Legislative News

March 10, 2008 issue

Medicaid

BILL: HB 1266 – Eligibility Criteria for Medicaid Waiver
AUTHOR: Rep. Sheila Klinker, D-Lafayette
SPONSOR: Sen. Marvin Riegsecker, R-Goshen
ISMA POSITION: Neutral

THIS WEEK: The House concurred with HB 1266 and voted 94-0 to approve the measure, sending it to Gov. Daniels for consideration.

The bill requires the Indiana Office of Medicaid Policy and Planning to seek an amendment to the developmental disabilities waiver to set priorities in providing services. The goal of the bill is to get needed services to those who are transitioning out of institutional care.

BILL: SB 42 – Select Joint Commission on Medicaid Oversight
AUTHOR: Sen. Patricia Miller, R-Indianapolis
SPONSOR: Rep. Charlie Brown, D-Gary
ISMA POSITION: Support

THIS WEEK: The bill was heard in conference committee and the author, Sen. Miller, announced that language regarding the funding of Area Health Education Centers (AHEC) was not germane to the bill and would be removed.  

Language regarding AHECs was inserted by the House and aimed to require the state budget agency, the fiscal arm of the administration, to disperse funds to AHECs in a certain manner. This language is strongly opposed by the Daniels administration because it is viewed as violating the separation of powers between the legislative and executive branches of government. 

The remainder of SB 42 repeals the expiration of the Select Joint Commission on Medicaid Oversight set for the end of 2008. This commission has been instrumental in monitoring Indiana’s Medicaid managed care program.

SB 42 also adds authority to the commission to determine whether a Medicaid managed care organization has met the terms of its contract with the state. The bill requires Medicaid managed care organizations in the risk-based and behavioral health programs to be NCQA certified and to accept electronic claims filed by Medicaid providers.

THIS WEEK: The bill was heard in a conference committee hearing last week and two changes are being made.

The conference committee will remove language that would have required Indiana Medicaid to pay a Federally Qualified Health Center or Rural Health Clinic based on a prospective payment (PPS) methodology if the Centers for Medicare & Medicaid Services (CMS) provides federal financial participation for such payment methodology. 

This language was removed because Indiana Medicaid already pays on a PPS methodology, and there is no current threat of that changing due to federal actions. 

The second change will be removal of language pertaining to a person’s ability to buy into the Healthy Indiana Program (HIP) when that person would not otherwise qualify. This issue will be the subject of a summer study committee to better understand how such a buy-in program may be achieved. 

The remainder of the bill requires a Medicaid managed care organization to abide by current insurance requirements regarding timely payment of claims. It also clarifies that Indiana Medicaid has authorization to extend eligibility for the Children’s Health Insurance Program up to the maximum amount approved by CMS, provided that eligibility is below 300 percent of the federal poverty level.