reglab/statecodes huggingface dataset:
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-7. Prekindergarten Program Established; Grants; Eligible Providers; Participation

Sec. 7. (a) The prekindergarten program is established to provide grants for:
(1) qualified early education services in a manner consistent with how funds are distributed under the Child Care and Development Fund (CCDF) grant program; and
(2) expansion plans as described in section 7.4(a)(2) of this chapter.
(b) The office shall administer the prekindergarten program. The prekindergarten program may include:
(1) eligible providers in Indiana; and
(2) potential eligible providers or existing eligible providers as described in section 7.4 of this chapter.
(c) Beginning July 1, 2020, the total number of grants during the immediately preceding state fiscal year shall include the number of grants issued under a preschool program established in March 2015 that operates in a consolidated city.
(d) The prekindergarten program includes eligible providers in any county in Indiana.
(e) Subject to the requirements of this chapter, the office shall determine:
(1) the eligibility requirements, application process, and selection process for awarding grants under the prekindergarten program;
(2) the administration and reporting requirements for:
(A) eligible providers; and
(B) potential eligible providers or existing eligible providers;
participating in the prekindergarten program; and
(3) with the assistance of the early learning advisory committee, an appropriate outcomes based accountability system for:
(A) eligible providers; and
(B) potential eligible providers or existing eligible providers.
(f) The office shall, subject to the availability of funding, determine the number of eligible children who will participate in the prekindergarten program. After December 31, 2019, the office shall, subject to the availability of funding, determine the number of limited eligibility children who will participate in the prekindergarten program.
As added by P.L.202-2014, SEC.2. Amended by P.L.184-2017, SEC.19; P.L.268-2019, SEC.7; P.L.246-2023, SEC.11.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-7.2. Qualifications; Parent or Guardian Requirements and Agreement

Sec. 7.2. (a) For an eligible child to qualify for a grant under this chapter, the eligible child must reside with a parent or guardian who is:
(1) working or attending a job training or an educational program; or
(2) actively seeking employment, subject to the approval by the United States Department of Health and Human Services as provided in 45 CFR 98.21.
(b) For a limited eligibility child to qualify for a grant under this chapter, the limited eligibility child must reside with a parent or guardian who:
(1) is working or attending a job training or an educational program;
(2) is actively seeking employment, subject to the approval by the United States Department of Health and Human Services as provided in 45 CFR 98.21; or
(3) receives Social Security Disability Insurance or Supplemental Security Income benefits.
(c) Before the office may award a grant to an eligible or limited eligibility child under this chapter, the office shall require that a parent or guardian of the eligible or limited eligibility child agree to the following:
(1) The eligible or limited eligibility child will attend the prekindergarten program of an eligible provider selected by the parent or guardian for the full duration of the prekindergarten program year.
(2) The parent or guardian will not transfer to another prekindergarten program during the prekindergarten program year.
(3) The eligible or limited eligibility child will attend the prekindergarten program at least eighty-five percent (85%) of the days that the prekindergarten program is provided.
(4) The parent or guardian will allow the eligible or limited eligibility child to participate in an external evaluation conducted by researchers, including the kindergarten readiness assessment and measuring of developmental and academic progress.
(5) The parent or guardian will participate in family engagement and involvement activities offered by the selected prekindergarten program, including meetings with the eligible or limited eligibility child's teacher to discuss the eligible or limited eligibility child's progress or any other conference concerning the eligible or limited eligibility child that is requested by the eligible provider.
(6) The parent or guardian will complete the necessary forms for the eligible child or limited eligibility child to receive a student test number from the department of education.
(7) The parent or guardian will send the eligible or limited eligibility child to kindergarten.
(8) The parent or guardian will read to the eligible or limited eligibility child each week.
(9) Any other condition the office determines is appropriate.
(d) Priority may be given to an eligible or limited eligibility child under this section if a parent or guardian of the eligible or limited eligibility child is:
(1) involved in activities that improve the parent's or guardian's education; or
(2) involved in job training.
As added by P.L.184-2017, SEC.21. Amended by P.L.268-2019, SEC.9.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-7.4. Potential Eligible Provider or Existing Eligible Provider Requirements; Expansion Plans; Agreement; Restrictions; Repayment for Noncompliance; Federal Grants

