SB 551-1_ Filed 02/13/2013, 16:22

COMMITTEE REPORT

MADAM PRESIDENT:

    The Senate Committee on Health and Provider Services, to which was referred Senate Bill No. 551, has had the same under consideration and begs leave to report the same back to the Senate with the recommendation that said bill be AMENDED as follows:

SOURCE: Page 1, line 1; (13)CR055101.1. -->     Page 1, between the enacting clause and line 1, begin a new paragraph and insert:
SOURCE: IC 12-15-2-3.5; (13)CR055101.1. -->     "SECTION 1. IC 12-15-2-3.5 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 3.5. An individual:
        (1) who is:
            (A) at least sixty-five (65) years of age; or
            (B) disabled, as determined by the Supplemental Security Income program; and
        (2) whose income and resources do not exceed those levels established by the Supplemental Security Income program;
is eligible to receive Medicaid assistance if the individual's family income does not exceed one hundred percent (100%) of the federal income poverty level for the same size family.
".
SOURCE: Page 2, line 6; (13)CR055101.2. -->     Page 2, between lines 6 and 7, begin a new paragraph and insert:
SOURCE: IC 12-15-2-14; (13)CR055101.3. -->     "SECTION 3. IC 12-15-2-14 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 14. (a) An individual:
        (1) who is less than nineteen (19) years of age;
        (2) who is not described in 42 U.S.C. 1396a(a)(10)(A)(I); and
        (3) whose family income does not exceed the income level established in subsection (b);
is eligible to receive Medicaid.
    (b) An individual described in this section is eligible to receive Medicaid, subject to 42 U.S.C. 1396a et seq., if the individual's family income does not exceed one hundred fifty percent (150%) of the federal income poverty level for the same size family.
    (c) The office may apply a resource standard in determining the eligibility of an individual described in this section. This subsection expires December 31, 2013.".
SOURCE: Page 3, line 34; (13)CR055101.3. -->     Page 3, between lines 34 and 35, begin a new paragraph and insert:
SOURCE: IC 12-15-2.3-10; (13)CR055101.6. -->     "SECTION 6. IC 12-15-2.3-10 IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 10. (a) If a woman described in section 1 of this chapter:
        (1) is determined to be presumptively eligible for Medicaid under this chapter; and
        (2) appoints, in writing, an agent of a qualified entity under section 4 of this chapter as the woman's authorized representative for purposes of completing all aspects of the Medicaid application process;
the county office shall conduct any face-to-face interview that is necessary to determine the woman's eligibility for Medicaid with the woman's authorized representative.
     (b) This section expires December 31, 2013.
SOURCE: IC 12-15-3-1; (13)CR055101.7. -->     SECTION 7. IC 12-15-3-1, AS AMENDED BY P.L.196-2011, SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 1. (a) Except as provided in subsections (b) and (c) and section 7 of this chapter, an applicant for or recipient of Medicaid is ineligible for assistance if the total cash value of money, stock, bonds, and life insurance owned by:
        (1) the applicant or recipient is more than one thousand five hundred dollars ($1,500) for assistance to the aged, blind, or disabled; or
        (2) the applicant or recipient and the applicant's or recipient's spouse is more than two thousand two hundred fifty dollars ($2,250) for medical assistance to the aged, blind, or disabled.
    (b) In the case of an applicant who is an eligible individual, a Holocaust victim's settlement payment received by the applicant or the applicant's spouse may not be considered when calculating the total cash value of money, stock, bonds, and life insurance owned by the

applicant or the applicant's spouse.
    (c) In the case of an individual who:
        (1) resides in a nursing facility or another medical institution; and
        (2) has a spouse who does not reside in a nursing facility or another medical institution;
the total cash value of money, stock, bonds, and life insurance that may be owned by the couple to be eligible for the program is determined under IC 12-15-2-24.
     (d) This section expires December 31, 2013.

