IndianaHB 1277Second Regular Session 124th General Assembly (2026)HouseWALLET

Health and human services matters.

Sponsored By: Brad Barrett (Republican)

Signed by Governor

Summary

Amends the duties of the office of the secretary of family and social services (office) concerning Medicaid home and community based services waivers (waiver). Requires: (1) a provider of waiver services to provide certain documentation to a waiver recipient; (2) a waiver recipient to review the documentation and report errors or inconsistencies; and (3) the recipient's case manager to provide assistance to the recipient in reviewing the documentation and reporting any errors or inconsistencies. Requires certain Medicaid recipients to choose the recipient's provider of integrated health care coordination. Provides that integrated health care coordination provided by a provider of assisted living services is not duplicative of certain other services. Establishes a time frame in which the bureau of disabilities services must review and approve or deny requests for an increase in service units provided to certain individuals with a disability. Requires the office to apply to the federal government for: (1) a new Medicaid waiver to provide assisted living services; and (2) an amendment to a specific Medicaid home and community based services waiver to establish an individual cost limit of not more than the institutional cost of nursing facility services. Specifies that provisions concerning reimbursement for assisted living services for individuals who are aged and disabled and receiving services under a Medicaid waiver apply to the new assisted living Medicaid waiver. Provides that, beginning July 1, 2027, an individual is no longer a member of the covered population upon receiving nursing facility services for 100 consecutive days. Provides that on the one hundredth day, the individual is not a member of the covered population and shall receive Medicaid services under a fee for service program. Provides that a provision prohibiting the office from reducing reimbursement for home health services expires June 30, 2027. Requires the office to collaborate with certain entities to develop a new reimbursement methodology for home health services. Specifies that public notice of at least six months (rather than one year) must be provided before a health facility service reimbursement that results in a reduction in reimbursement may be changed. Amends the definition of "bulk drug substance" for provisions concerning drug compounding. Provides that a claim by the estate recovery unit of the office of Medicaid policy and planning (estate recovery unit) is forever barred unless the estate recovery unit files a claim in the court in which the decedent's estate is being administered not later than nine months after the date of death of the decedent.

public healththe senateappropriationshealth and provider services

Personalized for You

How does this bill affect your finances?

Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.

Bill Overview

Analyzed Economic Effects

10 provisions identified: 3 benefits, 4 costs, 3 mixed.

Separate Medicaid assisted living waiver for seniors

Indiana must apply for a separate assisted living Medicaid waiver by September 1, 2026, with an intended July 1, 2026 start. It serves people age 60 or older who meet nursing facility care requirements, subject to federal approval. After approval, the state must transfer applicable slots from existing waivers and involve assisted living providers in a stakeholder workgroup. Beginning July 1, 2026, the state's waiver definition expressly includes long-term care and supports for older people and people with disabilities. Services covered directly through the Medicaid state plan remain outside that definition; this definition change alone adds no benefits.

Service coverage and choices in assisted living

Beginning July 1, 2026, assisted living waiver rules require payment for assisted living, integrated health care coordination, and transportation. Recipients must be aged or disabled, and each paid service must appear in their plan. When plans include both assisted living and coordination, recipients choose the assisted living provider or the state for coordination, without duplicate services. Existing limits on state housing requirements also apply: no forced private rooms, bans on consenting shared bathrooms, or setting-wide stricter building standards. Limits also cover kitchenette sinks in units participating before July 1, 2018, and bans on studio units with one sink. The state cannot require separate housing and service contracts, or force providers to house residents whose health needs create undue burdens. The waiver also receives the protection against reducing aged and disabled waiver services as of July 1, 2021.

Cost ceilings for Medicaid waiver care

Beginning July 1, 2026, Indiana's waiver program includes assisted living, with care costs capped at comparable institutional care costs. Indiana must also seek a specific individual cost limit through a waiver amendment by September 1, 2026. That limit applies to people age 60 or older who meet nursing facility care requirements and are not transferring from another waiver. It cannot exceed nursing facility care costs, and the amendment requirement expires July 1, 2028. These are program spending limits, not stated charges to recipients.

Medicaid payment switch after nursing facility stays

Beginning July 1, 2027, covered-population members leave that group on their 100th consecutive day of nursing facility services. They continue receiving Medicaid through fee-for-service rather than the covered population's managed-care arrangement. Medicaid coverage does not end; the payment and care delivery system changes.

Waiver recipients choose providers and track care

Beginning July 1, 2026, home and community-based waiver services must follow each recipient's service plan and provider choice. Indiana must set up a process to document compliance with service-coordination requirements in each plan. Providers must attest that the services they delivered match the plan.

