HB 1008-1_ Filed 02/22/2007, 07:02 Brownc


Text Box


    PREVAILED      Roll Call No. _______
    FAILED        Ayes _______
    WITHDRAWN        Noes _______
    RULED OUT OF ORDER


[

HOUSE MOTION ____

]

MR. SPEAKER:

    I move that House Bill 1008 be amended to read as follows:

    Delete everything after the enacting clause and insert the following:

SOURCE: IC 5-10-8-6.8; (07)MO100803.1. -->     SECTION 1. IC 5-10-8-6.8 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 6.8. (a) As used in this section, "small employer" means a private employer that employs at least two (2) but not more than fifty (50) full-time employees.
    (b) As used in this section, "state employee health plan" means:
        (1) a self-insurance program established under section 7(b) of this chapter to provide group health coverage; or
        (2) a contract with a prepaid health care delivery plan entered into by the state personnel department under section 7(c) of this chapter.
    (c) The state personnel department shall allow a small employer to provide coverage of health care services for employees of the small employer under any state employee health plan available to state employees.
    (d) IC 27-8-15 does not apply to coverage provided to employees of a small employer under this section.
    (e) A small employer's employee who receives coverage of health care services under a state employee health plan under subsection (c) must:
        (1) receive coverage equal to the coverage provided to state employees under the state employee health plan; and
        (2) be allowed to choose the state employee health plan under

which the employee will be covered.
    (f) The total premium rate that is charged to a small employer for the small employer's employee who is covered under a state employee health plan under this section must be the same total premium rate that is charged to the state for a state employee with the same coverage.

SOURCE: IC 6-3.1-31; (07)MO100803.2. -->     SECTION 2. IC 6-3.1-31 IS ADDED TO THE INDIANA CODE AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]:
    Chapter 31. Employee Wellness Program Tax Credit
    Sec. 1. As used in this chapter, "pass through entity" means:
        (1) a corporation that is exempt from the adjusted gross income tax under IC 6-3-2-2.8(2);
        (2) a partnership;
        (3) a limited liability company; or
        (4) a limited liability partnership.
    Sec. 2. As used in this chapter, "state tax liability" means a taxpayer's total tax liability that is incurred under:
        (1) IC 6-3-1 through IC 6-3-7 (the adjusted gross income tax);
        (2) IC 6-5.5 (the financial institutions tax); and
        (3) IC 27-1-18-2 (the insurance premiums tax);
as computed after the application of the credits that under IC 6-3.1-1-2 are to be applied before the credit provided by this chapter.
    Sec. 3. As used in this chapter, "taxpayer" means an individual or entity that has any state tax liability.
    Sec. 4. As used in this chapter, "wellness program" means a program that rewards:
        (1) overweight employees for losing weight and all employees for maintaining a healthy weight; or
        (2) employees for not using tobacco.
    Sec. 5. A taxpayer is entitled to a credit against the taxpayer's state tax liability for a taxable year in an amount equal to fifty percent (50%) of the costs incurred by the taxpayer during the taxable year for providing a wellness program for the taxpayer's employees during the taxable year.
    Sec. 6. If a pass through entity is entitled to a credit under section 5 of this chapter but does not have state tax liability against which the tax credit may be applied, a shareholder, partner, or member of the pass through entity is entitled to a tax credit equal to:
        (1) the tax credit determined for the pass through entity for the taxable year; multiplied by
        (2) the percentage of the pass through entity's distributive income to which the shareholder, partner, or member is entitled.
    Sec. 7. (a) If the credit provided by this chapter exceeds the

taxpayer's state tax liability for the taxable year for which the credit is first claimed, the excess may be carried forward to succeeding taxable years and used as a credit against the taxpayer's state tax liability during those taxable years. Each time that the credit is carried forward to a succeeding taxable year, the credit is to be reduced by the amount that was used as a credit during the immediately preceding taxable year.
    (b) A taxpayer is not entitled to any carryback or refund of any unused credit.
    Sec. 8. To receive the credit provided by this chapter, a taxpayer must claim the credit on the taxpayer's state tax return or returns in the manner prescribed by the department. The taxpayer shall submit to the department all information that the department determines is necessary for the calculation of the credit provided by this chapter.

