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26 07, 2023

HB 1513

Repeals Medicaid copayment provisions that: (1) require the office of the secretary of family and social services (office) to apply a copayment for certain Medicaid services; (2) require a recipient to make a copayment upon the receipt of services and for a provider not to voluntarily waive a copayment; (3) set forth exemptions from copayment requirements; and (4) require the provider to charge the maximum allowable copayment. Allows for an enrollment fee, a premium, a copayment, or a similar charge to be imposed as a condition of an individual's eligibility for the healthy Indiana plan [...]

HB 1513
26 07, 2023

HB 1583

Health plans and ambulance service providers. Amends the law requiring a health plan operator to fairly negotiate rates and terms with any ambulance service provider willing to become a participating provider with respect to the operator's health plan. Provides that, if negotiations between an ambulance service provider and a health plan operator that occur after June 30, 2022, do not result in the ambulance service provider becoming a participating provider with respect to the health plan, each party, beginning May 1, 2023, is required to provide to the department of insurance (department) a written [...]

HB 1583
26 07, 2023

HB 1602

Medicaid reimbursement rates. Specifies Medicaid reimbursement rates for specified services (physician services, nonemergency medical transportation, and dental services) in the Medicaid risk based managed care program and the Medicaid fee for service program. The office shall set a reimbursement rate that is comparable to the federal Medicare reimbursement rate for the services or one hundred thirty percent (130%) of the Medicaid reimbursement rate in place on January 1, 2023, for a service that does not have a Medicare rate. The office shall adjust the rates described in subsection (b) on a biennial basis to [...]

HB 1602
26 07, 2023

SB 357

Health care. Authorizes the Indiana department of health (state department) to assess a public health assessment fee (fee) upon nonprofit hospitals (excluding county hospitals). Provides that the fee shall be imposed on total hospital net patient revenues at a rate determined by the state department after review by the budget committee. Requires the rate to be formulated to result in total fee revenue generation of: (1) $120,000,000 in state fiscal year 2024; and (2) $230,000,000 in state fiscal year 2025, and each state fiscal year thereafter. Establishes the local public health department fund (fund). [...]

SB 357
26 07, 2023

SB 400

Health care matters. Requires the state employee health plan, policies of accident and sickness insurance, and health maintenance organization contracts to provide coverage for wearable cardioverter defibrillators. Specifies requirements for credentialing a provider for the Medicaid program, an accident and sickness insurance policy, and a health maintenance organization contract. Establishes a provisional credential until a decision is made on a provider's credentialing application and allows for retroactive reimbursement. Provides that a hospital's quality assessment and improvement program must include a process for determining and reporting the occurrence of serious reportable events. Provides that the [...]

SB 400
26 07, 2023

SB 457

Medicaid waiver reimbursement for direct care. Requires the office of the secretary of family and social services to apply for an amendment to specified Medicaid waivers to increase reimbursement rates for services provided by direct care staff. Sets forth the manner in which the increased reimbursement may be expended and sets requirements on authorized service providers as a condition to retaining the additional reimbursement.

SB 457
26 07, 2023

SB 8

Prescription drug rebates and pricing. Requires a pharmacy benefit manager to provide a report to the department of insurance at least every six months. Provides that the report must include the: (1) overall aggregate amount charged to a health plan for all pharmaceutical claims processed by the pharmacy benefit manager; and (2) overall aggregate amount paid to pharmacies for claims processed by the pharmacy benefit manager. Requires that, for individual health insurance coverage, the defined cost sharing for a prescription drug be calculated at the point of sale and based on a price that [...]

SB 8
26 07, 2023

HB 1610

Exemption from prior authorization requirements. Amends the law concerning the prior authorization of health care services by a health plan (which includes a policy of accident and sickness insurance, a health maintenance organization contract, and the Medicaid risk based managed care program). Provides that: (1) if a health plan, during a six month evaluation period, approves at least 90% of a health care provider's requests for prior authorization for a particular type of health care service, the health plan may not require the health care provider to obtain prior authorization for that type of [...]

HB 1610
26 07, 2023

SB 196

Healthy Indiana plan health care accounts. Repeals the health care account and cost sharing requirements of an individual for the healthy Indiana plan.

SB 196
26 07, 2023

HB 1273

Prescription drug rebates and pricing. Provides that, for individual health insurance coverage, the defined cost sharing for a prescription drug be calculated at the point of sale and based on a price that is reduced by an amount equal to at least 85% of all rebates received by the insurer in connection with the dispensing or administration of the prescription drug. Requires that, for group health insurance coverage, an insurer: (1) pass through to a plan sponsor 100% of all rebates received or estimated to be received by the insurer concerning the dispensing or [...]

HB 1273
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