Introduced Version






SENATE BILL No. 42

_____


DIGEST OF INTRODUCED BILL



Citations Affected: IC 12-15-12-19; IC 16-38-6.

Synopsis: Chronic disease management and registry. Removes exemption of the risk-based managed care program from the disease management program. Allows the state department of health to add chronic diseases to the chronic disease registry by administrative rule. Adds public and private third party payers as: (1) persons to be used by the office of Medicaid policy and planning in implementing a disease management program; and (2) persons that may report chronic disease cases for the chronic disease registry. (The introduced version of this bill was prepared by the select joint commission on Medicaid oversight.)

Effective: July 1, 2004.





Miller, Antich




    November 18, 2003, read first time and referred to Committee on Health and Provider Services.







Introduced

Second Regular Session 113th General Assembly (2004)


PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional provision adopted), the text of the new provision will appear in this style type. Also, the word NEW will appear in that style type in the introductory clause of each SECTION that adds a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts between statutes enacted by the 2003 Regular Session of the General Assembly.

SENATE BILL No. 42



    A BILL FOR AN ACT to amend the Indiana Code concerning health.

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

    SECTION 1. IC 12-15-12-19, AS AMENDED BY P.L.212-2003, SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2004]: Sec. 19. (a) This section applies to an individual who
        (1) is a Medicaid recipient. and
        (2) is not enrolled in the risk-based managed care program.
    (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.
        (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 health care providers 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.
    SECTION 2. IC 16-38-6-1, AS ADDED BY P.L.212-2003, SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2004]: Sec. 1. As used in this chapter, "chronic disease" means one (1) of the following conditions:
        (1) Asthma.
        (2) Diabetes.


        (3) Congestive heart failure or coronary heart disease.
        (4) Hypertension.
         (5) A condition that the state department:
            (A) determines should be included on the registry; and
            (B) chooses to add to the registry by rule under IC 4-22-2.

    SECTION 3. IC 16-38-6-4, AS ADDED BY P.L.212-2003, SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE JULY 1, 2004]: Sec. 4. (a) The following persons may report confirmed cases of chronic disease to the chronic disease registry:
        (1) Physicians.
        (2) Hospitals.
        (3) Medical laboratories.
         (4) Public and private third party payers.
    (b) A person who reports information to the state chronic disease registry under this section may use:
        (1) information submitted to any other public or private chronic disease registry; or
        (2) information required to be filed with federal, state, or local agencies;
when completing a report under this chapter. However, the state department may require additional, definitive information.
    (c) The office of Medicaid policy and planning shall provide data concerning services for chronic diseases reimbursed by the state Medicaid program to the chronic disease registry. The office shall work with the state department to identify the data available and to determine a means to transmit the information to assist the state department in data collection for the chronic disease registry.