SOURCE: IC 6-7-1-12; (07)MO100803.3. -->     SECTION 3. IC 6-7-1-12 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 12. (a) The following taxes are imposed, and shall be collected and paid as provided in this chapter, upon the sale, exchange, bartering, furnishing, giving away, or otherwise disposing of cigarettes within the state of Indiana:
        (1) On cigarettes weighing not more than three (3) pounds per thousand (1,000), a tax at the rate of two and seven hundred seventy-five thousandths of a cent ($0.02775) five and five tenths cents ($0.055) per individual cigarette.
        (2) On cigarettes weighing more than three (3) pounds per thousand (1,000), a tax at the rate of three seven and six thousand eight hundred eighty-one ten-thousandths of a cent ($0.036881) thirty-one hundredths cents ($0.0731) per individual cigarette, except that if any cigarettes weighing more than three (3) pounds per thousand (1,000) shall be more than six and one-half (6 1/2) inches in length, they shall be taxable at the rate provided in subdivision (1), counting each two and three-fourths (2 3/4) inches (or fraction thereof) as a separate cigarette.
    (b) Upon all cigarette papers, wrappers, or tubes, made or prepared for the purpose of making cigarettes, which are sold, exchanged, bartered, given away, or otherwise disposed of within the state of Indiana (other than to a manufacturer of cigarettes for use by him in the manufacture of cigarettes), the following taxes are imposed, and shall be collected and paid as provided in this chapter:
        (1) On fifty (50) papers or less, a tax of one-half cent ($0.005).
        (2) On more than fifty (50) papers but not more than one hundred (100) papers, a tax of one cent ($0.01).
        (3) On more than one hundred (100) papers, one-half cent ($0.005) for each fifty (50) papers or fractional part thereof.
        (4) On tubes, one cent ($0.01) for each fifty (50) tubes or fractional part thereof.
SOURCE: IC 6-7-1-17; (07)MO100803.4. -->     SECTION 4. IC 6-7-1-17 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 17. (a) Distributors who hold certificates and retailers shall be agents of the state in the collection of the taxes imposed by this chapter and the amount of the tax levied, assessed, and imposed by this chapter on cigarettes sold, exchanged, bartered, furnished, given away, or otherwise disposed of by distributors or to retailers. Distributors who hold certificates shall be agents of the department to affix the required stamps and shall be entitled to purchase the stamps from the department at a discount of one and two-tenths seven tenths percent (1.2%) (0.7%) of the amount of the tax stamps purchased, as compensation for their labor and expense.
    (b) The department may permit distributors who hold certificates and who are admitted to do business in Indiana to pay for revenue stamps within thirty (30) days after the date of purchase. However, the privilege is extended upon the express condition that:
        (1) except as provided in subsection (c), a bond or letter of credit satisfactory to the department, in an amount not less than the sales price of the stamps, is filed with the department; and
        (2) proof of payment is made of all local property, state income, and excise taxes for which any such distributor may be liable. The bond or letter of credit, conditioned to secure payment for the stamps, shall be executed by the distributor as principal and by a corporation duly authorized to engage in business as a surety company or financial institution in Indiana.
    (c) If a distributor has at least five (5) consecutive years of good credit standing with the state, the distributor shall not be required to post a bond or letter of credit under subsection (b).
SOURCE: IC 6-7-1-28.1; (07)MO100803.5. -->     SECTION 5. IC 6-7-1-28.1 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 28.1. The taxes, registration fees, fines, or penalties collected under this chapter shall be deposited in the following manner:
        (1) Six Three and six-tenths eighty-nine hundredths percent (6.6%) (3.89%) of the money shall be deposited in a fund to be known as the cigarette tax fund.
        (2) Ninety-four Fifty-five hundredths percent (0.94%) (0.55%) of the money shall be deposited in a fund to be known as the mental health centers fund.
        (3) Eighty-three Forty-nine and ninety-seven fifty hundredths percent (83.97%) (49.50%) of the money shall be deposited in the state general fund.
        (4) Eight Five and forty-nine hundredths percent (8.49%) (5.0%) of the money shall be deposited into the pension relief fund established in IC 5-10.3-11.
         (5) Forty-one and six hundredths percent (41.06%) of the money shall be deposited into the health coverage for children

and adults fund established by IC 12-17.9-14-1.
The money in the cigarette tax fund, the mental health centers fund, the health coverage for children and adults fund, or the pension relief fund at the end of a fiscal year does not revert to the state general fund. However, if in any fiscal year, the amount allocated to a fund under subdivision (1) or (2) is less than the amount received in fiscal year 1977, then that fund shall be credited with the difference between the amount allocated and the amount received in fiscal year 1977, and the allocation for the fiscal year to the fund under subdivision (3) shall be reduced by the amount of that difference.

SOURCE: IC 12-7-2-15.3; (07)MO100803.6. -->     SECTION 6. IC 12-7-2-15.3 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 15.3. "Application agent", for purposes of IC 12-17.9, has the meaning set forth in IC 12-17.9-1-2.
SOURCE: IC 12-7-2-28; (07)MO100803.7. -->     SECTION 7. IC 12-7-2-28, AS AMENDED BY P.L.145-2006, SECTION 37, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 28. "Child" means the following:
        (1) For purposes of IC 12-17.2, an individual who is less than eighteen (18) years of age.
         (2) For purposes of IC 12-17.9, the meaning set forth in IC 12-17.9-1-3.
        (2) (3) For purposes of IC 12-26, the meaning set forth in IC 31-9-2-13(d).
SOURCE: IC 12-7-2-76.4; (07)MO100803.8. -->     SECTION 8. IC 12-7-2-76.4 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 76.4. "Employer sponsored health coverage" has the meaning set forth in IC 12-17.9-1-4.
SOURCE: IC 12-7-2-91; (07)MO100803.9. -->     SECTION 9. IC 12-7-2-91 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 91. "Fund" means the following:
        (1) For purposes of IC 12-12-1-9, the fund described in IC 12-12-1-9.
        (2) For purposes of IC 12-13-8, the meaning set forth in IC 12-13-8-1.
        (3) For purposes of IC 12-15-20, the meaning set forth in IC 12-15-20-1.
        (4) For purposes of IC 12-17-12, the meaning set forth in IC 12-17-12-4.
        (5) For purposes of IC 12-17.6, the meaning set forth in IC 12-17.6-1-3.
         (6) For purposes of IC 12-17.9, the meaning set forth in IC 12-17.9-1-5.
        (6) (7) For purposes of IC 12-18-4, the meaning set forth in IC 12-18-4-1.
        (7) (8) For purposes of IC 12-18-5, the meaning set forth in IC 12-18-5-1.
        (8) (9) For purposes of IC 12-19-7, the meaning set forth in IC 12-19-7-2.
        (9) (10) For purposes of IC 12-23-2, the meaning set forth in IC 12-23-2-1.
        (10) (11) For purposes of IC 12-23-18, the meaning set forth in IC 12-23-18-4.
        (11) (12) For purposes of IC 12-24-6, the meaning set forth in IC 12-24-6-1.
        (12) (13) For purposes of IC 12-24-14, the meaning set forth in IC 12-24-14-1.
        (13) (14) For purposes of IC 12-30-7, the meaning set forth in IC 12-30-7-3.
SOURCE: IC 12-7-2-134; (07)MO100803.10. -->     SECTION 10. IC 12-7-2-134 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 134. "Office" means the following:
        (1) Except as provided in subdivisions (2) and (3), the office of Medicaid policy and planning established by IC 12-8-6-1.
        (2) For purposes of IC 12-10-13, the meaning set forth in IC 12-10-13-4.
        (3) For purposes of IC 12-17.6, the meaning set forth in IC 12-17.6-1-4.
         (4) For purposes of IC 12-17.9, the meaning set forth in IC 12-17.9-1-6.
SOURCE: IC 12-7-2-146; (07)MO100803.11. -->     SECTION 11. IC 12-7-2-146 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 146. "Program" refers to the following:
        (1) For purposes of IC 12-10-7, the adult guardianship services program established by IC 12-10-7-5.
        (2) For purposes of IC 12-10-10, the meaning set forth in IC 12-10-10-5.
        (3) For purposes of IC 12-17.6, the meaning set forth in IC 12-17.6-1-5.
         (4) For purposes of IC 12-17.9, the meaning set forth in IC 12-17.9-1-7.
SOURCE: IC 12-7-2-164; (07)MO100803.12. -->     SECTION 12. IC 12-7-2-164 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 164. "Resident" has the following meaning:
        (1) For purposes of IC 12-10-15, the meaning set forth in IC 12-10-15-5.
        (2) For purposes of IC 12-16, except IC 12-16-1, an individual who has actually resided in Indiana for at least ninety (90) days.
         (3) For purposes of IC 12-17.9, the meaning set forth in IC 12-17.9-1-8.
        (3) (4) For purposes of IC 12-20-8, the meaning set forth in IC 12-20-8-1.
        (4) (5) For purposes of IC 12-24-5, the meaning set forth in

