Indiana House Bill 1374 (Prior Session Legislation)

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Spectrum: Slight Partisan Bill (Republican 3-1)
Status: Introduced on January 14 2021 - 25% progression, died in committee
Action: 2021-01-14 - First reading: referred to Committee on Public Health
Pending: House Public Health Committee
Text: Latest bill text (Introduced) [PDF]

Medicaid providers and managed care organizations. Allows a provider that has entered into a contract with a managed care organization, after exhausting any internal procedures of the managed care organization for provider grievances and appeals, to request an administrative appeal within the office of Medicaid policy and planning of the managed care organization's action in denying or reducing reimbursement for claims for covered services provided to an applicant, pending applicant, conditionally eligible individual, or member. Establishes a procedure for an administrative appeal, including a hearing before an administrative law judge that could be followed by agency review and then by judicial review. Prohibits a provision in a contract between a provider and a managed care organization that would negate or restrict the right of a provider to an administrative appeal and provides that such a contract provision is void and unenforceable. Repeals a provision under which Medicaid law is controlling when Medicaid law conflicts with insurance law. Provides that if the office of the secretary of family and social services or a contractor of the office fails to pay or denies a clean claim for any eligible Medicaid service within certain time limits due to the office or contractor incorrectly processing the clean claim because of errors attributable to the internal system of an insurer or managed care organization, the office or contractor may not assert that the provider failed to meet the time filing requirements for the claim.

Medicaid providers and managed care organizations.

Rep. Edward Clere [R]

Rep. Ann Vermilion [R]

Rep. Jeffrey Thompson [R]

Rep. Rita Fleming [D]

Date	Chamber	Action
2021-01-14	House	First reading: referred to Committee on Public Health
2021-01-14	House	Coauthored by Representatives Vermilion, Thompson, Fleming
2021-01-14	House	Authored by Representative Clere

Type	Source
Summary	https://iga.in.gov/legislative/2021/bills/house/1374/details
Text	http://iga.in.gov/static-documents/a/2/8/2/a28287f3/HB1374.01.INTR.pdf
Supplement	http://iga.in.gov/static-documents/b/a/a/0/baa0cced/HB1374.01.INTR.FN001.pdf