reglab/housing_qa huggingface dataset:
IN Code § 12-17.6-1-5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 1. Definitions|12-17.6-1-5. "Program"

Sec. 5. "Program" refers to the children's health insurance program established by IC 12-17.6-2.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-1-6 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 1. Definitions|12-17.6-1-6. "Provider"

Sec. 6. "Provider" has the meaning set forth in IC 12-7-2-149.1(2).As added by P.L.273-1999, SEC.177. Amended by P.L.241-2003, SEC.20.
IN Code § 12-17.6-2-1 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|12-17.6-2-1. Administration of Program

Sec. 1. The secretary shall administer the children's health insurance program through the office of Medicaid policy and planning.As added by P.L.273-1999, SEC.177. Amended by P.L.35-2016, SEC.51.
IN Code § 12-17.6-2-2 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|12-17.6-2-2. Design and Administration of Health Benefits Coverage System

Sec. 2. The secretary, through 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. Amended by P.L.35-2016, SEC.52.
IN Code § 12-17.6-2-3 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|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.
IN Code § 12-17.6-2-4 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|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.
IN Code § 12-17.6-2-5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|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.
IN Code § 12-17.6-2-6 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|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.
IN Code § 12-17.6-2-7 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|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) interim study committee on public health, behavioral health, and human services established by IC 2-5-1.3-4 in an electronic format under IC 5-14-6.(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; P.L.205-2013, SEC.212; P.L.53-2014, SEC.111.
IN Code § 12-17.6-2-8 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|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.
IN Code § 12-17.6-2-9 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|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.
IN Code § 12-17.6-2-10 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|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.
IN Code § 12-17.6-2-11 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|12-17.6-2-11. Rules; Emergency Rules; Transfer of Rules

Sec. 11. (a) The secretary shall adopt rules under IC 4-22-2 to implement the program.(b) The secretary may adopt emergency rules under IC 4-22-2-37.1 to implement the program on an emergency basis.(c) A rule adopted before April 15, 2016, by the office of children's health insurance program is transferred to the office of the secretary.As added by P.L.273-1999, SEC.177. Amended by P.L.35-2016, SEC.53.
IN Code § 12-17.6-2-12 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 2. Program Administration|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) interim study committee on public health, behavioral health, and human services established by IC 2-5-1.3-4 in an electronic format under IC 5-14-6.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; P.L.205-2013, SEC.213; P.L.53-2014, SEC.112.
IN Code § 12-17.6-3-1 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 3. Eligibility, Outreach, and Enrollment|12-17.6-3-1. Applicability of Chapter

Sec. 1. This chapter does not apply until January 1, 2000.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-3-2 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 3. Eligibility, Outreach, and Enrollment|12-17.6-3-2. Eligibility Requirements

Sec. 2. (a) To be eligible to enroll in the program, a child must meet the following requirements:(1) The child is less than nineteen (19) years of age.(2) The child is a member of a family with an annual income of:(A) more than one hundred fifty percent (150%); and(B) not more than:(i) two hundred fifty percent (250%); or(ii) the maximum percentage approved by the federal Centers for Medicare and Medicaid Services if the approved amount is less than two hundred fifty percent (250%);of the federal income poverty level.(3) The child is a resident of Indiana.(4) The child meets all eligibility requirements under Title XXI of the federal Social Security Act.(5) The child's family agrees to pay any cost sharing amounts required by the office.(b) The office may adjust eligibility requirements based on available program resources under rules adopted under IC 4-22-2.As added by P.L.273-1999, SEC.177. Amended by P.L.218-2007, SEC.41; P.L.117-2008, SEC.3; P.L.229-2011, SEC.146.
IN Code § 12-17.6-3-2.5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 3. Eligibility, Outreach, and Enrollment|12-17.6-3-2.5. 529 Education Savings Plan

Sec. 2.5. Except as otherwise provided under federal law, the money in an account (as defined in IC 21-9-2-2) of an education savings program (as defined in IC 21-9-2-11) may not be considered as a resource or asset in determining an applicant's or recipient's eligibility for the program.As added by P.L.70-2017, SEC.4.
IN Code § 12-17.6-3-3 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 3. Eligibility, Outreach, and Enrollment|12-17.6-3-3. Termination of Eligibility; Continuous Eligibility Until Three Years of Age

Sec. 3. (a) Subject to subsections (b) and (c), a child who is eligible for the program shall receive services from the program until the earlier of the following:(1) The child becomes financially ineligible.(2) The child becomes nineteen (19) years of age.(b) Subsection (a) applies only if the child and the child's family comply with enrollment requirements.(c) After a child who is less than three (3) years of age is determined to be eligible for the program, the child is not required to submit eligibility information more frequently than once in a twelve (12) month period until the child becomes three (3) years of age.As added by P.L.273-1999, SEC.177. Amended by P.L.107-2002, SEC.25; P.L.218-2007, SEC.42.
IN Code § 12-17.6-3-4 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 3. Eligibility, Outreach, and Enrollment|12-17.6-3-4. Outreach Strategies

