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First Regular Session of the 124th General Assembly (2025)
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,
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provision adopted), the text of the new provision will appear in this style type. Also, the
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between statutes enacted by the 2024 Regular Session of the General Assembly.
SENATE ENROLLED ACT No. 486
AN ACT to amend the Indiana Code concerning human services.
Be it enacted by the General Assembly of the State of Indiana:
SECTION 1. IC 11-12-5-9, AS ADDED BY P.L.185-2015,
SECTION 7, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 9. (a) This section is effective beginning
September 1, 2015.
(b) For an offender who is incarcerated for less than thirty (30) days,
a sheriff, in consultation with the county executive or a person
designated by the county executive, may:
(1) assist an offender in applying for Medicaid; and
(2) act as the offender's Medicaid authorized representative as
described in IC 11-10-3-7;
so that the offender might be eligible for coverage when the offender
is subsequently released from the county jail.
(c) Before discharge or release from an offender who has been
incarcerated in a county jail of an offender incarcerated or a facility
listed in IC 12-15-1-20.4(a)(1) for at least thirty (30) days is released
or discharged from the county jail or facility, the sheriff, in
consultation with the county executive or a person designated by the
county executive in the county in which the incarcerated person is
located shall assist the offender in applying for Medicaid, if eligible, as
the authorized representative as described in IC 11-10-3-7 or as a
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health navigator under the requirements of IC 27-19-2-12, so that the
offender might be eligible for coverage when the offender is
subsequently released from the county jail.
(d) The sheriff shall provide the assistance described in subsection
(c) in sufficient time to ensure that the offender will be able to receive
coverage at the time the offender is released from the county jail.
(e) A county executive may contract with any entity that complies
with IC 27-19-2-12, including a hospital or outreach eligibility worker,
to assist with Medicaid applications under this section. A county
executive may develop intergovernmental agreements with other
counties to provide both authorized representative and health navigator
services required under this section. Upon a determination that an
incarcerated individual qualifies for Medicaid coverage, the office of
the secretary of family and social services, division of family resources,
shall authorize and then immediately suspend Medicaid coverage for
those inmates not requiring immediate medical attention.
SECTION 2. IC 12-15-1-20.4, AS AMENDED BY P.L.57-2021,
SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 20.4. (a) If a Medicaid recipient is:
(1) adjudicated to be a delinquent child and placed in:
(A) a community based correctional facility for children;
(B) a juvenile detention facility; or
(C) a secure facility, not including a facility licensed as a child
caring institution under IC 31-27; or
(2) incarcerated in a prison or jail; and
ineligible to participate in the Medicaid program during the placement
described in subdivision (1) or (2) because of federal Medicaid law, the
division of family resources, upon notice that a child has been
adjudicated to be a delinquent child and placed in a facility described
in subdivision (1) or upon notice that a person is incarcerated in a
prison or jail and placed in a facility described in subdivision (2), shall
suspend the person's participation in the Medicaid program.
(b) If the division of family resources receives:
(1) a dispositional decree under IC 31-37-19-28; or
(2) a modified disposition order under IC 31-37-22-9;
regarding a person described in subsection (a)(2) and the
department of correction gives the division of family resources at least
forty (40) days notice that a the person will be released from a facility
described in subsection (a)(1)(C) or (a)(2), the division of family
resources shall take action necessary to ensure that a the person
described in subsection (a) is eligible to participate in the Medicaid
program upon the person's release, if the person is eligible to
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participate.
(c) A facility described in subsection (a)(1) shall, not less than
forty-five (45) days before the release date of a person placed in the
facility as described in subsection (a)(1), provide notice of the
person's release date to the division of family resources. The
division of family resources shall take action necessary to ensure
that the person is eligible to:
(1) participate in the Medicaid program upon the person's
release, if the person is eligible to participate; and
(2) receive services mandated under 42 U.S.C. 1396a for thirty
(30) days before the person's release date and for thirty (30)
days after the person's release date.
