HOUSE BILL No. 1938
DIGEST OF INTRODUCED BILL
IC 12-7-2-154.8; IC 12-15-2-13.5
Synopsis: Medicaid coverage for breast and cervical cancer. Expands
Medicaid to include women screened and found to need treatment
under the federal Breast and Cervical Cancer Prevention and Treatment
Act of 2000. Allows presumptive eligibility for qualified women.
Appropriates funds from the state general fund.
Effective: July 1, 2001.
Becker, Brown C, Welch, Budak
January 17, 2001, read first time and referred to Committee on Human Affairs.
First Regular Session 112th General Assembly (2001)
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HOUSE BILL No. 1938
A BILL FOR AN ACT to amend the Indiana Code concerning
Medicaid and to make an appropriation.
Be it enacted by the General Assembly of the State of Indiana:
SECTION 1. IC
IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2001]: Sec. 154.8. "Qualified
entity" means the following:
(1) For purposes of IC
, has the meaning set forth in
(2) For purposes of IC 12-15-2.3, has the meaning set forth in
SOURCE: IC 12-15-2-13.5; (01)IN1938.1.2. -->
IS ADDED TO THE INDIANA
CODE AS A NEW
SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2001]: Sec. 13.5. (a) A woman who:
(1) is not eligible for Medicaid under any other section of this
(2) is less than sixty-five (65) years of age;
(3) has been:
(A) screened for breast or cervical cancer through the
breast and cervical cancer screening program under the
federal Breast and Cervical Cancer Mortality Prevention
Act of 1990 (42 U.S.C. 300k); and
(B) determined to need treatment for breast or cervical
(4) is not otherwise covered under credible coverage (as
defined in 42 U.S.C. 300gg(c));
is eligible for Medicaid.
(b) Medicaid made available to a woman described in subsection
(a) is limited to:
(1) medical assistance for services required for treatment of
breast or cervical cancer; and
(2) the duration of treatment required for breast or cervical
(c) The office may apply a resource standard not to exceed the
resource standard applied to a pregnant woman under section 13
of this chapter in determining the eligibility of a woman described
in subsection (a).
SOURCE: IC 12-15-2.3; (01)IN1938.1.3. -->
IS ADDED TO THE INDIANA CODE
AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]:
Chapter 2.3. Presumptive Eligibility for Women With Breast or
Sec. 1. This chapter applies to a woman who is eligible for
Medicaid under IC 12-15-2-13.5.
Sec. 2. As used in this chapter, "qualified entity" means an
(1) is eligible to receive payments and provide items and
services under this article;
(2) provides outpatient hospital services, rural health clinic
services, and any other ambulatory services offered by a rural
health clinic, or clinic services furnished by or under the
direction of a licensed physician; and
(3) meets all other requirements set forth in 42 U.S.C. 1920B.
Sec. 3. A qualified entity may establish the presumptive
eligibility of a woman described in section 1 of this chapter.
Sec. 4. The office shall consider the following to be qualified
(1) A disproportionate share provider under
or IC 12-15-16-1(b).
(2) A federally qualified health clinic.
(3) A rural health clinic.
Sec. 5. The office shall provide each qualified entity with the
(1) Application forms for Medicaid.
(2) Information on how to assist a woman described in section
1 of this chapter in completing and filing the application
Sec. 6. Subject to section 7(2) of this chapter, the office shall
provide Medicaid services to a woman described in section 1 of this
chapter during a period that:
(1) begins on the date on which a qualified entity determines
on the basis of preliminary information that the woman is
eligible for Medicaid under IC 12-15-2-13.5; and
(2) ends on the earlier of the following:
(A) The date on which a determination is made by a
representative of the county office with respect to the
eligibility of the woman under IC 12-15-2-13.5.
(B) The last day of the month following the month in which
the qualified entity makes the determination described in
Sec. 7. A woman described in section 1 of this chapter:
(1) may only have a presumptive eligibility determination
made by an entity described in section 2 of this chapter; and
(2) is eligible to receive only ambulatory care during a period
of presumptive eligibility.
Sec. 8. A qualified entity that determines that a woman
described in section 1 of this chapter is presumptively eligible for
Medicaid shall do the following:
(1) Notify the office of the determination within five (5)
working days after the date on which the determination is
(2) Inform the woman at the time a determination is made
that an application for Medicaid is required to be made at the
county office in the county where the woman resides or an
enrollment center (as provided in
) not later than
the last day of the month following the month during which
the determination is made.
Sec. 9. If a woman described in section 1 of this chapter is
determined to be presumptively eligible for Medicaid under this
chapter, the woman must complete an application for Medicaid as
not later than the last day of the month
following the month during which the determination is made.
Sec. 10. If a woman described in section 1 of this chapter:
(1) is determined to be presumptively eligible for Medicaid
under this chapter; and
(2) appoints, in writing, an agent of a qualified entity under
section 4 of this chapter as the woman's authorized
representative for purposes of completing all aspects of the
Medicaid application process;
the county office shall conduct any face-to-face interview that is
necessary to determine the woman's eligibility for Medicaid with
the woman's authorized representative.
Sec. 11. If a woman described in section 1 of this chapter is:
(1) determined to be presumptively eligible for Medicaid
under this chapter; and
(2) subsequently determined not to be eligible for Medicaid;
a qualified entity under section 4(1) or 4(2) of this chapter that
determined that the woman was presumptively eligible for
Medicaid shall reimburse the office for all funds expended by the
office in paying for care for the woman during the woman's period
of presumptive eligibility.
Sec. 12. The office shall adopt rules under
implement this chapter, including rules that may impose additional
requirements for qualified entities that are consistent with federal
SOURCE: ; (01)IN1938.1.4. -->
SECTION 4. [EFFECTIVE JULY 1, 2001] There is annually
appropriated to the office of the secretary of family and social
services from the state general fund an amount sufficient to
provide services to those individuals eligible for Medicaid under
, both as added by this act.