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 isestablished 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 providehealth 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 forchildren
Sec. 3. To the greatest extent possible, the office shall use thesame:
(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 sponsoredcoverage under the program.
(2) Expanding health insurance coverage under the program toother populations as provided under section 2105(c)(3) of thefederal 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 isoccurring.
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 parentor 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 independentorganization 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 establishedby IC 2-5-26-3.
(c) This section does not modify the requirements of other statutesrelating 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, contractwith 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 thefollowing:
(1) Encourage beneficial and appropriate use of health careservices.
(2) Pursue efforts to enhance provider availability.
(b) In determining the best approach for each area, the office shalldo the following:
(1) Evaluate distinct market areas.
(2) Weigh the advantages and disadvantages of alternativedelivery 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), theemployer 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 toimplement the program.
(b) The office may adopt emergency rules under IC 4-22-2-37.1to 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 reportdescribing the program's activities during the preceding calendar yearto 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 establishedby IC 2-5-26-3.
A report provided under this section to the legislative council mustbe 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.