IC 12-24-5-1.

SOURCE: IC 12-7-2-196.7; (07)MO100803.13. -->     SECTION 13. IC 12-7-2-196.7 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 196.7. "Usual and customary or reasonable charge", for purposes of IC 12-17.9, has the meaning set forth in IC 12-17.9-1-9.
SOURCE: IC 12-15-2-15.8; (07)MO100803.14. -->     SECTION 14. IC 12-15-2-15.8 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 15.8. An individual who is less than nineteen (19) years of age and who is eligible for Medicaid under section 14 of this chapter is eligible to receive Medicaid until the earlier of the following:
        (1) The end of a period of twelve (12) consecutive months following a determination of the individual's eligibility for Medicaid.
        (2) The individual becomes nineteen (19) years of age.

SOURCE: IC 12-15-12-12; (07)MO100803.15. -->     SECTION 15. IC 12-15-12-12 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 12. (a) For a managed care program or demonstration project established or authorized by the office, or established or authorized by another entity or agency working in conjunction with or under agreement with the office, the office must provide for payment to providers in the managed care program that the office finds is reasonable and adequate to meet the costs that must be incurred by efficiently and economically operated providers in order to:
        (1) provide care and services in conformity with applicable state and federal laws, regulations, and quality and safety standards; and
        (2) ensure that individuals eligible for medical assistance under the managed care program or demonstration project have reasonable access (taking into account geographic location and reasonable travel time) to the services provided by the managed care program.
     (b) In addition to the requirements under subsection (a), the office shall establish payments to a physician who:
        (1) is licensed under IC 25-22.5;
        (2) is a primary care provider; and
        (3) provides physician services under a managed care program or demonstration project established or authorized by the office;
that represent a fifty percent (50%) increase of the Medicaid reimbursement rates used January 1, 2007.

SOURCE: IC 12-15-13-2; (07)MO100803.16. -->     SECTION 16. IC 12-15-13-2 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 2. (a) Except as provided in IC 12-15-14 and IC 12-15-15, payments to Medicaid providers must be:
        (1) consistent with efficiency, economy, and quality of care; and
        (2) sufficient to enlist enough providers so that care and services are available under Medicaid, at least to the extent that such care and services are available to the general population in the geographic area.
    (b) If federal law or regulations specify reimbursement criteria, payment shall be made in compliance with those criteria.
     (c) In addition to the requirements under subsection (a), the office shall establish payments to a physician who:
        (1) is licensed under IC 25-22.5;
        (2) is a primary care provider; and
        (3) provides physician services under a fee for service program or the Medicaid primary care case management program;
that represent a fifty percent (50%) increase of the Medicaid reimbursement rates used January 1, 2007.

SOURCE: IC 12-17.6-2-3; (07)MO100803.17. -->     SECTION 17. IC 12-17.6-2-3 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 3. (a) To the greatest extent possible, the office shall use the same:
        (1) eligibility determination;
        (2) enrollment;
        (3) provider networks; and
        (4) claims payment systems;
as are used by the Medicaid managed care program for children.
     (b) The office shall establish payments to a physician who:
        (1) is licensed under IC 25-22.5;
        (2) is a primary care provider; and
        (3) provides physician services under the program;
that are equal to payments under the Medicaid program under IC 12-15.

SOURCE: IC 12-17.6-3-2; (07)MO100803.18. -->     SECTION 18. IC 12-17.6-3-2 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 2. (a) To be eligible to enroll in the program, a child must meet the following requirements:
        (1) The child is less than nineteen (19) years of age.
        (2) The child is a member of a family with an annual income of:
            (A) more than one hundred fifty percent (150%); and
            (B) not more than two three hundred percent (200%); (300%);
        of the federal income poverty level.
        (3) The child is a resident of Indiana.
        (4) The child meets all eligibility requirements under Title XXI of the federal Social Security Act.
        (5) The child's family agrees to pay any cost sharing amounts required by the office.
    (b) The office may adjust eligibility requirements based on available program resources under rules adopted under IC 4-22-2.
SOURCE: IC 12-17.6-3-3; (07)MO100803.19. -->     SECTION 19. IC 12-17.6-3-3 IS AMENDED TO READ AS

FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 3. (a) Subject to subsection (b), a child who is eligible for the program shall receive services from the program until the earlier of the following:
        (1) The child becomes financially ineligible. end of a period of twelve (12) consecutive months following the determination of the child's eligibility for the program.
        (2) The child becomes nineteen (19) years of age.
    (b) Subsection (a) applies only if the child and the child's family comply with enrollment requirements.