SECTION 3. IC 12-15-29-4.5, AS AMENDED BY P.L.265-2019,
SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 4.5. (a) An insurer shall:
(1) accept a Medicaid claim for a Medicaid recipient for three (3)
years from the date the service was provided; and
(2) respond to an inquiry by the office regarding the claim not
later than sixty (60) days after receiving the inquiry.
(b) An insurer may not deny a Medicaid claim submitted by the
office solely on the basis of:
(1) the date of submission of the claim;
(2) the type or format of the claim form;
(3) the method of submission of the claim; or
(4) a failure to provide proper documentation at the point of sale
that is the basis of the claim;
if the claim is submitted by the office within three (3) years from the
date the service was provided as required in subsection (a) and the
office commences action to enforce the office's rights regarding the
claim within six (6) years of the office's submission of the claim.
(c) In accordance with 42 U.S.C. 1396a, an insurer, other than
Medicare, Medicare Advantage, and Medicare Part D, may not
deny a Medicaid claim submitted by the office solely due to a lack of
prior authorization. An insurer shall:
(1) after December 31, 2020, meet the requirements set forth in
IC 27-1-37.5;
(2) conduct the prior authorization on a retrospective basis for
claims where prior authorization is necessary; and
(3) adjudicate any claim authorized in this manner as if the claim
received prior authorization.
SECTION 4. IC 12-15-29-9, AS AMENDED BY P.L.187-2007,
SECTION 7, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
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JULY 1, 2025]: Sec. 9. (a) IC 27-8-23 applies to this section.
(b) To the extent that payment for covered medical expenses has
been made under the state Medicaid program for health care items or
services furnished to a person, in a case where a third party has a legal
liability to make payments, the state is considered to have acquired the
rights of the person to payment by any other party for the health care
items or services.
(c) As required under 42 U.S.C. 1396a(a)(25), an insurer shall
accept the state's right of recovery and the assignment to the state of
any right of the individual or entity to payment for a health care item
or service for which payment has been made under the state Medicaid
plan.
(d) The state may seek reimbursement under 42 U.S.C. 1396k(a)
from settlement amounts representing:
(1) past medical expenses; and
(2) rights to payment of future medical expenses.
SECTION 5. IC 12-15-33-2, AS AMENDED BY P.L.42-2024,
SECTION 86, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 2. The Medicaid advisory commission is created
to act in an advisory capacity to the following: office in matters
related to policy development and in the effective administration
of the Medicaid program.
(1) The office in the administration of the Medicaid program.
(2) The children's health policy board established by IC 4-23-27-2
in the board's responsibility to direct policy coordination of
children's health programs.
SECTION 6. IC 12-15-33-3, AS AMENDED BY P.L.42-2024,
SECTION 87, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 3. (a) The commission shall be appointed as
follows:
(1) One (1) member Sixteen (16) members shall be appointed by
the administrator of the office to represent each of the following
organizations: as follows:
(A) Six (6) members representing Medicaid providers, with
no more than one (1) representative of each Medicaid type.
(B) Two (2) members representing managed care entities.
(C) Two (2) members representing:
(i) state or local consumer advocacy groups; or
(ii) other community based organizations;
that represent the interests of, or provide direct service to,
Medicaid beneficiaries.
(D) Six (6) members of the Medicaid beneficiary advisory
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commission established by IC 12-15-33.3-2.
(A) Indiana Council of Community Mental Health Centers.
(B) Indiana State Medical Association.
(C) Indiana State Chapter of the American Academy of
Pediatrics.
(D) Indiana Hospital Association.
(E) Indiana Dental Association.
(F) Indiana State Psychiatric Association.
(G) Indiana State Osteopathic Association.
(H) Indiana State Nurses Association.
(I) Indiana State Licensed Practical Nurses Association.
(J) Indiana State Podiatry Association.
(K) Indiana Health Care Association.
(L) Indiana Optometric Association.
(M) Indiana Pharmaceutical Association.
