Indiana Code
Chapter 44.5. Healthy Indiana Plan 2.0
12-15-44.5-10. Benefits for Adult Group; Negotiation of Plan Limitations

Sec. 10. (a) The secretary has the authority to provide benefits to individuals eligible under the adult group described in 42 CFR 435.119 only in accordance with this chapter.
(b) The secretary may negotiate and make changes to the plan, except that the secretary may not negotiate or change the plan that would do the following:
(1) Reduce the following:
(A) Contribution amounts below the minimum levels set forth in section 4.7 of this chapter.
(B) Deductible amounts below the minimum amount established in section 4.5(c) of this chapter.
(2) Remove or reduce the penalties for nonpayment set forth in section 4.7 of this chapter.
(3) Revise the use of the health care account requirement set forth in section 4.5 of this chapter.
(4) Include noncommercial benefits or add additional plan benefits in a manner inconsistent with section 3.5 of this chapter.
(5) Allow services to begin:
(A) without the payment established or required by; or
(B) earlier than the time frames otherwise established by;
section 4.7 of this chapter.
(6) Reduce financial penalties for the inappropriate use of the emergency room below the minimum levels set forth in section 5.7 of this chapter.
(7) Permit members to change health plans without cause in a manner inconsistent with section 4.7(g) of this chapter.
(8) Operate the plan in a manner that would obligate the state to financial participation beyond the level of state appropriations or funding otherwise authorized for the plan.
(c) The secretary may make changes to the plan under this chapter if the changes are required by federal law or regulation.
As added by P.L.213-2015, SEC.136. Amended by P.L.30-2016, SEC.35.

Structure Indiana Code

Indiana Code

Title 12. Human Services

Article 15. Medicaid

Chapter 44.5. Healthy Indiana Plan 2.0

12-15-44.5-1. "Phase Out Period"

12-15-44.5-2. "Plan"

12-15-44.5-2.3. "Preventative Care Services"

12-15-44.5-3. Plan Established; Eligibility; Oversight of Marketing; Promotion of Plan; Ensure Enrollment Distribution; Consumer Protection; Provider Participation; Exemptions

12-15-44.5-3.5. Coverage; Vision and Dental; Preventative Care Services

12-15-44.5-4. Scope of the Plan; Termination of Plan; Obligation of State; Report to Budget Committee

12-15-44.5-4.5. Required Health Care Account; Payments

12-15-44.5-4.7. Application; Pregnant Woman Exemption; Payments; Failure to Make Payments; State Contribution; Change in Health Plan

12-15-44.5-4.9. Eligibility Period; Renewal; Unused Share of Health Care Account Distribution

12-15-44.5-5. Managed Care Organization Responsibilities; Reimbursement; Cultural Competency Standards

12-15-44.5-5.5. Workforce Training and Job Search Program Referral

12-15-44.5-5.7. Nonemergency Services Received in an Emergency Room; Copayment

12-15-44.5-6. Phase Out Funds Deposited From Incremental Hospital Assessment Fees; Notice and Phase Out if Plan Is Terminated

12-15-44.5-7. Phase Out Trust Fund Established; Purpose of the Fund; Uses; Administration; Fund Is Considered a Trust Fund

12-15-44.5-8. Requirements for Use of Money Appropriated to the Fund; Requirements for Use of the Incremental Hospital Assessment Fee; Payment for Health Care Services; Administrative Costs; Profit

12-15-44.5-9. Rules

12-15-44.5-10. Benefits for Adult Group; Negotiation of Plan Limitations