HB 1176

Bill Subjects

Abstract

Provides that: (1) a health benefits plan; or (2) an employee health plan; may not require authorization for services specified in a covered individual's individualized family service plan once the individualized family service plan is signed by a physician. Adds habilitative services to the services that are required under the definition of "early intervention services" for purposes of the First Steps program. Provides that a member of the interagency coordinating council (council) shall continue to serve until a successor is appointed. Removes the authority of the governor to designate the chairperson of the council or to call a meeting of the council. Requires the council to annually elect a chairperson and vice chairperson. Provides that, except for members of the general assembly, per diem and travel expenses for council members are governed by the policies and procedures established by the Indiana department of administration and approved by the budget agency. Establishes procedures that the division must follow before making a change to the cost participation schedule under the First Steps program. Establishes a method to determine the rate at which: (1) a provider of the services under the First Steps program; or (2) the division; is reimbursed for providing early intervention services using Current Procedural Terminology (CPT) code rates. Provides that: (1) a health plan information card issued: (A) to an insured by an insurer for a policy of accident and sickness insurance; or (B) to an enrollee by a health maintenance organization (HMO); must indicate the type of health plan that is providing the health benefits and services under the insurance policy or HMO contract; and (2) these requirements apply only to a health plan information card issued: (A) initially to a new insured or new enrollee; or (B) to an insured or enrollee at the time of the insured's or enrollee's policy or contract renewal; after July 1, 2020. Provides that: (1) the electronic database by which an issuer of a policy of accident and sickness insurance, or an administrator of a self insured plan, allows an insured or a provider to verify the coverage or benefits of an insured must indicate: (A) whether health benefits and services under the policy of accident and sickness insurance are provided by the issuer of the policy or by a third party administrator; and (B) whether the policy of accident and sickness insurance is subject to state or federal regulation; and (2) the electronic database by which by which an HMO, or an administrator of benefits and health care services under an HMO contract, allows an enrollee or a provider to verify the coverage or benefits of an enrollee must indicate: (A) whether benefits and health care services under the HMO contract are provided by the HMO or by a third party administrator; and (B) whether the HMO contract is a self funded or fully funded plan. Requires the department of insurance to adopt rules to ensure compliance with certain provisions added by the bill.