Citations Affected: IC 12-15-12-19 ; IC 16-18-2-55.5 ; IC 16-38-6 ; IC 34-30-2-77.2 .
Synopsis: Disease management and chronic disease registry.
Removes: (1) HIV and AIDS; and (2) population parameters; from the
state's disease management program and sets implementation dates for
the statewide program. Creates a chronic disease registry administered
by the state department of health.
Effective: Upon passage.
January 15, 2003, read first time and referred to Committee on Health and Provider
A BILL FOR AN ACT to amend the Indiana Code concerning
, AS AMENDED BY P.L.66-2002,
SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]: Sec. 19. (a) This section applies to an individual
(1) is a Medicaid recipient; and
(2) is not enrolled in the risk-based managed care program.
(3) resides in a county having a population of more than one
hundred thousand (100,000).
(b) Subject to subsection (c), the office shall develop the following programs regarding individuals described in subsection (a):
(1) A disease management program for recipients with any of the following diseases:
(C) Congestive heart failure or coronary heart disease.
(D) HIV or AIDS.
(2) A case management program for recipients
recipient Medicaid cost is in the highest ten percent (10%) of all
individuals described in subsection (a), who are at high risk of
disease, that is based on a combination of cost measures and
clinical measures identified and developed by the office with
input and guidance from the state department of health.
(c) The office shall implement:
(1) a pilot program for at least two (2) of the diseases listed in subsection (b) not later than July 1, 2003; and
(2) a statewide chronic disease program as soon as practicable after the office has done the following:
(A) Evaluated a pilot program described in subdivision (1).
(B) Made any necessary changes in the program based on the evaluation performed under clause (A).
(d) The office shall develop and implement a program required under this section in cooperation with the state department of health and shall use the following health care providers to the extent possible:
(1) Community health centers.
(2) Federally qualified health centers (as defined in 42 U.S.C. 1396d(l)(2)(B)).
(3) Rural health clinics (as defined in 42 U.S.C. 1396d(l)(1)).
(4) Local health departments.
(5) Public hospitals.
(e) The office
shall may contract with an outside vendor or vendors
to assist in the develop development and implement implementation
of the programs required under subsection (b). this section. The office
shall begin the contract procurement process not later than October 1,
2001. The contract required under this subsection must be effective not
later than July 1, 2002.
(d) (f) The vendor or vendors with whom the office contracts under
subsection (c) and the state department of health shall provide the
office and the select joint commission on Medicaid oversight
with an evaluation and recommendations on
the costs, benefits, and health outcomes of the pilot programs required
under subsection (b). this section. The evaluations required under this
subsection must be provided not more than nine (9) twelve (12) months
after the effective implementation date of the contract. pilot
(e) (g) The office and the state department of health shall report
to the select joint commission on Medicaid oversight established by
not later than December 31, 2002, November 1 of each
year regarding the programs developed under this section.
when completing a report required by this chapter. However, the state department may require additional, definitive information.
(c) The office of Medicaid policy and planning shall provide data concerning services for chronic diseases reimbursed by the state Medicaid program to the chronic disease registry. The office shall work with the state department to identify the data available and to determine a means to transmit the information to assist the state department in data collection for the chronic disease registry.
Sec. 5. Except as provided in sections 6, 7, and 8 of this chapter, information obtained by the state department under this chapter concerning chronic disease patients is confidential and may be used by the state department only for the purposes of this chapter.
Sec. 6. The state department may grant a researcher access to confidential information obtained under this chapter concerning individual chronic disease patients if the researcher who is requesting additional information for research purposes or soliciting the patient's participation in a research project obtains the following:
(1) First, the oral or written consent of the patient's attending physician.
(2) Second, the patient's written consent by completing a confidential medical release form.
Sec. 7. The state department may release confidential information obtained under this chapter concerning individual chronic disease patients to the following:
(1) The chronic disease registry of another state if the following conditions are met:
(A) The other state has entered into a reciprocal agreement with the state department.
(B) The reciprocal agreement under clause (A) states that information that identifies a patient will not be released to any other person without the written consent of the patient.
(2) Physicians and local health officers for diagnostic and treatment purposes if the following conditions are met:
(A) The patient's attending physician gives oral or written consent to the release of the information.
(B) The patient gives written consent by completing a confidential medical release form.
(3) The office of Medicaid policy and planning for purposes related to administering the state Medicaid plan.