CHAPTER 2. PROGRAM ADMINISTRATION
IC 12-17.6-2
Chapter 2. Program Administration
IC 12-17.6-2-1
Office of children's health insurance program established
Sec. 1. The office of the children's health insurance program is
established within the office of the secretary.
As added by P.L.273-1999, SEC.177.
IC 12-17.6-2-2
Design and administration of health benefits coverage system
Sec. 2. The office shall design and administer a system to provide
health benefits coverage for children eligible for the program.
As added by P.L.273-1999, SEC.177.
IC 12-17.6-2-3
Use of same factors as Medicaid managed care program for
children
Sec. 3. To the greatest extent possible, the office shall use the
same:
(1) eligibility determination;
(2) enrollment;
(3) provider networks; and
(4) claims payment systems;
as are used by the Medicaid managed care program for children.
As added by P.L.273-1999, SEC.177.
IC 12-17.6-2-4
Feasibility studies
Sec. 4. The office shall evaluate the feasibility of the following:
(1) Establishing a program to subsidize employer sponsored
coverage under the program.
(2) Expanding health insurance coverage under the program to
other populations as provided under section 2105(c)(3) of the
federal Social Security Act.
As added by P.L.273-1999, SEC.177.
IC 12-17.6-2-5
Program review requirements
Sec. 5. Reviews of the program shall:
(1) be conducted in compliance with federal requirements; and
(2) include an analysis of the extent to which crowd out is
occurring.
As added by P.L.273-1999, SEC.177.
IC 12-17.6-2-6
Performance criteria and monitoring
Sec. 6. The office shall do the following:
(1) Establish performance criteria and evaluation measures.
(2) Monitor program performance.
(3) Adopt a formula that:
(A) specifies the premiums, if any, to be paid by the parent
or guardian of a child enrolled in the program; and
(B) is based on the child's family income.
As added by P.L.273-1999, SEC.177.
IC 12-17.6-2-7
Evaluation of program
Sec. 7. (a) The office shall contract with an independent
organization to evaluate the program.
(b) The office shall report the results of each evaluation to the:
(1) children's health policy board established by IC 4-23-27-2;
and
(2) select joint commission on Medicaid oversight established
by IC 2-5-26-3.
(c) This section does not modify the requirements of other statutes
relating to the confidentiality of medical records.
As added by P.L.273-1999, SEC.177. Amended by P.L.66-2002,
SEC.11.
IC 12-17.6-2-8
Contracts with community entities
Sec. 8. The office may, in administering the program, contract
with community entities, including private entities, for the following:
(1) Outreach for and enrollment in the managed care program.
(2) Provision of services.
(3) Consumer education and public health education.
As added by P.L.273-1999, SEC.177.
IC 12-17.6-2-9
Creative methods reflective of community level objectives
Sec. 9. (a) The office shall incorporate creative methods,
reflective of community level objectives and input, to do the
following:
(1) Encourage beneficial and appropriate use of health care
services.
(2) Pursue efforts to enhance provider availability.
(b) In determining the best approach for each area, the office shall
do the following:
(1) Evaluate distinct market areas.
(2) Weigh the advantages and disadvantages of alternative
delivery models, including the following:
(A) Risk based managed care only.
(B) Primary care gatekeeper model only.
(C) A combination of clauses (A) and (B).
As added by P.L.273-1999, SEC.177.
IC 12-17.6-2-10
Program to subsidize employer sponsored coverage
Sec. 10. (a) The office may establish a program to subsidize
employer sponsored coverage for:
(1) eligible individuals; and
(2) the families of eligible individuals;
consistent with federal law.
(b) If the office establishes a program under subsection (a), the
employer sponsored benefit package must comply with federal law.
As added by P.L.273-1999, SEC.177.
IC 12-17.6-2-11
Rules
Sec. 11. (a) The office shall adopt rules under IC 4-22-2 to
implement the program.
(b) The office may adopt emergency rules under IC 4-22-2-37.1
to implement the program on an emergency basis.
As added by P.L.273-1999, SEC.177.
IC 12-17.6-2-12
Annual report
Sec. 12. Not later than April 1, the office shall provide a report
describing the program's activities during the preceding calendar year
to the:
(1) budget committee;
(2) legislative council;
(3) children's health policy board established by IC 4-23-27-2;
and
(4) select joint commission on Medicaid oversight established
by IC 2-5-26-3.
A report provided under this section to the legislative council must
be in an electronic format under IC 5-14-6.
As added by P.L.273-1999, SEC.177. Amended by P.L.66-2002,
SEC.12; P.L.28-2004, SEC.110.