(N) Indiana Psychological Association.
(O) Indiana State Chiropractic Association.
(P) Indiana Ambulance Association.
(Q) Indiana Association for Home Care.
(R) Indiana Academy of Ophthalmology.
(S) Indiana Speech and Hearing Association.
(T) Indiana Academy of Physician Assistants.
(U) Indiana Association of Rehabilitation Facilities.
(V) Indiana Association of Health Plans.
(W) Indiana Primary Health Care Association.
(2) Ten (10) members shall be appointed by the governor as
follows:
(A) One (1) member who represents agricultural interests.
(B) One (1) member who represents business and industrial
interests.
(C) One (1) member who represents labor interests.
(D) One (1) member who represents insurance interests.
(E) One (1) member who represents a statewide taxpayer
association.
(F) Two (2) members who are parent advocates.
(G) Three (3) members who represent Indiana citizens.
(3) (2) Three (3) Two (2) members of the senate appointed by the
president pro tempore of the senate.
(4) (3) Three (3) Two (2) members of the senate appointed by the
president pro tempore of the senate after consultation with the
minority leader of the senate.
(5) (4) Three (3) Two (2) members of the house of representatives
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appointed by the speaker of the house.
(6) (5) Three (3) Two (2) members of the house of representatives
appointed by the speaker of the house after consultation with the
minority leader of the house.
(b) The president pro tempore of the senate shall appoint three (3)
of the commission members appointed under subsection (a)(3) and
(a)(4) to the standing fiscal subcommittee created under section 8(b)
of this chapter.
(c) The speaker of the house shall appoint three (3) of the
commission members appointed under subsection (a)(5) and (a)(6) to
the standing fiscal subcommittee created under section 8(b) of this
chapter.
SECTION 7. IC 12-15-33-4, AS AMENDED BY P.L.42-2024,
SECTION 88, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 4. (a) Subject to subsection (b), an appointment
to the commission expires in accordance with section 5 of this chapter,
but a member serves until the member's successor is designated.
(b) A member of the commission serves at the pleasure of the
appointing authority who appointed the member to the commission.
(c) A member of the commission may be reappointed to successive
terms.
(d) (c) A vacancy on the commission shall be filled by the
appropriate appointing authority. An individual appointed to fill a
vacancy serves for the unexpired term of the individual's predecessor.
SECTION 8. IC 12-15-33-5, AS AMENDED BY P.L.42-2024,
SECTION 89, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 5. (a) This subsection does not apply to a member
of the general assembly appointed to the commission under section 3
of this chapter. Except as provided in subsection (c), an appointment
to the commission is for a four (4) year term that expires as follows:
(1) For a member appointed under section 3(a)(1)(A) through
3(a)(1)(Q) 3(1)(A) or 3(1)(B) of this chapter, December 31, 2025,
2027, and every fourth year thereafter.
(2) For a member appointed under section 3(a)(1)(R) through
3(a)(1)(W) 3(1)(C) or 3(1)(D) of this chapter, or under section
3(a)(2) of this chapter, December 31, 2027, 2029, and every
fourth year thereafter.
(b) This subsection applies only to a member of the general
assembly appointed to the commission under section 3 of this chapter.
The member serves a term of two (2) years that expires June 30 of each
odd-numbered year.
(c) A member described in subsection (a)(2) who is appointed to
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the commission in 2025 serves until the member's term expires on
December 31, 2029.
SECTION 9. IC 12-15-33-6, AS AMENDED BY P.L.42-2024,
SECTION 90, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 6. The following shall serve as ex officio members
of the commission:
(1) The state health commissioner or the commissioner's
designee.
(2) The director of the division of mental health and addiction or
the director's designee.
(3) The administrator of the office.
(4) The director of the department of child services or the
director's designee.
SECTION 10. IC 12-15-33-8 IS REPEALED [EFFECTIVE JULY
1, 2025]. Sec. 8. (a) A subcommittee may be created as the commission
considers necessary.