Sec. 4. The office shall implement outreach strategies that build on community resources.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-3-5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 3. Eligibility, Outreach, and Enrollment|12-17.6-3-5. Enrollment

Sec. 5. A child may, in any manner determined by the office, apply to receive health care services from the program if the child meets the eligibility requirements of section 2 of this chapter.As added by P.L.273-1999, SEC.177. Amended by P.L.210-2015, SEC.55.
IN Code § 12-17.6-4-1 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 4. Benefits, Crowd Out, and Cost Sharing|12-17.6-4-1. Applicability of Chapter

Sec. 1. This chapter does not apply until January 1, 2000.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-4-2 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 4. Benefits, Crowd Out, and Cost Sharing|12-17.6-4-2. Services Covered; Prohibition on Treatment Limitations or Financial Requirements; Mental Health Services

Sec. 2. (a) The benefit package provided under the program shall focus on age appropriate preventive, primary, and acute care services.(b) The office shall offer health insurance coverage for the following basic services:(1) Inpatient and outpatient hospital services.(2) Physicians' services provided by a physician (as defined in 42 U.S.C. 1395x(r)).(3) Laboratory and x-ray services.(4) Well-baby and well-child care, including:(A) age appropriate immunizations; and(B) periodic screening, diagnosis, and treatment services according to a schedule developed by the office.The office may offer services in addition to those listed in this subsection if appropriations to the program exist to pay for the additional services.(c) The office shall offer health insurance coverage for the following additional services if the coverage for the services has an actuarial value equal to or greater than the actuarial value of the services provided by the benchmark program determined by the children's health policy board established by IC 4-23-27-2:(1) Prescription drugs.(2) Mental health services.(3) Vision services.(4) Hearing services.(5) Dental services.(d) Notwithstanding subsections (b) and (c), the office may not impose treatment limitations or financial requirements on the coverage of services for a mental illness if similar treatment limitations or financial requirements are not imposed on coverage for services for other illnesses. Coverage for mental illness under the program must include the following:(1) Inpatient mental health services and substance abuse services provided in an institution that:(A) treats mental disease; and(B) has more than sixteen (16) beds;unless coverage is prohibited by federal law.(2) Psychiatric residential treatment services.(3) Community mental health rehabilitation services.(4) Outpatient mental health services and substance abuse services, with no greater limitations on the number of units per rolling year than are required under the Medicaid program.However, the office may require prior authorization for the services specified in subdivisions (1) through (4).As added by P.L.273-1999, SEC.177. Amended by P.L.103-2009, SEC.1.
IN Code § 12-17.6-4-2.5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 4. Benefits, Crowd Out, and Cost Sharing|12-17.6-4-2.5. Prescription Drug Requirements

Sec. 2.5. Prescription drugs provided under the program are subject to the requirements of IC 12-15-35.5.As added by P.L.6-2002, SEC.5.
IN Code § 12-17.6-4-3 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 4. Benefits, Crowd Out, and Cost Sharing|12-17.6-4-3. Limits on Premium and Cost Sharing Amounts

Sec. 3. Premium and cost sharing amounts established by the office are limited by the following:(1) Deductibles, coinsurance, or other cost sharing is not permitted with respect to benefits for:(A) well-baby and well-child care, including age appropriate immunizations; and(B) services provided for treatment of an emergency in an emergency department of a hospital licensed under IC 16-21.(2) Premiums and other cost sharing may be imposed based on family income. However, the total annual aggregate cost sharing with respect to all children in a family under this article may not exceed five percent (5%) of the family's income for the year.As added by P.L.273-1999, SEC.177. Amended by P.L.95-2000, SEC.3.
IN Code § 12-17.6-4-4 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 4. Benefits, Crowd Out, and Cost Sharing|12-17.6-4-4. Powers of Office; Cost Sharing and Crowd Out

Sec. 4. The office may do the following:(1) Determine cost sharing amounts.(2) Determine waiting periods that may not exceed three (3) months and exceptions to the requirement of waiting periods for potential enrollees in the program.(3) Adopt additional methods for complying with federal requirements relating to crowd out.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-4-5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 4. Benefits, Crowd Out, and Cost Sharing|12-17.6-4-5. Prohibited Referrals; Mechanisms to Minimize Incentive for Employer to Eliminate or Reduce Coverage

Sec. 5. (a) It is a violation of IC 27-4-1-4 if an insurer, or an insurance producer or insurance broker compensated by the insurer, knowingly or intentionally refers an insured or the dependent of an insured to the program for health insurance coverage when the insured already receives health insurance coverage through an employer's health care plan that is underwritten by the insurer.(b) The office shall coordinate with the children's health policy board under IC 4-23-27 to evaluate the need for mechanisms that minimize the incentive for an employer to eliminate or reduce health care coverage for an employee's dependents.As added by P.L.273-1999, SEC.177. Amended by P.L.178-2003, SEC.3.
IN Code § 12-17.6-4-6 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 4. Benefits, Crowd Out, and Cost Sharing|12-17.6-4-6. Community Health Centers

