2014 Indiana Code TITLE 12. HUMAN SERVICES ARTICLE 15. MEDICAID CHAPTER 46. MEDICAID WAIVERS AND STATE PLAN AMENDMENTS
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IC 12-15-46
Chapter 46. Medicaid Waivers and State Plan Amendments
IC 12-15-46-1
Eligibility for family planning services; state plan amendment;
rules
Sec. 1. (a) As used in this section, "family planning services" does
not include the performance of abortions or the use of a drug or
device intended to terminate fertilization.
(b) As used in this section, "fertilization" means the joining of a
human egg cell with a human sperm cell.
(c) As used in this section, "state plan amendment" refers to an
amendment to Indiana's Medicaid State Plan as authorized by Section
1902(a)(10)(A)(ii)(XXI) of the federal Social Security Act (42 U.S.C.
1315).
(d) Before January 1, 2012, the office shall do the following:
(1) Apply to the United States Department of Health and Human
Services for approval of a state plan amendment to expand the
population eligible for family planning services and supplies as
permitted by Section 1902(a)(10)(A)(ii)(XXI) of the federal
Social Security Act (42 U.S.C. 1315). In determining what
population is eligible for this expansion, the state must
incorporate the following:
(A) Inclusion of women and men.
(B) Setting income eligibility at one hundred thirty-three
percent (133%) of the federal income poverty level.
(C) Adopting presumptive eligibility for services to this
population.
(2) Consider the inclusion of additional:
(A) medical diagnosis; and
(B) treatment services;
that are provided for family planning services in a family
planning setting for the population designated in subdivision (1)
in the state plan amendment.
(e) The office may adopt rules under IC 4-22-2 to implement this
section.
(f) This section expires January 1, 2016.
As added by P.L.6-2012, SEC.95. Amended by P.L.205-2013,
SEC.208.
IC 12-15-46-2
Report by division concerning review of plan to reduce cost of
waiver
Sec. 2. (a) As used in this section, "commission" refers to the
select joint commission on Medicaid oversight established by
IC 2-5-26-3 (before its repeal).
(b) As used in this section, "division" refers to the division of
disability and rehabilitative services established by IC 12-9-1-1.
(c) As used in this chapter, "waiver" refers to the federal Medicaid
developmental disabilities home and community based services
waiver program that is administered by the office and the division.
(d) Before July 1, 2012, the division shall report orally and in
writing to the commission for review of a plan to reduce the
aggregate and per capita cost of the waiver by implementing changes
to the waiver, which may include the following:
(1) Calculating budget neutrality on an individual rather than an
aggregate basis.
(2) Instituting a family care program to provide recipients with
another option for receiving services.
(3) Evaluating the current system to determine whether a group
home or a waiver home is the most appropriate use of resources
for placement of the individual.
(4) Evaluating alternative placements for high cost individuals
to ensure individuals are served in the most integrated setting
appropriate to the individual's needs and within the resources
available to the state.
(5) Migrating individuals from the waiver to a redesigned
waiver that provides options to individuals for receiving
services and supports appropriate to meet the individual's needs
and that are cost effective and high quality and focus on social
and health outcomes.
(6) Requiring cost participation by a recipient whose family
income exceeds five hundred percent (500%) of the federal
income poverty level, factoring in medical expenses and
personal care needs expenses of the recipient.
(e) After the division makes the report required under subsection
(d), the division may consult with the office and take any action
necessary to carry out the requirements of this section, including
applying to the federal Department of Health and Human Services for
approval to amend the waiver.
As added by P.L.6-2012, SEC.95. Amended by P.L.205-2013,
SEC.209.
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