(b) The commission shall create a standing fiscal subcommittee.
(c) The chairman of each subcommittee must be a member of the
commission.
(d) Subcommittees may convene as often as needed.
SECTION 11. IC 12-15-33.3 IS ADDED TO THE INDIANA
CODE AS A NEW CHAPTER TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2025]:
Chapter 33.3. Medicaid Beneficiary Advisory Commission
Sec. 1. As used in this chapter, "commission" refers to the
Medicaid beneficiary advisory commission created by section 2 of
this chapter.
Sec. 2. The Medicaid beneficiary advisory commission is created
under the executive branch of government to act in an advisory
capacity to the office in matters related to policy development and
in the effective administration of the Medicaid program.
Sec. 3. (a) The commission is composed of individuals who:
(1) are:
(A) current and former Medicaid beneficiaries; and
(B) family members and caregivers of current and former
Medicaid beneficiaries; and
(2) are appointed as follows:
(A) Four (4) members appointed by the administrator of
the office.
(B) One (1) member who is not a member of the general
assembly, appointed by the president pro tempore of the
senate.
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(C) One (1) member who is not a member of the general
assembly, appointed by the minority leader of the senate.
(D) One (1) member who is not a member of the general
assembly, appointed by the speaker of the house.
(E) One (1) member who is not a member of the general
assembly, appointed by the minority leader of the house.
(b) The administrator of the office shall appoint the chair of the
commission from among the members of the commission and
serves at the pleasure of the administrator.
Sec. 4. (a) Except as provided in subsection (b), and subject to
subsection (c), an appointment to the commission is for a four (4)
year term that expires as follows:
(1) For a member appointed under section 3(a)(2)(A) of this
chapter, December 31, 2027, and every fourth year thereafter.
(2) For a member appointed under section 3(a)(2)(B) through
3(a)(2)(E) of this chapter, December 31, 2029, and every
fourth year thereafter.
(b) A member described in subsection (a)(2) who is appointed to
the commission in 2025 serves until the member's term expires on
December 31, 2029.
(c) A member of the commission:
(1) serves at the pleasure of the appointing authority who
appointed the member to the commission; and
(2) serves until the member's successor is designated.
(d) A vacancy on the commission shall be filled by the
appointing authority of the member whose position on the
commission is vacant. An individual appointed to fill a vacancy
serves for the unexpired term of the individual's predecessor.
Sec. 5. The office shall provide staff support to the commission.
Sec. 6. The commission shall:
(1) meet at least four (4) times each year, with one (1) meeting
held in each calendar quarter; and
(2) hold special meetings at the request of the commission or
the secretary.
Sec. 7. (a) Each member of the commission who is not a state
employee is entitled to the minimum salary per diem provided by
IC 4-10-11-2.1(b). The member is also entitled to reimbursement
for mileage, traveling expenses as provided under IC 4-13-1-4, and
other expenses actually incurred in connection with the member's
duties as provided in the state policies and procedures established
by the Indiana department of administration and approved by the
budget agency.
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(b) Each member of the commission who is a state employee is
entitled to reimbursement for traveling expenses as provided under
IC 4-13-1-4 and other expenses actually incurred in connection
with the member's duties as provided in the state policies and
procedures established by the Indiana department of
administration and approved by the budget agency.
(c) Expenses paid under subsections (a) and (b) shall be paid
from appropriations made to the family and social services
administration.
SECTION 12. IC 12-17.2-3.5-6 IS REPEALED [EFFECTIVE JULY
1, 2025]. Sec. 6. (a) A provider who is an individual shall have an
intradermal tuberculosis test before the provider is eligible for a
voucher payment.
(b) A provider shall assure that an individual who is at least
eighteen (18) years of age and:
(1) who, if the provider operates a child care program in the
provider's home, resides with the provider; or
(2) who:
(A) is employed; or
(B) volunteers;
as a caregiver at the facility where the provider operates a child
care program;
has an intradermal tuberculosis test before the individual resides with
the provider or is employed or allowed to volunteer as a caregiver.
