Title 12, HUMAN SERVICES

Sec. 1. This chapter applies to qualified long term care insurance policies that are entered into, issued, or renewed after June 30, 2022. As added by P.L.196-2021, SEC.6.

Sec. 2. As used in this chapter, "program" means the Indiana long term care insurance partnership program established by section 4(a) of this chapter. As added by P.L.196-2021, SEC.6.

Sec. 3. As used in this chapter, "qualified long term care insurance policy" means an insurance policy that meets the following requirements: (1) The policy covers an individual who was a resident of the state when the coverage first became effective under the policy. (2) The pol…

Sec. 4. (a) The Indiana long term care insurance partnership program is established. (b) The office of Medicaid policy and planning and the department of insurance shall administer the program in accordance with Section 6021 of the federal Deficit Reduction Act of 2005. As added …

Sec. 5. Under the program, the office of Medicaid policy and planning must exclude and disregard an amount equal to the amount of benefits an individual receives under a qualified long term care insurance policy when determining the following: (1) The individual's resources for p…

Sec. 6. (a) The department of insurance shall develop a training program for insurance producers who sell qualified long term care insurance policies that includes a certified prelicensing course and continuing education courses. The courses must cover, at a minimum, the followin…

Sec. 7. An insurer that issues a qualified long term care insurance policy shall provide regular reports to: (1) the Secretary of the United States Department of Health and Human Services, as required by federal regulations; and (2) the office of Medicaid policy and planning and …

Sec. 8. The secretary of family and social services and the department of insurance may adopt rules under IC 4-22-2 necessary to implement this chapter. As added by P.L.196-2021, SEC.6.

Sec. 17. (a) The healthy Indiana plan trust fund is established for the following purposes: (1) Administering a plan created by the general assembly to provide health insurance coverage for low income residents of Indiana under this chapter and IC 12-15-44.5. (2) Providing copaym…

Sec. 20. (a) The office may establish a health insurance coverage premium assistance program for individuals who meet the following: (1) Have an annual household income of the following: (A) Through December 31, 2013, not more than two hundred percent (200%) of the federal income…

Sec. 1.5. As used in this chapter, "office" refers to the office of the secretary. As added by P.L.63-2026, SEC.16.

Note: This version of section effective until 1-1-2027. See also following version of this section, effective 1-1-2027. Sec. 10. (a) The secretary has the authority to provide benefits to individuals eligible under the adult group described in 42 CFR 435.119 only in accordance wi…

Sec. 2. As used in this chapter, "plan" refers to the healthy Indiana plan established by section 3 of this chapter. As added by P.L.213-2015, SEC.136. Amended by P.L.30-2016, SEC.25.

Sec. 2.3. As used in this chapter, "preventative care services" means care that is provided to an individual to prevent disease, diagnose disease, or promote good health. As added by P.L.30-2016, SEC.26.

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…