Longer government claim window against estates

Beginning July 1, 2026, government units have nine months after a person's death to file estate claims, instead of 120 days. They can file in an existing estate proceeding or open an estate and file the claim. Estate assets remain exposed to government claims longer, which can reduce money available to heirs.

Deadline for requesting more Medicaid care

Beginning July 1, 2026, requests for more service units on an approved plan face a 45-calendar-day filing deadline. The deadline runs from the first day of a qualifying event defined by the bureau. Requests must reach the bureau for review and approval or denial; filing does not guarantee more services.

Less notice before facility payment cuts

Indiana must give at least six months' public notice before reducing payment for a health facility service, down from one year. The notice must still explain the proposed change's financial impact. The law shortens advance notice; it does not itself set a payment cut.

Waiver billing access with error-reporting deadlines

Beginning July 1, 2026, waiver providers must give recipients or legal guardians service-delivery accounting records on request, once per calendar quarter. Recipients can also request a plain-language, itemized statement of billed services twice per calendar year. Recipients must report errors or mismatches with services received within 45 days after receiving a covered record or statement. On request, case managers must help review records, report problems, and resolve them.

Temporary payment protection for home health providers

Indiana's ban on reducing home health reimbursement, including through the specified rule or a successor, expires June 30, 2027. The expiration does not itself cut payment rates. The state must work with home health providers and an industry association to develop a new payment method. It must submit that method electronically to the Legislative Council by November 30, 2026. The development requirement expires December 31, 2027, and does not itself adopt new rates.

Sponsors & Cosponsors

Sponsor

  • Brad Barrett

    Republican • House

Cosponsors

  • Ed Charbonneau

    Republican • Senate

  • Gregory Porter

    Democratic • House

  • Harold Slager

    Republican • House

  • Justin Busch

    Republican • Senate

  • Liz Brown

    Republican • Senate

  • Lonnie Randolph

    Democratic • Senate

  • Lori Goss-Reaves

    Republican • House

  • Michael Crider

    Republican • Senate

  • Vaneta Becker

    Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 282 • No: 4

House vote • 2/27/2026

Rules Suspended. Conference Committee Report 1: adopted by the House

Yes: 96 • No: 0

Senate vote • 2/27/2026

Rules Suspended. Conference Committee Report 1: adopted by the Senate

Yes: 46 • No: 4

Senate vote • 2/24/2026

Third reading: passed

Yes: 47 • No: 0

House vote • 2/2/2026

Third reading: passed

Yes: 93 • No: 0

Actions Timeline

  1. Signed by the Governor

    3/12/2026House
  2. Public Law 160

    3/12/2026House
  3. Signed by the President Pro Tempore

    3/5/2026Senate
  4. Signed by the President of the Senate

    3/2/2026Senate
  5. Rules Suspended. Conference Committee Report 1: adopted by the Senate; Roll Call 325: yeas 46, nays 4

    2/27/2026Senate
  6. Rules Suspended. Conference Committee Report 1: adopted by the House; Roll Call 416: yeas 96, nays 0

    2/27/2026House
  7. CCR # 1 filed in the Senate

    2/27/2026Senate
  8. CCR # 1 filed in the House

    2/27/2026House
  9. Signed by the Speaker

    2/27/2026House
  10. Senate advisors appointed: Busch, Yoder, Brown L

    2/25/2026Senate
  11. House conferees appointed: Barrett, Shackleford

    2/25/2026House
  12. House advisors appointed: Goss-Reaves, Slager, Lopez, Bauer, Porter

    2/25/2026House
  13. Returned to the House with amendments

    2/25/2026Senate
  14. Senate conferees appointed: Crider, Jackson L

    2/25/2026Senate
  15. House dissented from Senate amendments

    2/25/2026House
  16. Motion to dissent filed

    2/25/2026House
  17. Third reading: passed; Roll Call 250: yeas 47, nays 0

    2/24/2026Senate
  18. Second reading: amended, ordered engrossed

    2/23/2026Senate
  19. Amendment #2 (Ford J.D.) failed; voice vote

    2/23/2026Senate
  20. Amendment #1 (Qaddoura) failed; voice vote

    2/23/2026Senate
  21. Amendment #3 (Crider) prevailed; voice vote

    2/23/2026Senate
  22. Amendment #8 (Brown L) prevailed; voice vote

    2/23/2026Senate
  23. Committee report: amend do pass, adopted

    2/19/2026Senate
  24. Senator Charbonneau added as cosponsor

    2/12/2026Senate
  25. Senator Randolph added as cosponsor

    2/12/2026Senate

Bill Text

  • Engrossed House Bill (H)

  • Enrolled House Bill (H)

  • House Bill (H)

  • House Bill (S)

  • Introduced House Bill (H)

Related Bills

Back to State Legislation