(c) A provider shall maintain documentation of an annual health
assessment by a physician reflecting the results of symptom screening
for tuberculosis for:
(1) the provider, if the provider is an individual; and
(2) an individual described in subsection (b);
who has a history of latent or active tuberculosis.
(d) A provider shall provide the results of the tests and screening
required under this section to the division upon request.
SECTION 13. IC 12-17.2-3.5-8, AS AMENDED BY P.L.92-2024,
SECTION 8, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 8. (a) At least one (1) adult individual who
maintains certification in a course of pediatric cardiopulmonary
resuscitation applicable to all age groups of children cared for by a
provider shall be present at all times when a child is in the care of the
provider.
(b) The following apply to an individual who is employed or
volunteers as a caregiver at a facility where a provider operates a child
care program:
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(1) The individual shall maintain current certification in pediatric
first aid applicable to all age groups of children cared for by the
provider.
(2) If the individual is:
(A) at least eighteen (18) years of age, the individual may act
as a caregiver without supervision of another caregiver; or
(B) less than eighteen (18) years of age, the individual may act
as a caregiver only if the individual:
(i) is at least fourteen (14) years of age; and
(ii) is, at all times when child care is provided, directly
supervised by a caregiver who is at least eighteen (18) years
of age.
(3) Before beginning employment or volunteer duties, the
individual must receive a formal orientation to the facility and the
child care program.
(4) Beginning July 1, 2015, unless the provider is a parent,
stepparent, guardian, custodian, or other relative to each child in
the care of the provider, the individual annually must receive at
least twelve (12) hours of continuing education approved by the
division and related to the age appropriate educational
development, care, and safety of children. The hours of
continuing education required by this subdivision may include the
training described in this chapter concerning child abuse
detection and prevention, first aid, cardiopulmonary resuscitation,
and safe sleeping practices.
(5) Not more than three (3) months after the individual begins
employment or volunteer duties, the individual must receive
training approved by the division concerning child abuse
detection and prevention.
(6) Not more than ninety (90) days after the individual begins
employment or volunteer duties, the individual must be
trained in pediatric cardiopulmonary resuscitation applicable
to all age groups of children cared for by the child care
provider.
(c) A provider shall:
(1) maintain at the facility where the provider operates a child
care program documentation of all training and completion of
continuing education required by this section; and
(2) make the documentation available to the division upon
request.
SECTION 14. IC 12-17.2-4-2, AS AMENDED BY P.L.246-2023,
SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
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JULY 1, 2025]: Sec. 2. (a) A license may be issued only if a child care
center is in compliance with food, health, safety, and sanitation
standards as determined by the division under rules adopted by the
division under IC 12-17.2-2-4 or in accordance with a variance or
waiver approved by the division under IC 12-17.2-2-10.
(b) A license may be issued only if the child care center is in
substantial compliance with the fire and life safety rules as determined
by the state fire marshal under rules adopted by the division under
IC 12-17.2-2-4 or in accordance with a variance or waiver approved by
the division under IC 12-17.2-2-10.
(c) The division may issue a waiver or variance regarding a
determination by the division or the state fire marshal under
subsections (a) and (b).
(d) At least one (1) adult individual who maintains current
certification in a course of pediatric cardiopulmonary resuscitation
applicable to all age groups of children cared for by the child care
center shall be present at all times when a child is in the care of a child
care center. Certifications accepted under this subsection must include
a live return demonstration of skills.
(e) An individual who (1) is employed or (2) volunteers as a
caregiver at a child care center:
(1) must, not more than ninety (90) days after the individual
begins employment or volunteer duties, be trained in pediatric
cardiopulmonary resuscitation applicable to all age groups of
children cared for by the child care center; and
(2) shall maintain current certification in pediatric first aid
applicable to all age groups of children cared for by the child care
center.