Sec. 6. Community health centers shall be used to provide health care services.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-4-7 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 4. Benefits, Crowd Out, and Cost Sharing|12-17.6-4-7. Selection of Primary Dental Provider Encouraged

Sec. 7. The office shall encourage the parent of a child who is enrolled in the program to select a primary dental provider for the child before the child is eighteen (18) months of age.As added by P.L.169-2001, SEC.3.
IN Code § 12-17.6-4-8 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 4. Benefits, Crowd Out, and Cost Sharing|12-17.6-4-8. Use of Generic Drugs and Preferred Drug List Required

Sec. 8. (a) The office shall require the use of generic drugs in the program.(b) The office shall use the preferred drug list implemented under IC 12-15-35-28.7.As added by P.L.291-2001, SEC.158. Amended by P.L.107-2002, SEC.26.
IN Code § 12-17.6-5-1 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 5. Provider Contracts|12-17.6-5-1. Applicability of Chapter

Sec. 1. This chapter does not apply until January 1, 2000.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-5-2 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 5. Provider Contracts|12-17.6-5-2. Required Information

Sec. 2. A provider agreement must include information that the office finds necessary to facilitate carrying out this article.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-5-3 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 5. Provider Contracts|12-17.6-5-3. Compliance With Enrollment Requirements

Sec. 3. A provider who participates in the program, including a provider who is a member of a managed care organization, must comply with the enrollment requirements that are established under IC 12-15.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-5-4 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 5. Provider Contracts|12-17.6-5-4. Direct Access of Enrollee to Provider

Sec. 4. (a) A provider that participates in the Medicaid program is considered a provider for both the Medicaid program and the program under this article.(b) If an enrollee in the Medicaid managed care program for children has direct access to a provider who has entered into a provider agreement under IC 12-15-11, an enrollee in the program has direct access to the same provider.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-6-1 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes|12-17.6-6-1. Applicability of Chapter

Sec. 1. This chapter does not apply until January 1, 2000.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-6-2 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes|12-17.6-6-2. Provider Sanctions

Sec. 2. If after investigation the office finds that a provider has violated this article or rule adopted under this article, the office may impose at least one (1) of the following sanctions:(1) Deny payment to the provider for program services provided during a specified time.(2) Reject a prospective provider's application for participation in the program.(3) Terminate a provider agreement allowing a provider's participation in the program.(4) Assess a civil penalty against the provider in an amount not to exceed three (3) times the amount paid to the provider that exceeds the amount that was legally due.(5) Assess an interest charge, at a rate not to exceed the rate established by IC 24-4.6-1-101(2) for judgments on money, on the amount paid to the provider that exceeds the amount that was legally due. The interest charge accrues from the date of the overpayment to the provider.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-6-3 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes|12-17.6-6-3. Ineligibility to Participate in Program

Sec. 3. In addition to any sanction imposed on a provider under section 2 of this chapter, a provider convicted of an offense under IC 35-43-5 relating to the program is ineligible to participate in the program for ten (10) years after the conviction.As added by P.L.273-1999, SEC.177. Amended by P.L.174-2021, SEC.11.
IN Code § 12-17.6-6-4 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes|12-17.6-6-4. Administrative Review

Sec. 4. A provider may appeal a sanction imposed under section 2 of this chapter under rules concerning Medicaid provider appeals that are adopted by the secretary under IC 4-22-2.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-6-5 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes|12-17.6-6-5. Judicial Review

Sec. 5. After exhausting all administrative remedies, a provider may obtain judicial review of a sanction under IC 4-21.5-5.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-6-6 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes|12-17.6-6-6. Provider to Notify Recipients of Services for Which Office Will Not Pay

Sec. 6. A final directive made by the office that:(1) denies payment to a provider for medical services provided during a specified period; or(2) terminates a provider agreement permitting a provider's participation in the program;must direct the provider to inform each eligible recipient of services, before services are provided, that the office will not pay for those services if provided.As added by P.L.273-1999, SEC.177.
IN Code § 12-17.6-6-7 (2021)
2021 Indiana Code|Title 12. Human Services|Article 17.6. Children's Health Insurance Program|Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes|12-17.6-6-7. Duration of Final Directive

Sec. 7. Subject to section 8 of this chapter, a final directive:(1) denying payment to a provider;(2) rejecting a prospective provider's application for participation in the program; or(3) terminating a provider agreement allowing a provider's participation in the program;must be for a sufficient time, in the opinion of the office, to allow for the correction of all deficiencies or to prevent further abuses.As added by P.L.273-1999, SEC.177.