SOURCE: Page 1, line 1; (09)MO039301.1. -->
Page 1, between the enacting clause and line 1, begin a new
paragraph and insert:
SOURCE: IC 12-15-44.2-4; (09)MO039301.1. -->
"SECTION 1. IC 12-15-44.2-4, AS ADDED BY P.L.3-2008,
SECTION 98, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2009]: Sec. 4. (a) The plan must include the following in a
manner and to the extent determined by the office:
(1) Mental health care services.
(2) Inpatient hospital services.
(3) Prescription drug coverage.
(4) Emergency room services.
(5) Physician office services.
(6) Diagnostic services.
(7) Outpatient services, including therapy services.
(8) Comprehensive disease management.
(9) Home health services, including case management.
(10) Urgent care center services.
(11) Preventative care services.
(12) Family planning services:
(A) including contraceptives and sexually transmitted disease
testing, as described in federal Medicaid law (42 U.S.C. 1396
et seq.); and
(B) not including abortion or abortifacients.
(13) Hospice services.
(14) Substance abuse services.
(15) Chiropractor office services.
(b) The plan must do the following:
(1) Offer coverage for dental and vision services to an individual
who participates in the plan.
(2) Pay at least fifty percent (50%) of the premium cost of dental
and vision services coverage described in subdivision (1).
(c) An individual who receives the dental or vision coverage offered
under subsection (b) shall pay an amount determined by the office for
the coverage. The office shall limit the payment to not more than five
percent (5%) of the individual's annual household income. The
payment required under this subsection is in addition to the payment
required under section 11(b)(2) of this chapter for coverage under the
(d) Vision services offered by the plan must include services
provided by an optometrist.
(e) The plan must comply with any coverage requirements that
apply to an accident and sickness insurance policy issued in Indiana.
(f) The plan may not permit treatment limitations or financial
requirements on the coverage of mental health care services or
substance abuse services if similar limitations or requirements are not
imposed on the coverage of services for other medical or surgical
(g) The plan may not permit treatment limitations or financial
requirements on the coverage of chiropractor office services if
similar limitations or requirements are not imposed on the
coverage of physician office services.
Renumber all SECTIONS consecutively.
(Reference is to ESB 393 as printed April 10, 2009.)
MO039301/DI 44 2009