SECTION 15. IC 12-17.2-5-18.2, AS AMENDED BY
P.L.246-2023, SECTION 6, IS AMENDED TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2025]: Sec. 18.2. (a) At least one (1) adult
individual who maintains current certification in a course of pediatric
cardiopulmonary resuscitation applicable to all age groups of children
cared for by the child care home shall be present at all times when a
child is in the care of a child care home. Certifications accepted under
this subsection must include a live return demonstration of skills.
(b) An individual who (1) is employed or (2) volunteers as a
caregiver at a child care home:
(1) must, not more than ninety (90) days after the individual
begins employment or volunteer duties, be trained in pediatric
cardiopulmonary resuscitation applicable to all age groups of
children cared for by the child care home; and
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(2) shall maintain current certification in pediatric first aid
applicable to all age groups of children cared for by the child care
home.
SECTION 16. IC 12-17.2-6-7.5, AS AMENDED BY P.L.246-2023,
SECTION 7, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 7.5. (a) At least one (1) adult individual who
maintains current certification in a course of pediatric
cardiopulmonary resuscitation applicable to all age groups of children
cared for by the child care ministry shall be present at all times when
a child is in the care of a child care ministry. Certifications accepted
under this subsection must include a live return demonstration of skills.
(b) An individual who (1) is employed or (2) volunteers as a
caregiver at a child care ministry:
(1) must, not more than ninety (90) days after the individual
begins employment or volunteer duties, be trained in pediatric
cardiopulmonary resuscitation applicable to all age groups of
children cared for by the child care ministry; and
(2) shall maintain current certification in pediatric first aid
applicable to all age groups of children cared for by the child care
ministry.
SECTION 17. IC 12-21-4-3, AS AMENDED BY P.L.207-2021,
SECTION 9, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 3. The council consists of the following
twenty-nine (29) members, not less than fifty percent (50%) of whom
must be individuals who are not state employees or providers of mental
health services:
(1) The director.
(2) The secretary of education or the secretary's designee.
(3) The director of the office of Medicaid policy and planning, or
the secretary's designee.
(4) The director of the bureau of rehabilitation services or the
director's designee.
(5) The executive director of the Indiana housing and community
development authority created by IC 5-20-1-3 or the executive
director's designee.
(6) The director of the criminal justice institute or the director's
designee.
(7) The director of the department of child services or the
director's designee.
(8) Twenty-two (22) individuals at least two (2) of whom are
community mental health center chief executive officers or a chief
executive officer's designee, who:
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(A) are appointed by the secretary;
(B) have a recognized knowledge of or interest in the
programs administered by the division; including
representatives of parents of children with serious emotional
disturbances;
(C) include:
(i) at least two (2) community mental health center chief
executive officers or designees of community mental
health center chief executive officers;
(ii) at least one (1) individual who has a serious mental
illness and is receiving, or has received, mental health
services;
(iii) at least one (1) individual with personal or family
experience with mental illness;
(iv) at least one (1) individual representing a public
entity concerned with the need for, and the planning,
operation, funding, and use of, mental health services
and related support services;
(v) at least one (1) individual representing a private
entity concerned with the need for, and the planning,
operation, funding, and use of, mental health services
and related support services; and
(vi) parents of children with serious emotional
disturbances, in a sufficiently representative number in
relation to the number of other members of the council;
(C) (D) are appointed for a term of four (4) years; and
(D) (E) serve until a successor is appointed.
SECTION 18. IC 12-21-4-8 IS REPEALED [EFFECTIVE JULY 1,
2025]. Sec. 8. (a) This section applies to a member of the council who
is appointed under section 3(8) of this chapter.
(b) Notwithstanding section 3(8)(C) of this chapter, for the
appointments made in 2012, eleven (11) members shall be appointed
for a term of four (4) years, and eleven (11) members shall be
appointed for a term of three (3) years.
SEA 486
President of the Senate
President Pro Tempore
Speaker of the House of Representatives
Governor of the State of Indiana
Date: Time:
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