First Regular Session 115th General Assembly (2007)


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    HOUSE ENROLLED ACT No. 1242



     AN ACT to amend the Indiana Code concerning Medicaid.

Be it enacted by the General Assembly of the State of Indiana:

SOURCE: IC 12-15-12-19; (07)HE1242.1.1. -->
    SECTION 1. IC 12-15-12-19, AS AMENDED BY P.L.48-2005, SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 19. (a) This section applies to an individual who is a Medicaid recipient.
    (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 chronic diseases:
            (A) Asthma.
            (B) Diabetes.
            (C) Congestive heart failure or coronary heart disease.
            (D) Hypertension.
            (E) Kidney disease.
        (2) A case management program for recipients described in subsection (a) who are at high risk of chronic disease, that is based on a combination of cost measures, clinical measures, and health outcomes identified and developed by the office with input and guidance from the state department of health and other experts in health care case management or disease management programs.
    (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 persons 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) Hospitals.
        (6) Public and private third party payers.
    (e) The office may contract with an outside vendor or vendors to assist in the development and implementation of the programs required under this section.
    (f) The office and the state department of health shall provide the select joint commission on Medicaid oversight established by IC 2-5-26-3 with an evaluation and recommendations on the costs, benefits, and health outcomes of the pilot programs required under this section. The evaluations required under this subsection must be provided not more than twelve (12) months after the implementation date of the pilot programs.
    (g) The office and the state department of health shall report to the select joint commission on Medicaid oversight established by IC 2-5-26-3 not later than November 1 of each year regarding the programs developed under this section.
     (h) The disease management program services for a recipient diagnosed with diabetes or hypertension must include education for the recipient on kidney disease and the benefits of having evaluations and treatment for chronic kidney disease according to accepted practice guidelines.


HEA 1242

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