SB 460-1_ Filed 04/24/2003, 16:30
Adopted 4/26/2003
CONFERENCE COMMITTEE REPORT
DIGEST FOR ESB 460
Citations Affected:
IC 12-14-15-1
;
IC 12-15-2-6.
Synopsis: Audit and eligibility assistance for the disabled. Conference committee report for
ESB 460. Amends eligibility requirements for assistance for disabled individuals. Requires the
office of Medicaid policy and planning, in cooperation with the attorney general's office, to
contract with an outside vendor to conduct an annual audit of specified areas of the Medicaid
program. (This conference committee report: (1) removes references to activities of daily
living in the Medicaid eligibility requirements for a disabled individual and resets current
eligibility statutory language of performing labor or services or engaging in a useful
occupation; (2) removes language that required the audit to be submitted to the attorney
general, the health professions bureau, and specified boards and committees; and (3) adds
language to require the office to provide the Medicaid clinical advisory committee with
atypical or unusual information obtained under the audit.)
Effective: Upon passage; July 1, 2003.
Text Box
Adopted Rejected
[
]
CONFERENCE COMMITTEE REPORT
MR. SPEAKER:
Your Conference Committee appointed to confer with a like committee from the Senate
upon Engrossed House Amendments to Engrossed Senate Bill No. 460 respectfully reports
that said two committees have conferred and agreed as follows to wit:
that the Senate recede from its dissent from all House amendments and that
the Senate now concur in all House amendments to the bill and that the bill
be further amended as follows:
Delete everything after the enacting clause and insert the following:
SOURCE: IC 12-14-15-1; (03)CC046002.1. -->
SECTION 1.
IC 12-14-15-1
, AS AMENDED BY P.L.67-2000,
SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2003]: Sec. 1. Assistance shall be given to a needy disabled
individual (referred to as "disabled person" in this chapter) who meets
the following qualifications:
(1) Has a pending application on file with the federal Social
Security Administration for assistance under Public Law 92-603,
supplemental security income (SSI), or is receiving assistance.
However, a person whose application for assistance under Public
Law 92-603 has been denied but who meets all other requirements
of this chapter is eligible for supplemental assistance.
(2) Has one (1) of the following:
(A) A physical or mental impairment, disease, or loss that is
verifiable by a physician licensed under IC 25-22.5, that appears
reasonably certain to result in death or that has lasted or appears
reasonably certain to last for a continuous period of at least four
(4) years twelve (12) months without significant improvement,
and that substantially impairs the individual's ability to perform
labor or services or to engage in a useful occupation.
(B) A mental impairment, disease, or loss that is:
(i) diagnosed by a physician licensed under IC 25-22.5 or a
health services provider in psychology licensed under
IC 25-33-1
; and
(ii) verifiable by a physician licensed under IC 25-22.5 or a
psychologist licensed under IC 25-33;
that has lasted or appears reasonably certain to last for a
continuous period of at least four (4) years twelve (12) months
without significant improvement, and that substantially impairs the
individual's ability to perform labor or services or to engage in a
useful occupation. Employment in a sheltered workshop or under
an approved vocational rehabilitation plan is not considered a
useful occupation for the purposes of this chapter. The
determination of medical disability under this subdivision shall be
made without reference to the individual's ability to pay for
treatment.
(3) Does not have a parent, spouse, or other legally responsible
relative able to support the individual.
(4) Is at least eighteen (18) years of age.
(5) Is residing and intends to remain in Indiana in a bona fide
living arrangement.
(6) Has insufficient income or other resources to provide a
reasonable subsistence according to the standards established by
the division.
(7) Except as otherwise provided in this chapter, is not an inmate
of or being maintained by a municipal, state, or national institution
while receiving assistance.
(8) Has not, at any time within five (5) years immediately before
the date of the filing of an application for assistance under this
chapter, made an assignment or transfer of property for the purpose
of making or that will make the individual eligible for assistance
under this chapter, except as otherwise provided in this chapter.
SOURCE: IC 12-15-2-6; (03)CC046002.2. -->
SECTION 2.
IC 12-15-2-6
, AS AMENDED BY P.L.287-2001,
SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2003]: Sec. 6. (a) Subject to subsection (b), an individual
who:
(1) is receiving monthly assistance payments under the federal
Supplemental Security Income program; and
(2) meets the income and resource requirements established by
statute or the office unless the state is required to provide medical
assistance to the individual under Section 209(b) of Public Law
92-603 passed by the United States Congress 42 U.S.C. 1396a(f)
or under Section 1619(b)(3) of the federal Social Security Act (42
U.S.C. 1382h); 42 U.S.C. 1382h;
is eligible to receive Medicaid.
(b) An individual who is receiving monthly disability assistance
payments under the federal Supplemental Security Income program or
the federal Social Security Disability Insurance program must meet the
eligibility requirements specified in
IC 12-14-15
unless the state is
required to provide medical assistance to the individual under Section
1619(b)(3) of the federal Social Security Act (42 U.S.C. 1382h). 42
U.S.C. 1382h.
(c) The office may not apply a spend down requirement to an
individual who is eligible for medical assistance under Section
1619(b)(3) of the federal Social Security Act (42 U.S.C. 1382h). 42
U.S.C. 1382h.
SOURCE: ; (03)CC046002.3. -->
SECTION 3. [EFFECTIVE UPON PASSAGE] (a) The office of
Medicaid policy and planning established by
IC 12-8-6-1
, in
cooperation with the attorney general's office, shall contract with
an outside vendor to conduct an annual audit of areas of the state
Medicaid program, including:
(1) the claims processing contractor;
(2) provider billing practices; and
(3) overutilization of services by Medicaid recipients.
(b) The office of Medicaid policy and planning shall provide any
atypical or unusual information collected under this SECTION to
the Medicaid clinical advisory committee established under
IC 12-15-33.5.
The committee shall review individual cases of
utilization and clinical practice.
(c) Information obtained or used in the audit required under
subsection (a) that identifies an individual Medicaid contractor,
provider, or recipient must be kept confidential unless the attorney
general commences an official action by the state concerning
fraudulent activity.
(d) The office of Medicaid policy and planning shall report to the
state budget committee and the select joint commission on
Medicaid oversight upon request regarding the office's
implementation of this SECTION.
(e) This SECTION expires December 31, 2007.
SOURCE: ; (03)CC046002.4. -->
SECTION 4.
An emergency is declared for this act.
(Reference is to ESB 460 as reprinted April 1, 2003.)
Conference Committee Report
on
Engrossed Senate Bill 460
Text Box
S
igned by:
____________________________ ____________________________
Senator MillerRepresentative Brown C
Chairperson
____________________________ ____________________________
Senator SimpsonRepresentative Lehe
Senate Conferees House Conferees