Sec. 1. As used in this chapter, “phase out period” refers to the following periods: (1) The time during which a: (A) phase out plan; (B) demonstration expiration plan; or (C) similar plan approved by the United States Department of Health and Human Services; is in effect for the plan set forth in this chapter. […]
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 with this chapter. (b) The secretary may negotiate and make changes to the plan, except that the secretary may not negotiate or change the plan that would do the […]
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. (b) The office shall administer the plan. (c) The following individuals are eligible for the plan: (1) The adult group described in 42 CFR 435.119. (2) Parents and caretaker relatives eligible under 42 CFR 435.110. (3) Low income individuals who are: (A) at least nineteen (19) […]
Sec. 3.5. (a) The plan must include the following in a manner and to the extent determined by the office: (1) Mental health care services. (2) Inpatient hospital services. (3) Prescription drug coverage, including coverage of a long acting, nonaddictive medication assistance treatment drug if the drug is being prescribed for the treatment of substance […]
Sec. 4. (a) The plan: (1) is not an entitlement program; and (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.). (b) If either of the following occurs, the office shall terminate the plan in accordance with section 6(b) of this […]
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 under the plan. (c) An individual’s deductible must […]
Sec. 4.7. (a) To participate in the plan, an individual must apply for the plan on a form prescribed by the office. The office may develop and allow a joint application for a household. (b) A pregnant woman is not subject to the cost sharing provisions of the plan. Subsections (c) through (g) do not […]
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 plan requirements specified in this chapter. (b) If an individual chooses to renew participation in the plan, the individual is subject to an annual renewal process […]
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 rate that is not less than the rate established by […]
Sec. 5.5. The office 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.
Sec. 5.7. Subject to appeal to the office, an individual may 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’s health care account to pay for the nonemergency services and paying a copayment for the services of at least […]
Sec. 6. (a) For a state fiscal year beginning July 1, 2018, or thereafter, 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 established under section 7 of this chapter. (b) If the plan […]
Sec. 7. (a) The phase out trust fund is established for the purpose of holding the money needed during a phase out period of the plan. Funds deposited under this section shall be used only: (1) to fund the state share of the expenses described in IC 16-21-10-13.3(b)(1)(A) through IC 16-21-10-13.3(b)(1)(F) incurred during a phase […]
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 amount determined by the office of the secretary […]
Sec. 9. (a) The office 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. (b) The office may adopt emergency rules under IC 4-22-2-37.1 to implement the plan […]