SOURCE: IC 12-17.9; (07)MO100803.20. -->     SECTION 20. IC 12-17.9 IS ADDED TO THE INDIANA CODE AS A NEW ARTICLE TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]:
    ARTICLE 17.9. HEALTH COVERAGE FOR CHILDREN AND ADULTS
    Chapter 1. Definitions
    Sec. 1. The definitions in this chapter apply throughout this article.
    Sec. 2. "Application agent" means an organization or individual, including a licensed health care provider, a school, a youth service agency, an employer, a labor union, a local chamber of commerce, a community organization, or another organization, that is approved by the office to assist in enrolling children in the program.
    Sec. 3. "Child" means an individual who is less than nineteen (19) years of age.
    Sec. 4. "Employer sponsored health coverage" means coverage that is available through an employer.
    Sec. 5. "Fund" refers to the health coverage for children and adults fund established by IC 12-17.9-14-1.
    Sec. 6. "Office" refers to the office of the children's health insurance program established by IC 12-17.6-2-1.
    Sec. 7. "Program" refers to the health coverage for children program created by IC 12-17.9-2-1.
    Sec. 8. "Resident" means an individual who is:
        (1) in Indiana for a purpose other than a temporary or transitory purpose during the taxable year; or
        (2) domiciled in Indiana, but is absent from Indiana for a temporary or transitory purpose during the taxable year.
    Sec. 9. "Usual and customary or reasonable charge" means a charge for health care services consistent with the average charge for similar health care services furnished by similar health care providers in a particular geographic area.
    Chapter 2. Health Coverage for Children Program
    Sec. 1. The health coverage for children program is created.
    Sec. 2. The office shall administer the program.
    Sec. 3. The office has the same powers and authority to administer the program as the powers and duties available to the

office under IC 12-17.6.
    Sec. 4. The office shall coordinate the program with existing children's health programs operated by state agencies.
    Chapter 3. Eligibility
    Sec. 1. To be eligible for the program, an individual must be a child:
        (1) who is a resident;
        (2) who is ineligible for coverage under the:
            (A) children's health insurance program under IC 12-17.6; or
            (B) Medicaid program under IC 12-15; and
        (3) to whom one (1) of the following applies:
            (A) The child has been without health coverage for a period of at least six (6) months.
            (B) The child previously was covered by affordable dependent health coverage through a parent's employment and is no longer covered due to the parent's loss of employment.
            (C) The child is a newborn for whom affordable private health coverage or employer sponsored health coverage is not available.
            (D) The child, less than six (6) months before applying for coverage under the program, lost coverage under the children's health insurance program under IC 12-17.6 or the Medicaid program under IC 12-15.
    Sec. 2. (a) An administrator licensed under IC 27-1-25, an insurer that holds a certificate of authority under IC 27 to issue or deliver a policy of accident and sickness insurance (as defined in IC 27-8-5-1), and a health maintenance organization that holds a certificate of authority under IC 27-13 shall provide health coverage data match information to the office for the use of the office in determining an individual's eligibility for the program.
    (b) Personal information contained in the data provided to the office under subsection (a) is confidential and may not be disclosed or used for any other purpose.
    (c) The office, in collaboration with the department of insurance, shall adopt rules under IC 4-22-2:
        (1) to govern the exchange of information under this section; and
        (2) that are consistent with laws relating to the confidentiality and privacy of personal information, including the federal Health Insurance Portability and Accountability Act.
    Sec. 3. The office shall:
        (1) monitor the availability and retention of employer sponsored health coverage; and
        (2) modify a period specified in section 1(3) of this chapter as necessary to promote retention of private health coverage or

employer sponsored health coverage and timely access to health care services. However, the period described in section 1(3)(A) of this chapter may not be less than six (6) months.
    Sec. 4. The office may consider the affordability of dependent health coverage in making a determination concerning whether employer sponsored health coverage is available upon reemployment of a child's parent described in section 1(3)(B) of this chapter.
    Sec. 5. A child who is eligible for the program under this chapter remains eligible for twelve (12) months if the child:
        (1) remains a resident;
        (2) is less than nineteen (19) years of age; and
        (3) is not excluded under section 6 of this chapter.
    Sec. 6. (a) A child is not eligible for coverage under the program if:
        (1) the premium required under IC 12-17.9-8 has not been timely paid; or
        (2) the child is an inpatient in a public institution or an institution for mental illness.
    (b) If a premium described in subsection (a)(1) is not paid:
        (1) the liability of the program is limited to benefits received under the program for the period for which premiums have been paid;
        (2) the child is ineligible for reenrollment in the program for at least three (3) months;
        (3) reenrollment in the program must be completed before the next covered medical visit; and
        (4) the first month's premium after reenrollment must be paid before the next covered medical visit.
    Chapter 4. Enrollment in Program
    Sec. 1. The office shall develop procedures to allow application agents to assist in enrolling children in the program or other children's health programs.
    Sec. 2. At the office's discretion, technical assistance payments may be made for approved applications facilitated by an application agent.
    Chapter 5. Program Outreach and Marketing
    Sec. 1. The office may provide grants to application agents and other community based organizations to educate the public about the availability of the program.
    Sec. 2. The office shall adopt rules under IC 4-22-2 regarding performance standards and outcome measures expected of organizations that are awarded grants under this chapter, including penalties for nonperformance of contract standards.
    Chapter 6. Health Coverage for Children
    Sec. 1. The office shall purchase or provide for eligible children health coverage, except for nonemergency transportation, that is

