A BILL FOR AN ACT to amend the Indiana Code concerning Medicaid.

Plain English Breakdown

Checked against official source text during the last sync.

Medicaid Changes in Indiana

This bill changes how Medicaid works in Indiana by requiring notices and reviews for terminations, reporting claim denials quarterly, and providing up to 30 days of retroactive coverage.

What This Bill Does

• Requires the office to post information about being medically frail on its website.
• Sets rules for notices when someone's Medicaid might end.
• Needs the office and managed care groups to look at all submitted info before ending coverage.
• Asks managed care organizations to report claim denials every three months and other details each month.
• Requires the office to put these reports on its website.
• Adds that people in the Healthy Indiana Plan can get up to 30 days of Medicaid coverage for past costs.

Who It Names or Affects

• People who use Medicaid services
• Managed care organizations that work with Medicaid recipients
• The office of the secretary of family and social services

Terms To Know

Medically frail

Someone who needs extra medical help because they are very sick or have a serious condition.

Redetermination

The process of checking if someone still qualifies for Medicaid benefits.

Limits and Unknowns

• It is not clear when the bill will become law.
• Details about how and where reports are posted on the website are not specified.

Official Summary Text

A BILL FOR AN ACT to amend the Indiana Code concerning Medicaid.
Medicaid matters.

Current Bill Text

A BILL FOR AN ACT to amend the Indiana Code concerning Medicaid.

Medicaid matters.

Requires the office of the secretary of family and social services (office) to post information concerning the criteria for being determined to be medically frail and examples of notices on the office's website. Specifies requirements for a notice of Medicaid termination. Requires the office and managed care organizations to review all timely submitted information in a Medicaid redetermination before terminating coverage of a recipient. Requires a managed care organization to report information concerning: (1) claim denials under the Medicaid program on a quarterly basis; and (2) certain information on a monthly basis. Requires the office to post the reports on the office's website. Provides that the healthy Indiana plan includes at least 30 days of retroactive coverage.