IN HB 1277: Health and human services matters.

Indiana HB 1277, signed by the Governor, amends the duties of the Office of the Secretary of Family and Social Services (FSSA) with respect to Medicaid home and community based services (HCBS) waivers. The bill requires waiver service providers to furnish specified documentation to waiver recipients, requires recipients to review that documentation and report errors or inconsistencies, and requires recipients' case managers to assist in that review and reporting process.

The bill requires certain Medicaid recipients to choose their own provider of integrated health care coordination, and specifies that integrated health care coordination delivered by an assisted living services provider is not duplicative of other covered services. It also establishes a defined time frame within which the Bureau of Disabilities Services must review and either approve or deny requests for increased service units for individuals with a disability.

HB 1277 requires the FSSA office to apply to the federal government for: (1) a new Medicaid waiver to cover assisted living services; and (2) an amendment to an existing HCBS waiver to establish an individual cost limit of not more than the institutional cost of nursing facility services. Reimbursement provisions for assisted living services for aged and disabled individuals under a Medicaid waiver are extended to apply to the new assisted living Medicaid waiver.

Beginning July 1, 2027, an individual who receives nursing facility services for 100 consecutive days is removed from the covered population on the one-hundredth day and transitions to Medicaid services under a fee-for-service program. The provision prohibiting the office from reducing reimbursement for home health services expires June 30, 2027, after which the office must collaborate with specified entities to develop a new reimbursement methodology for home health services. The bill also reduces the required public notice period before a health facility service reimbursement reduction may take effect from one year to six months.

Additionally, the bill amends the definition of "bulk drug substance" for drug compounding provisions, and establishes that a claim by the estate recovery unit of the Office of Medicaid Policy and Planning is forever barred unless filed in the court administering the decedent's estate no later than nine months after the date of the decedent's death.