identical to the coverage provided for children under the children's health insurance program under IC 12-17.6.
    Sec. 2. If cost effective, the office may, as an alternative to the coverage required under section 1 of this chapter, offer subsidies toward the cost of private health coverage or employer sponsored health coverage.
    Sec. 3. The office may offer to a child who would be eligible for the program, but does not meet at least one (1) of the requirements of IC 12-17.9-3-1(3), the following:
        (1) Partial coverage if the child is covered under a private, high deductible health coverage plan.
        (2) A limited package of benefits if the child is covered under private health coverage or employer sponsored health coverage that does not provide dental, vision, or other particular benefits.
    Sec. 4. (a) Subject to subsection (b), the office has sole discretion to determine the:
        (1) content and availability of;
        (2) terms of eligibility for; and
        (3) efficacy and cost effectiveness of providing;
benefits described in sections 2 and 3 of this chapter.
    (b) In making the determination under subsection (a), the office shall consider the need to promote retention of private health coverage and employer sponsored health coverage.
    Sec. 5. The office shall ensure that reimbursement under the program to a physician who is licensed under IC 25-22.5 and is a primary care provider is not less than the reimbursement rate on January 1, 2007, under the Medicaid program under IC 12-15 plus fifty percent (50%).
    Sec. 6. The parent or other individual who is responsible for a child who participates in the program shall make an annual contribution to the health incentives account established under IC 12-17.9-14-7 of not more than two percent (2%) of the individual's annual income, according to a contribution schedule adopted by the office in rules under IC 4-22-2.
    Chapter 7. Health Coverage for Adults Plan
    Sec. 1. The office shall establish a plan through which the office purchases or provides health coverage to individuals who:
        (1) are residents;
        (2) are at least nineteen (19) years of age; and
        (3) do not have coverage for health care services.
    Sec. 2. The office shall design the plan established under section 1 of this chapter to make health coverage available as follows:
        (1) To an individual described in section 1 of this chapter who has a family income equal to not more than one hundred percent (100%) of the federal income poverty level, health coverage with no premium or cost sharing amounts to be paid

by the individual.
        (2) To an individual described in section 1 of this chapter who has a family income equal to more than one hundred percent (100%) but not more than three hundred percent (300%) of the federal income poverty level, health coverage with premium and cost sharing amounts to be paid by the individual according to a sliding scale based on family income and established by the office in rules adopted under IC 4-22-2.
        (3) To an individual described in section 1 of this chapter who has a family income equal to more than three hundred percent (300%) of the federal income poverty level, health coverage with all premium and cost sharing amounts to be paid by the individual.
    Sec. 3. (a)The health coverage made available under this chapter shall include benefits determined by the office.
    (b) The office may not allow the imposition of treatment limitations or financial requirements on the coverage of services for a mental illness under the plan if similar treatment limitations or financial requirements are not imposed on coverage for services for other illnesses under the plan.
    Sec. 4. If cost effective, the office may provide subsidies toward the cost of private health coverage or employer sponsored health coverage.
    Sec. 5. The office shall ensure that reimbursement under the plan to a physician who is licensed under IC 25-22.5 and is a primary care provider is not less than the reimbursement rate on January 1, 2007, under the Medicaid program under IC 12-15 plus fifty percent (50%).
    Sec. 6. An individual who participates in coverage under section 2(2) or 2(3) of this chapter shall make an annual contribution to the health incentives account established under IC 12-17.9-14-7 of not more than two percent (2%) of the individual's annual income, according to a contribution schedule adopted by the office in rules under IC 4-22-2.
    Chapter 8. Cost Sharing
    Sec. 1. (a) The office shall adopt rules under IC 4-22-2 to establish cost sharing requirements, including:
        (1) copayments and coinsurance for health care services (other than well baby or well child health care services and age appropriate immunizations required by law); and
        (2) monthly premiums for coverage under the program;
for children receiving coverage described in IC 12-17.9-6-1.
    (b) Cost sharing requirements established under subsection (a) must be determined under a sliding scale based on family income.
    (c) The office may periodically modify the cost sharing requirements established under this section.
    Sec. 2. Children and adults who are enrolled in private health

coverage or employer sponsored health coverage for which a subsidy is provided as described in IC 12-17.9-6-2 or IC 12-17.9-7-4 are subject to the cost sharing provisions stated in the private health coverage or employer sponsored health coverage plan.
    Sec. 3. Notwithstanding any other law, rates paid by the office for coverage under the program or under the plan established under IC 12-17.9-7-1 may not be considered in determining a usual and customary or reasonable charge.
    Chapter 9. Study
    Sec. 1. The office shall conduct a study that does the following:
        (1) Establishes estimates of the following that are calculated using data compiled from particular regions of Indiana:
            (A) Number of children who have health coverage.
            (B) Number of children who do not have health coverage.
            (C) Number of children who are eligible for Medicaid under IC 12-15 or the children's health insurance program under IC 12-17.6.
            (D) Number of children who are enrolled in Medicaid under IC 12-15 or the children's health insurance program under IC 12-17.6.
            (E) Number of children who have access to employer sponsored health coverage.
            (F) Number of children who are enrolled in employer sponsored health coverage.
        (2) Surveys families:
            (A) whose children have access to employer sponsored health coverage; and
            (B) who decline the coverage described in clause (A);
        concerning the reason for declining the coverage.
        (3) Ascertains, for the population of children accessing employer sponsored health coverage or who have access to the coverage, the:
            (A) comprehensiveness of coverage available;
            (B) cost sharing associated with the coverage; and
            (C) amount of cost sharing currently required of employees.
        (4) Measures health outcomes or other benefits for children using the program.
        (5) Analyzes the effects of enrollment in the program on use of health care services by children after enrollment compared to use of health care services before enrollment.
    Sec. 2. The study described in section 1 of this chapter must be conducted annually and must compare the data for each year with the data for the immediately preceding year.
    Sec. 3. The office shall submit the results of the study conducted under this chapter to the governor and, in an electronic format under IC 5-14-6, to the legislative council as follows:


        (1) Preliminary results, not later than July 1, 2009.
        (2) Final results, not later than July 1, 2011.
    Chapter 10. Consultation With Interested Parties
    Sec. 1. The office shall present details regarding implementation of the program to the select joint commission on Medicaid oversight established by IC 2-5-26-3.
    Sec. 2. The select joint commission on Medicaid oversight serves as the forum for health care providers, advocates, consumers, and other interested parties to advise the office with respect to the program.
    Chapter 11. Federal Financial Participation
    Sec. 1. The office, in cooperation with the office of Medicaid policy and planning established by IC 12-8-6-1, shall request necessary state plan amendments or waivers of federal requirements to allow receipt of federal funds to implement the program.
    Sec. 2. The failure of a responsible federal agency to approve a state plan amendment or waiver requested under section 1 of this chapter does not prevent the implementation of this article.
    Chapter 12. Rulemaking
    Sec. 1. (a) The office shall adopt under IC 4-22-2 rules necessary to implement this article, including rules:
        (1) regarding annual eligibility renewals;
        (2) providing for reenrollment, grace periods, notice requirements, and hearing procedures related to a determination of ineligibility under IC 12-17.9-3-6(a)(1) or IC 12-17.9-3-6(b); and
        (3) used to determine availability and affordability of private health coverage or employer sponsored health coverage, including consideration of:
            (A) the percentage of income needed to purchase child or family health coverage;
            (B) the availability of employer subsidies; and
            (C) other relevant factors.
    (b) The office may adopt emergency rules under IC 4-22-2-37.1 to implement this article.
    Chapter 13. Subrogation
    Sec. 1. The program is subrogated to all claims, demands, and causes of action for injuries to an individual covered under the program for all amounts paid by the program from the time of injury of the individual to the date of recovery on the claim, demand, or cause of action.
    Chapter 14. Health Coverage for Children and Adults Fund
    Sec. 1. The health coverage for children and adults fund is established to provide funding for:
        (1) the health coverage for children program created by IC 12-17.9-2-1;
        (2) a health coverage for adults plan established under IC 12-17.9-7-1; and
        (3) the annual deposit to the health incentives account under section 7(c)(2) of this chapter.
The fund shall be administered by the office.
    Sec. 2. The fund consists of the following:
        (1) Money deposited in the fund under IC 6-7-1-28.1.
        (2) Donations to the fund.
        (3) Contributions to the health incentives account as described in section 7(c) of this chapter.
        (4) Appropriations made by the general assembly.
    Sec. 3. The expenses of administering the fund shall be paid from money in the fund.
    Sec. 4. The treasurer of state shall invest the money in the fund not currently needed to meet the obligations of the fund in the same manner as other public money may be invested. (Interest that accrues from these investments shall be deposited in the fund.)
    Sec. 5. Money in the fund at the end of a state fiscal year does not revert to the state general fund.
    Sec. 6. There is annually appropriated to the office the money in the fund for the use of the office in carrying out the purposes described in section 1 of this chapter.
    Sec. 7. (a) The health incentives account is established within the fund to provide funding only for the payment of the following for individuals who participate in the program established by IC 12-17.9-2-1 or the plan established under IC 12-17.9-7-1:
        (1) Copayments.
        (2) Cost sharing requirements.
        (3) Wellness programs.
        (4) Other preventive measures as determined by the office.
    (b) The account shall be administered by the office.
    (c) The account consists of the following:
        (1) Annual contributions to the account as described in IC 12-17.9-6-6 and IC 12-17.9-7-6.
        (2) An amount that is:
            (A) annually deposited in the account from the fund; and
            (B) equal to one hundred percent (100%) of the amount of the contributions to the account during the previous year.
    (d) The expenses of administering the account shall be paid from money in the account.
    (e) The treasurer of state shall invest the money in the account not currently needed to meet the obligations of the account in the same manner as other public money may be invested. (Interest that accrues from these investments shall be deposited in the account.)
    (f) Money in the account at the end of a state fiscal year does not revert to the state general fund.
    (g) There is annually appropriated to the office the money in the

account for the use of the office in carrying out the purposes described in subsection (a).

SOURCE: IC 16-47-1-4; (07)MO100803.21. -->     SECTION 21. IC 16-47-1-4 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 4. (a) The department, with the approval of the budget agency, shall establish, implement, and maintain an aggregate prescription drug purchasing program through which terms are negotiated related to the purchase of prescription drugs by:
        (1) an entity described in section 5(a) or 5(b) of this chapter; or
        (2) an individual who is covered under a health benefit plan that includes a prescription drug benefit.
    (b) The budget agency may contract with a pharmacy benefit manager or other person to conduct the negotiations of the program established under subsection (a).
    (c) The terms and conditions of the program are subject to the approval of the budget agency.
SOURCE: IC 16-47-1-5; (07)MO100803.22. -->     SECTION 22. IC 16-47-1-5 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 5. (a) The following shall participate in the program:
        (1) The department, for a health benefit plan:
            (A) described in section 2(1) or 2(2) or 2(3) of this chapter; and
            (B) that provides coverage for prescription drugs.
        (2) A state educational institution, for a health benefit plan:
            (A) described in section 2(4) section 2(3) of this chapter; and
            (B) that provides coverage for prescription drugs.
        unless the budget agency determines that the state educational institution's participation in the program would not result in an overall financial benefit to the state educational institution.
    (b) The following may participate in the program:
        (1) (3) A state agency other than the department that:
            (A) purchases prescription drugs; or
            (B) arranges for the payment of the cost of prescription drugs.
        (2) (4) A local unit (as defined in IC 5-10-8-1).
        (3) (5) The Indiana comprehensive health insurance association established under IC 27-8-10.
    (c) (b) The state Medicaid program may not participate in the program under this chapter.
SOURCE: IC 27-8-5-2; (07)MO100803.23. -->     SECTION 23. IC 27-8-5-2, AS AMENDED BY P.L.125-2005, SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 2. (a) No individual policy of accident and sickness insurance shall be delivered or issued for delivery to any person in this state unless it complies with each of the following:
        (1) The entire money and other considerations for the policy are expressed in the policy.
        (2) The time at which the insurance takes effect and terminates is