SOURCE: IC 12-15-3-1.5; (13)CR055101.8. -->     SECTION 8. IC 12-15-3-1.5 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 1.5. (a) Beginning January 1, 2014, the office shall determine eligibility for a Medicaid applicant or Medicaid recipient who is aged, blind, or disabled under IC 12-15-2-3.5.
    (b) If an individual:
        (1) resides in a nursing facility or another medical institution; and
        (2) has a spouse who does not reside in a nursing facility or another medical institution;
the total cash value of money, stock, bonds, and life insurance that may be owned by the couple to be eligible for Medicaid is determined under IC 12-15-2-24.

SOURCE: IC 12-15-3-2; (13)CR055101.9. -->     SECTION 9. IC 12-15-3-2, AS AMENDED BY P.L.196-2011, SECTION 4, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 2. (a) Except as provided in section 7 of this chapter, if the parent of an applicant for or a recipient of assistance to the blind or disabled who is less than eighteen (18) years of age owns money, stock, bonds, and life insurance whose total cash value is more than one thousand five hundred dollars ($1,500), the amount of the excess shall be added to the total cash value of money, stock, bonds, and life insurance owned by the applicant or recipient to determine the recipient's eligibility for Medicaid under section 1 of this chapter.
    (b) However, a Holocaust victim's settlement payment received by the parent of an applicant for or a recipient of assistance may not be added to the total cash value of money, stock, bonds, and life insurance owned by the applicant or recipient to determine the recipient's eligibility for Medicaid under section 1 of this chapter.
     (c) This section expires December 31, 2013.
SOURCE: IC 12-15-3-3; (13)CR055101.10. -->     SECTION 10. IC 12-15-3-3, AS AMENDED BY P.L.196-2011, SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 3. (a) Except as provided in section 7 of this chapter, if the parents of an applicant for or a recipient of assistance to the blind or disabled who is less than eighteen (18) years of age own money, stock, bonds, and life insurance whose total cash value is more than two thousand two hundred fifty dollars ($2,250), the amount of the excess shall be added to the total cash value of money, stock, bonds, and life insurance owned by the applicant or recipient to determine the recipient's eligibility for Medicaid under section 1 of this chapter.
     (b) This section expires December 31, 2013.".
SOURCE: Page 5, line 25; (13)CR055101.5. -->     Page 5, between lines 25 and 26, begin a new paragraph and insert:
SOURCE: IC 12-15-46-3; (13)CR055101.12. -->     "SECTION 12. IC 12-15-46-3 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 3. (a) The office of the secretary has the authority to negotiate with the United States Department of Health and Human Services for amendments to the state Medicaid plan or for any Medicaid waivers necessary to establish a block grant system for providing services under the Medicaid program, including providing coverage for individuals described in 42 U.S.C. 1396a(a)(10)(A)(i)(VIII).
    (b) A waiver or state plan amendment negotiated under this section must include the following:
        (1) Allow the office to withdraw from participating in a program negotiated under this section at any time.
        (2) Include federal financial participation at least at the levels specified in the federal Patient Protection and Affordable Care Act.
        (3) Include, when appropriate, consumer driven principles.
        (4) Include coverage for preventative care services provided at no cost to the recipient and allow incentives for increasing preventative care for recipients.
        (5) Allow for personal responsibility requirements.
        (6) Require a recipient to make out-of-pocket payments related to coverage for health care expenses provided under the program.
        (7) Require a health care account to be used to pay the recipient's out-of-pocket health care expenses associated with

health care coverage provided as part of the recipient's participation in the program described in this section.
         (8) Include health care initiatives designed to promote the general health and well being of recipients and encourage an understanding of the cost and quality of care.
    (c) The office of the secretary may not implement a waiver or Medicaid state plan amendment negotiated under this section until the office of the secretary has developed a sustainable financing plan for the Medicaid state plan amendment or waiver.

