Title 12, HUMAN SERVICES

Sec. 3. (a) The healthy Indiana plan is established. The secretary shall oversee the plan and has the authority to set policy for the plan in compliance with this chapter. (b) The office, under the direction of the secretary, shall administer the plan. (c) The adult group describ…

Sec. 3.5. (a) The plan must include the following in a manner and to the extent determined by the secretary: (1) Mental health care services. (2) Inpatient hospital services. (3) Prescription drug coverage, including coverage of a long acting, nonaddictive medication assistance t…

Sec. 4. (a) The plan: (1) is not an entitlement program; (2) serves as an alternative to health care coverage under Title XIX of the federal Social Security Act (42 U.S.C. 1396 et seq.); (3) except as provided in section 4.2(a) of this chapter, must not grant eligibility under th…

Sec. 4.2. (a) Notwithstanding section 3 of this chapter, the secretary shall amend the Medicaid state plan to not include individuals described in 42 CFR 435.119. The secretary shall delay the effective date of the amendment to not later than upon the completion of negotiations w…

Sec. 4.5. (a) An individual who participates in the plan must have a health care account to which payments may be made for the individual's participation in the plan. (b) An individual's health care account must be used to pay the individual's deductible for health care services …

Sec. 4.7. (a) To participate in the plan, an individual must: (1) apply for the plan on a form prescribed by the secretary; (2) comply with the requirements of section 3(c) of this chapter for the three (3) consecutive months immediately preceding the month the individual applies…

Note: This version of section effective until 1-1-2027. See also following version of this section, effective 1-1-2027. Sec. 4.9. (a) An individual who is approved to participate in the plan is eligible for a twelve (12) month plan period if the individual continues to meet the p…

Sec. 5. (a) A managed care organization that contracts with the office to provide health coverage, dental coverage, or vision coverage to an individual who participates in the plan: (1) is responsible for the claim processing for the coverage; (2) shall reimburse providers at a r…

Sec. 5.5. The office, under the direction of the secretary, shall refer any member of the plan who: (1) is employed for less than twenty (20) hours per week; and (2) is not a full-time student; to a workforce training and job search program. As added by P.L.30-2016, SEC.33. Amend…

Sec. 5.7. (a) Subject to appeal to the office and except as provided in subsection (b), an individual shall be held responsible under the plan for receiving nonemergency services in an emergency room setting, including prohibiting the individual from using funds in the individual…

Sec. 6. (a) For a state fiscal year beginning July 1, 2018, and before July 1, 2024, the office, after review by the state budget committee, may determine that no incremental fees collected under IC 16-21-10-13.3 are required to be deposited into the phase out trust fund establis…

Sec. 8. The following requirements apply to funds appropriated by the general assembly to the plan and the incremental fee used for purposes of IC 16-21-10-13.3: (1) At least eighty-seven percent (87%) of the funds must be used to fund payment for health care services. (2) An amo…

Sec. 9. The secretary may adopt rules under IC 4-22-2 necessary to implement: (1) this chapter; or (2) a Section 1115 Medicaid demonstration waiver concerning the plan that is approved by the United States Department of Health and Human Services. As added by P.L.213-2015, SEC.136…