expressed in the policy.
        (3) The policy purports to insure only one (1) person, except that a policy may must insure, originally or by subsequent amendment, upon the application of any member of a family who shall be deemed the policyholder and who is at least eighteen (18) years of age, any two (2) or more eligible members of that family, including husband, wife, dependent children, or any children under a specified age, which shall not exceed nineteen (19) who are less than twenty-four (24) years of age, and any other person dependent upon the policyholder.
        (4) The style, arrangement, and overall appearance of the policy give no undue prominence to any portion of the text, and unless every printed portion of the text of the policy and of any endorsements or attached papers is plainly printed in lightface type of a style in general use, the size of which shall be uniform and not less than ten point with a lower-case unspaced alphabet length not less than one hundred and twenty point (the "text" shall include all printed matter except the name and address of the insurer, name or title of the policy, the brief description if any, and captions and subcaptions).
        (5) The exceptions and reductions of indemnity are set forth in the policy and, except those which are set forth in section 3 of this chapter, are printed, at the insurer's option, either included with the benefit provision to which they apply, or under an appropriate caption such as "EXCEPTIONS", or "EXCEPTIONS AND REDUCTIONS", provided that if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of such exception or reduction shall be included with the benefit provision to which it applies.
        (6) Each such form of the policy, including riders and endorsements, shall be identified by a form number in the lower left-hand corner of the first page of the policy.
        (7) The policy contains no provision purporting to make any portion of the charter, rules, constitution, or bylaws of the insurer a part of the policy unless such portion is set forth in full in the policy, except in the case of the incorporation of or reference to a statement of rates or classification of risks, or short-rate table filed with the commissioner.
        (8) If an individual accident and sickness insurance policy or hospital service plan contract or medical service plan contract provides that hospital or medical expense coverage of a dependent child terminates upon attainment of the limiting age for dependent children specified in such policy or contract, the policy or contract must also provide that attainment of such limiting age does not operate to terminate the hospital and medical coverage of such child while the child is and continues to be both:


            (A) incapable of self-sustaining employment by reason of mental retardation or mental or physical disability; and
            (B) chiefly dependent upon the policyholder for support and maintenance.
        Proof of such incapacity and dependency must be furnished to the insurer by the policyholder within thirty-one (31) days of the child's attainment of the limiting age. The insurer may require at reasonable intervals during the two (2) years following the child's attainment of the limiting age subsequent proof of the child's disability and dependency. After such two (2) year period, the insurer may require subsequent proof not more than once each year. The foregoing provision shall not require an insurer to insure a dependent who is a mentally retarded or mentally or physically disabled child where such dependent does not satisfy the conditions of the policy provisions as may be stated in the policy or contract required for coverage thereunder to take effect. In any such case the terms of the policy or contract shall apply with regard to the coverage or exclusion from coverage of such dependent. This subsection applies only to policies or contracts delivered or issued for delivery in this state more than one hundred twenty (120) days after August 18, 1969.
    (b) If any policy is issued by an insurer domiciled in this state for delivery to a person residing in another state, and if the official having responsibility for the administration of the insurance laws of such other state shall have advised the commissioner that any such policy is not subject to approval or disapproval by such official, the commissioner may by ruling require that such policy meet the standards set forth in subsection (a) and in section 3 of this chapter.
    (c) An insurer may issue a policy described in this section in electronic or paper form. However, the insurer shall:
        (1) inform the insured that the insured may request the policy in paper form; and
        (2) issue the policy in paper form upon the request of the insured.
SOURCE: IC 27-8-5-28; (07)MO100803.24. -->     SECTION 24. IC 27-8-5-28 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 28. A policy of accident and sickness insurance may not be issued, delivered, amended, or renewed, unless the policy provides for coverage of a child of the policyholder or certificate holder, upon request of the policyholder or certificate holder, until the date that the child becomes twenty-four (24) years of age.
SOURCE: IC 27-13-7-3; (07)MO100803.25. -->     SECTION 25. IC 27-13-7-3 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 3. (a) A contract referred to in section 1 of this chapter must clearly state the following:
        (1) The name and address of the health maintenance organization.
        (2) Eligibility requirements.
        (3) Benefits and services within the service area.
        (4) Emergency care benefits and services.
        (5) Any out-of-area benefits and services.
        (6) Copayments, deductibles, and other out-of-pocket costs.
        (7) Limitations and exclusions.
        (8) Enrollee termination provisions.
        (9) Any enrollee reinstatement provisions.
        (10) Claims procedures.
        (11) Enrollee grievance procedures.
        (12) Continuation of coverage provisions.
        (13) Conversion provisions.
        (14) Extension of benefit provisions.
        (15) Coordination of benefit provisions.
        (16) Any subrogation provisions.
        (17) A description of the service area.
        (18) The entire contract provisions.
        (19) The term of the coverage provided by the contract.
        (20) Any right of cancellation of the group or individual contract holder.
        (21) Right of renewal provisions.
        (22) Provisions regarding reinstatement of a group or an individual contract holder.
        (23) Grace period provisions.
        (24) A provision on conformity with state law.
        (25) A provision or provisions that comply with the:
            (A) guaranteed renewability; and
            (B) group portability;
        requirements of the federal Health Insurance Portability and Accountability Act of 1996 (26 U.S.C. 9801(c)(1)).
         (26) That the contract provides, upon request of the subscriber, coverage for a child of the subscriber until the date the child becomes twenty-four (24) years of age.
    (b) For purposes of subsection (a), an evidence of coverage which is filed with a contract may be considered part of the contract.
SOURCE: ; (07)MO100803.26. -->     SECTION 26. [EFFECTIVE JULY 1, 2007] (a) As used in this SECTION, "task force" refers to the healthy Indiana task force established by subsection (b).
    (b) The healthy Indiana task force is established to:
        (1) study and provide guidance to the state concerning expanding coverage for health care services for all children in Indiana;
        (2) develop methods to increase availability of affordable coverage for health care services for all Indiana residents; and
        (3) make recommendations to the legislative council.
    (c) The task force:
        (1) shall operate under the policies governing study

