846	29 clinical rationale that supports the denial.
847	847	30 (6) That the insurer may request a copy of relevant documentation
848	848	31 from the insured's medical record in support of a protocol
849	849	32 exception.
850	850	33 (i) A health maintenance organization may not require step
851	851	34 therapy protocol for a prescription drug that is prescribed for the
852	852	35 treatment of a postpartum mental health condition (as defined in
853	853	36 section 29(b) of this chapter).
854	854	37 SECTION 20. IC 27-13-7-29 IS ADDED TO THE INDIANA
855	855	38 CODE AS A NEW SECTION TO READ AS FOLLOWS
856	856	39 [EFFECTIVE JULY 1, 2025]: Sec. 29. (a) This section applies to an
857	857	40 individual contract and a group contract that is entered into,
858	858	41 delivered, amended, or renewed after June 30, 2025.
859	859	42 (b) As used in this section, "postpartum mental health
860	860	2025 IN 522—LS 7371/DI 104 20
861	861	1 condition" means a mental health condition that occurs:
862	862	2 (1) during pregnancy or after childbirth; and
863	863	3 (2) as a result of pregnancy or childbirth.
864	864	4 The term includes postpartum depression.
865	865	5 (c) An individual contract or a group contract must provide
866	866	6 coverage for:
867	867	7 (1) a postpartum mental health condition screening for an
868	868	8 enrollee; and
869	869	9 (2) postpartum mental health condition treatment for an
870	870	10 enrollee, which includes prescription drugs used to treat a
871	871	11 postpartum mental health condition.
872	872	12 SECTION 21. IC 27-13-7-30 IS ADDED TO THE INDIANA
873	873	13 CODE AS A NEW SECTION TO READ AS FOLLOWS
874	874	14 [EFFECTIVE JULY 1, 2025]: Sec. 30. (a) This section applies to an
875	875	15 individual contract and a group contract that is entered into,
876	876	16 delivered, amended, or renewed after June 30, 2025.
877	877	17 (b) As used in this section, "tubal ligation procedure" means a
878	878	18 surgical procedure that involves severing and tying the fallopian
879	879	19 tubes.
880	880	20 (c) As used in this section, "vasectomy procedure" means a
881	881	21 surgical procedure that involves cutting and sealing part of each
882	882	22 vas deferens.
883	883	23 (d) An individual contract or a group contract shall provide
884	884	24 coverage for a tubal ligation procedure for an enrollee.
885	885	25 (e) An individual contract or a group contract shall provide
886	886	26 coverage for a vasectomy procedure for an enrollee.
887	887	27 SECTION 22. [EFFECTIVE JULY 1, 2025] (a) There is
888	888	28 appropriated to the stillbirth prevention through fetal movement
889	889	29 pilot program fund established by IC 16-41-17.5-4, as added by this
890	890	30 act:
891	891	31 (1) for the state fiscal year beginning July 1, 2025, and ending
892	892	32 June 30, 2026, one hundred twenty-five thousand dollars
893	893	33 ($125,000); and
894	894	34 (2) for the state fiscal year beginning July 1, 2026, and ending
895	895	35 June 30, 2027, one hundred twenty-five thousand dollars
896	896	36 ($125,000);
897	897	37 from the state general fund for use by the Indiana department of
898	898	38 health to carry out the purposes of IC 16-41-17.5, as added by this
899	899	39 act.
900	900	40 (b) This SECTION expires July 1, 2027.
901	901	41 SECTION 23. [EFFECTIVE JULY 1, 2025] (a) There is
902	902	42 appropriated from the state general fund five million dollars
903	903	2025 IN 522—LS 7371/DI 104 21
904	904	1 ($5,000,000) to the Indiana housing and community development
905	905	2 authority for deposit in the lactation room grant fund established
906	906	3 by IC 5-16-16-10, as added by this act, for the period beginning
907	907	4 July 1, 2025, and ending June 30, 2026.
908	908	5 (b) This SECTION expires January 1, 2027.
909	909	2025 IN 522—LS 7371/DI 104