SOURCE: IC 12-15-46-5; (13)CR055101.13. -->     SECTION 13. IC 12-15-46-5 IS ADDED TO THE INDIANA CODE AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2013]: Sec. 5. (a) The office shall apply to the United States Department of Health and Human Services for an amendment to the state Medicaid plan to require Medicaid recipients to participate in cost sharing, as allowable under federal law.
    ( b) The office may not implement the state plan amendment described in this section until the office files an affidavit with the governor attesting that the state plan amendment applied for under this section has been approved by the United States Department of Health and Human Services. The office shall file the affidavit under this subsection not later than five (5) days after the office is notified that the state plan amendment described in this section has been approved.
     (c) The office may adopt rules under IC 4-22-2 necessary to implement this section.".
SOURCE: Page 19, line 15; (13)CR055101.19. -->     Page 19, delete lines 15 through 16.
    Page 19, line 17, delete "(c)" and insert " (b)".
    Page 19, line 22, delete "(d)" and insert " (c)".
    Page 19, line 25, delete "(e)" and insert " (d)".
    Page 19, line 32, delete "(f)" and insert " (e)".
    Page 20, line 11, delete "(g)" and insert " (f)".
    Page 20, line 12, delete "(f)" and insert " (e)".
    Page 20, line 16, delete "(f)." and insert " (e).".
    Page 20, line 17, delete "(h)" and insert " (g)".
    Page 20, line 17, delete "(f)" and insert " (e)".
    Page 20, line 19, delete "(i)" and insert " (h)".
    Page 20, line 22, delete "(j)" and insert " (i)".
    Page 20, line 24, delete "(g)." and insert " (f).".
    Page 20, line 25, delete "(k)" and insert " (j)".
    Page 20, line 28, delete "(l)" and insert " (k)".
    Page 20, line 29, delete "(f)," and insert " (e),".
    Page 20, line 31, delete "(g)." and insert " (f).".
    Page 30, between lines 26 and 27, begin a new paragraph and insert:
SOURCE: ; (13)CR055101.14. -->     "SECTION 14. [EFFECTIVE JULY 1, 2013] (a) As used in this SECTION, "commission" refers to the health finance commission established by IC 2-5-23-3.
    (b) Before August 1, 2013, the office of Medicaid policy and planning shall present a plan to the Indiana general assembly and the commission concerning the following:
        (1) Whether to require a Medicaid recipient who is eligible for Medicaid based on the individual's aged, blind, or disabled status to enroll in the risk-based managed care program.
        (2) How to address the provision of health care for the following populations:
            (A) Individuals who currently participate in the Indiana check-up plan (IC 12-15-44.2).
            (B) Individuals who are dually eligible for the federal Medicare program (42 U.S.C. 1395 et seq.) and the Medicaid program (IC 12-15).
        (3) Information concerning the number of individuals participating in a program described in subdivision (2)(A) and (2)(B) who would be eligible for a tax credit under the federal Patient Protection and Affordable Care Act (P.L. 111-148).
    (c) This SECTION expires December 31, 2013.

SOURCE: ; (13)CR055101.18. -->     SECTION 18. [EFFECTIVE UPON PASSAGE] (a) As used in this SECTION, "Affordable Care Act" refers to the federal Patient Protection and Affordable Care Act (P.L. 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (P.L. 111-152).
    (b) As used in this SECTION, "commission" refers to the health finance commission established by IC 2-5-23-3.
    (c) As used in this SECTION, "exchange" refers to an American health benefit exchange established under the Affordable Care Act.
    (d) Before August 1, 2013, the department of insurance, the office of the secretary of family and social services, and the state

department of health shall work together to prepare a report for the commission concerning the following:
        (1) The establishment and implementation of an exchange in Indiana.
        (2) The definition of "essential health benefits" for use in Indiana under the Affordable Care Act, including ensuring that the definition results in adequate benefits.
    (e) This chapter expires December 31, 2013.
".
    Renumber all SECTIONS consecutively.
    (Reference is to SB 551 as introduced.)

and when so amended that said bill do pass and be reassigned to the Senate Committee on Appropriations.

Committee Vote: Yeas 9, Nays 3.

____________________________________

    Miller Patricia
Chairperson


CR055101/DI 104    2013