committees adopted by the legislative council; and
        (2) may request funding from the legislative council to hire consultants.
    (d) The affirmative votes of a majority of the voting members appointed to the task force are required for the task force to take action on any measure, including final reports.
    (e) The task force consists of the following voting members:
        (1) Eight (8) members appointed by the speaker of the house of representatives, three (3) of whom are appointed based on the recommendation of the minority leader of the house of representatives and none of whom are legislators.
        (2) Eight (8) members appointed by the president pro tempore of the senate, three (3) of whom are appointed based on the recommendation of the minority leader of the senate and none of whom are legislators.
    (f) In making appointments under subsection (e), the speaker of the house of representatives and the president pro tempore of the senate shall each appoint one (1) member representing each of the following:
        (1) Hospitals.
        (2) Insurance companies.
        (3) Primary care providers.
        (4) Health professionals who are not primary care providers.
        (5) Minority health concern experts.
        (6) Business.
        (7) Organized labor.
        (8) Consumers.
    (g) The chairperson of the legislative council shall appoint the chairperson of the task force.
    (h) The task force shall report findings and make recommendations in a final report to the legislative council in an electronic format under IC 5-14-6 before November 1, 2008.
    (i) The task force expires November 1, 2008, unless the legislative council extends the work of the task force until November 1, 2009.
    (j) If the legislative council extends the work of the task force until November 1, 2009, the task force shall submit additional findings and recommendations in a final report before November 1, 2009.
    (k) This SECTION expires January 1, 2010.

SOURCE: ; (07)MO100803.27. -->     SECTION 27. [EFFECTIVE JULY 1, 2007] The state personnel department shall implement the requirements of IC 5-10-8-6.8, as added by this act, not later than July 1, 2008.
SOURCE: ; (07)MO100803.28. -->     SECTION 28. [EFFECTIVE JULY 1, 2007] IC 6-3.1-31, as added by this act, applies to taxable years beginning after December 31, 2007.
SOURCE: ; (07)MO100803.29. -->     SECTION 29. [EFFECTIVE JULY 1, 2007] Notwithstanding

IC 6-7-1-14, revenue stamps paid for before July 1, 2007, and in the possession of a distributor may be used after June 30, 2007, only if the full amount of the tax imposed by IC 6-7-1-12, as effective after June 30, 2007, and as amended by this act, is remitted to the department of state revenue under the procedures prescribed by the department.

SOURCE: ; (07)MO100803.30. -->     SECTION 30. [EFFECTIVE UPON PASSAGE] (a) As used in this SECTION, "office" refers to the office of Medicaid policy and planning established by IC 12-8-6-1.
    (b) Before July 1, 2007, the office shall apply to the United States Department of Health and Human Services for approval to amend the state Medicaid plan to include services for an individual who:
        (1) is:
            (A) at least eighteen (18) years of age; and
            (B) less than twenty-two (22) years of age; and
        (2) was receiving foster care when the individual became:
            (A) eighteen (18) years of age; or
            (B) emancipated.
    (c) If the office determines a Medicaid waiver is necessary, before July 1, 2007, the office shall apply to the United States Department of Health and Human Services for approval of a Medicaid waiver to fund services for an individual described in subsection (b).
    (d) The office may not implement the amendment to the state Medicaid plan until the office files an affidavit with the governor attesting that the amendment applied for under this SECTION is in effect. The office shall file the affidavit under this subsection not more than five (5) days after the office is notified that the amendment is approved.
    (e) The office may not implement the Medicaid waiver until the office files an affidavit with the governor attesting that the waiver applied for under this SECTION is in effect. The office shall file the affidavit under this subsection not more than five (5) days after the office is notified that the waiver is approved.
    (f) If the office receives approval to amend the state Medicaid plan under this SECTION from the United States Department of Health and Human Services and the governor receives the affidavit filed under subsection (d), the office shall implement the amendment not more than five (5) days after the governor receives the affidavit.
    (g) If the office receives approval for the Medicaid waiver under this SECTION from the United States Department of Health and Human Services and the governor receives the affidavit filed under subsection (e), the office shall implement the waiver not more than five (5) days after the governor receives the affidavit.

SOURCE: ; (07)MO100803.31. -->     SECTION 31. [EFFECTIVE UPON PASSAGE] (a) As used in this

SECTION, "office" refers to the office of Medicaid policy and planning established by IC 12-8-6-1.
    (b) The office shall apply to the United States Department of Health and Human Services for any amendment to the state Medicaid plan or demonstration waiver that is needed to implement IC 12-17.6-3-2, as amended by this act, or IC 12-17.9, as added by this act.
    (c) The office may not implement the amendment or waiver until the office files an affidavit with the governor attesting that the amendment or waiver applied for under this SECTION is in effect. The office shall file the affidavit under this subsection not more than five (5) days after the office is notified that the amendment or waiver is approved.
    (d) If the office receives approval for the amendment or waiver under this SECTION from the United States Department of Health and Human Services and the governor receives the affidavit filed under subsection (c), the office shall implement the amendment or waiver not more than sixty (60) days after the governor receives the affidavit.
    (e) The office may adopt rules under IC 4-22-2 to implement this SECTION.

SOURCE: ; (07)MO100803.32. -->     SECTION 32. [EFFECTIVE JULY 1, 2007] (a) IC 27-8-5-2, as amended by this act, and IC 27-8-5-28, as added by this act, apply to a policy of accident and sickness insurance that is issued, delivered, amended, or renewed after June 30, 2007.
    (b) IC 27-13-7-3, as amended by this act, applies to a health maintenance organization contract that is entered into, delivered, amended, or renewed after June 30, 2007.

SOURCE: ; (07)MO100803.33. -->     SECTION 33. An emergency is declared for this act.
    (Reference is to HB 1008 as printed February 20, 2007.)

________________________________________

Representative Brown C


MO100803/DI 97     2007