Indiana legislation · 2025 Regular Session

Indiana SB2: Medicaid matters.

Status: Chaptered, May 1, 2025

Medicaid matters. Requires the office of the secretary of family and social services (office) to report specified Medicaid data to the Medicaid oversight committee. Requires the office to annually prepare and present a report to the budget committee concerning the enforcement of the Medicaid five year look back period. Prohibits specified persons from advertising or otherwise marketing the Medicaid program. Provides that the office may adopt rules concerning permissible advertising or marketing indicating participation in the Medicaid program by a person that has contracted with the office. Allows the office to reimburse medical providers at the appropriate Medicaid fee schedule rate for certified medical claims prior to the beginning of benefits, provided the claims satisfy certain conditions. Repeals language allowing for marketing of the Medicaid program. Requires the office to receive and review data from specified federal and state agencies concerning Medicaid recipients to determine whether circumstances have changed that affect Medicaid eligibility for recipients and to perform a redetermination. Requires the office to establish: (1) performance standards for hospitals that make presumptive eligibility determinations and sets out action for when hospitals do not comply with the standards; and (2) an appeals procedure for hospitals that dispute the violation determination. Sets out a hospital's responsibilities when making a presumptive eligibility determination. Imposes corrective action and restrictions for failing to meet presumptive eligibility standards. Specifies requirements, allowances, and limitations for the healthy Indiana plan.