Citations Affected: IC 12-15; IC 16-18; IC 16-25.5; noncode.
Synopsis: Health matters. Requires a managed care organization to
provide specified recipients with: (1) early periodic screening,
diagnosis, and treatment services; and (2) lead screening; and to
annually document the provision of these services to the office of
Medicaid policy and planning. Establishes the dialysis facility council,
and requires dialysis facilities to be licensed by the state department of
health. Makes it a Class A misdemeanor for a person to knowingly or
intentionally operate or advertise the operation of a dialysis facility
without a license. Requires the state department of health to develop
and provide a plan to ensure that health benefit plan providers in
Indiana comply with the certain data measures.
Effective: Upon passage; July 1, 2007.
January 23, 2007, read first time and referred to Committee on Public Health.
February 1, 2007, reported _ Do Pass.
A BILL FOR AN ACT to amend the Indiana Code concerning
represented by the outgoing member.
(b) The governor shall appoint a chairperson from the members of the council.
Sec. 3. A member of the council who is not a state employee is entitled to the minimum salary per diem provided by IC 4-10-11-2.1(b). A member is entitled to reimbursement for traveling expenses provided under IC 4-13-1-4 and other expenses actually incurred in connection with the member's duties, as provided in the state policies and procedures established by the Indiana department of administration and approved by the budget agency.
Sec. 4. (a) The first meeting of the council shall be called by the chairperson and held not later than thirty (30) days after the appointment of the members of the council. The council shall meet at least two (2) times each calendar year on dates fixed by the chairperson.
(b) Special meetings of the council shall be called by the chairperson at the request of any three (3) members of the council.
(c) Five (5) members constitute a quorum for the transaction of business.
Sec. 5. In the first meeting of the council and in the first annual meeting during each subsequent year, the council shall elect from the members a secretary who shall keep a record of all meetings. The term of secretary is one (1) year.
Sec. 6. At the request of the council, the state department may obtain the services of experts or other persons to assist the council in the formulation of policy or in conducting the council's business.
Sec. 7. (a) Except as provided in subsection (b), the council shall propose and the executive board may adopt rules under IC 4-22-2 necessary to protect the health, safety, rights, and welfare of patients, including the following:
(1) Rules pertaining to the licensure, operation, and management of a dialysis facility.
(2) Rules establishing standards for equipment, facilities, and staffing required for efficient and quality care of patients of a dialysis facility.
(b) The state department may request the council to propose a new rule or an amendment to an existing rule necessary to protect the health, safety, rights, and welfare of patients of a dialysis facility. If the council does not propose a rule within ninety (90) days of the state department's request, the state department may propose the department's own rule.
provide a written copy of the report to an individual upon request.
Chapter 2. Licensure of Dialysis Facilities
Sec. 1. (a) The state department shall license and regulate dialysis facilities.
(b) A dialysis facility must be licensed by the state department in order to operate in the state.
Sec. 2. The council may determine if a dialysis facility is covered by this chapter. A decision of the council under this section is subject to review under IC 4-21.5.
Sec. 3. The state department shall administer this chapter with the advice of the council.
Sec. 4. (a) An applicant for a license under this chapter must submit an application for a license on a form prescribed by the state department showing that:
(1) the applicant is of reputable and responsible character; and
(2) the applicant is able to comply with the minimum standards for a dialysis facility and with rules adopted under this chapter.
(b) The submitted application must contain the following information:
(1) The name of the applicant.
(2) The location of the dialysis facility.
(3) The name of the person to be in charge of the dialysis facility.
(4) Other information required by the state department.
Sec. 5. An application for a license under this chapter must be accompanied by a licensing fee at a rate adopted by the council under IC 4-22-2.
Sec. 6. The state health commissioner may:
(1) issue a license upon receipt of the application without further evidence; or
(2) request additional information concerning the application and conduct an investigation to determine whether a license should be granted.
Sec. 7. A license issued under this chapter:
(1) expires one (1) year after the date of issuance;
(2) is not assignable or transferable;
(3) is issued only for the premises named on the application;
(4) must be posted in a conspicuous place in the dialysis facility for which the license was issued; and
(5) may be renewed each year upon the payment of a renewal
fee at the renewal rate adopted by the council under
Sec. 8. A dialysis facility that provides to a patient notice concerning a third party billing for a service provided to the patient shall ensure that the notice:
(1) conspicuously states that the notice is not a bill;
(2) does not include a tear-off portion; and
(3) is not accompanied by a return mailing envelope.
Chapter 3. Remedies for Violations
Sec. 1. The state health commissioner may take any of the following actions on any of the grounds listed in section 2 of this chapter:
(1) Issue a letter of correction.
(2) Issue a probationary license.
(3) Conduct a resurvey.
(4) Deny renewal of a license.
(5) Revoke a license.
(6) Impose a civil penalty in an amount not to exceed ten thousand dollars ($10,000).
Sec. 2. The state health commissioner may take action under section 1 of this chapter on any of the following grounds:
(1) Violation of any of the provisions of this article or the rules adopted under this article.
(2) Permitting, aiding, or abetting the commission of an illegal act in a dialysis facility.
(3) Knowingly collecting or attempting to collect from a subscriber (as defined in IC 27-13-1-32) or an enrollee (as defined in IC 27-13-1-12) of a health maintenance organization (as defined in IC 27-13-1-19) any amounts that are owed by the health maintenance organization.
(4) Conduct or practice found by the council to be detrimental to the health, safety, rights, and welfare of the patients of a dialysis facility.
Sec. 3. (a) IC 4-21.5 applies to an action under this chapter.
(b) A licensee or an applicant for a license aggrieved by an action under this article may request review under IC 4-21.5.
Sec. 4. The state department shall investigate a report of an unlicensed dialysis facility and report the findings to the attorney general. The attorney general may seek any of the following:
(1) An injunction in a court with jurisdiction in the county in which the unlicensed dialysis facility is located or in the circuit or superior court of Marion County.
(2) Relief under IC 4-21.5, including a civil penalty not to exceed an amount of twenty-five thousand dollars ($25,000) for each day of unlicensed operation.
(3) Criminal penalties as provided in section 5 of this chapter.
Sec. 5. A person who knowingly or intentionally:
(1) operates a dialysis facility that is required to be licensed under this article that is not licensed under this article; or
(2) advertises the operation of a dialysis facility that is required to be licensed under this article and that is not licensed under this article;
commits a Class A misdemeanor.
include the following:
(1) An assessment of current compliance by health benefit plans.
(2) A determination of the actions necessary to achieve compliance by all health benefit plan providers.
(d) This SECTION expires June 30, 2008.