Sec. 7.4. (a) To qualify as a potential eligible provider or existing eligible provider, an applicant must:
(1) provide an expansion plan to the office that details the potential eligible provider's or existing eligible provider's plan to:
(A) increase the capacity of providers of qualified early education services to serve a greater number of eligible or limited eligibility children;
(B) increase the number of providers of qualified early education services; or
(C) increase the capacity as described in clause (A) and increase the number as described in clause (B);
(2) comply with the agreement with the office concerning the plan under subdivision (1) and the use of a grant awarded under this chapter;
(3) agree:
(A) to operate as an eligible provider; or
(B) that the applicant intends to operate as an eligible provider;
(4) agree that the applicant will not use any grant funds awarded under this section for capital expenditures; and
(5) comply with any other standards and procedures established under this chapter.
(b) Subject to subsections (c) and (d), the office may award a grant to an applicant that meets the requirements of subsection (a).
(c) The office may not use more than a total of twenty percent (20%) of the money in the fund each state fiscal year:
(1) for grants awarded under this chapter to potential eligible providers and existing eligible providers for expansion plans; and
(2) to meet any state match amounts required for a federal grant described in subsection (f).
(d) The office may not award grant funds under this section to an applicant for any of the following:
(1) The purchase of land or a building.
(2) The construction or expansion of a building.
(e) If a potential eligible provider or existing eligible provider fails to:
(1) use the grant funds in accordance with the expansion plan described in subsection (a); or
(2) comply with the agreement entered into with the office under subsection (a);
the potential eligible provider or existing eligible provider shall repay to the office the total amount of the grant awarded to the potential eligible provider or existing eligible provider under this chapter.
(f) The office may use money in the fund that is allocated for expansion plans under this section for a state fiscal year to meet any state match amounts required for a federal grant if the purpose of the federal grant is that the grant money be used for increasing:
(1) the capacity;
(2) the number; or
(3) both the capacity and number;
of providers of early education services for children four (4) years of age.
As added by P.L.184-2017, SEC.23. Amended by P.L.268-2019, SEC.11; P.L.246-2023, SEC.13.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-7.5. Rules

Sec. 7.5. The office may adopt rules under IC 4-22-2 concerning the implementation and the administration of the prekindergarten program.
As added by P.L.35-2016, SEC.49. Amended by P.L.184-2017, SEC.24; P.L.246-2023, SEC.14.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-7.6. Monitoring Educational Outcomes of Expansion Plans; Report

Sec. 7.6. (a) The office shall monitor the educational outcomes resulting from the implementation of expansion plans described in section 7.4(a) of this chapter by potential eligible providers or existing eligible providers that receive a grant under this chapter over the period established by the office to evaluate the contribution that the expansion plans make toward improved educational outcomes.
(b) Beginning in 2018, the office shall annually provide the:
(1) governor; and
(2) legislative council in an electronic format under IC 5-14-6;
a report of the findings of the office concerning the educational outcomes under subsection (a).
As added by P.L.184-2017, SEC.25.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-7.8. Random Onsite Inspections; Determination of Ineligibility

Sec. 7.8. (a) The office shall make random onsite inspections each year, as determined necessary by the office, at the facility of:
(1) an eligible provider; or
(2) a potential eligible provider or existing eligible provider;
that receives a grant under this chapter.
(b) The office may determine that an eligible provider or potential eligible provider or existing eligible provider is not eligible to receive a grant under the prekindergarten program if the eligible provider or potential eligible provider or existing eligible provider:
(1) fails to comply with this chapter; or
(2) refuses to allow, during normal business hours, the office or an agent of the office to inspect the facility at which the eligible provider or potential eligible provider or existing eligible provider operates a child care program for eligible or limited eligibility children.
As added by P.L.184-2017, SEC.26. Amended by P.L.268-2019, SEC.12; P.L.246-2023, SEC.15.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-8. Eligibility; Amount of Grant; Funding From Donations and Gifts

Sec. 8. (a) The office shall determine:
(1) which applicants shall be awarded a grant; and
(2) subject to subsection (b) and to the availability of funding, the amount of each grant.
(b) At least five percent (5%) but not more than fifty percent (50%) of the:
(1) tuition for eligible or limited eligibility children under the prekindergarten pilot program; or
(2) expansion plan described in section 7.4(a) of this chapter;
during the state fiscal year must be paid from donations, gifts, grants, bequests, and other funds received from a private entity or person, from the United States government, or from other sources (excluding funds from a grant provided under this chapter and excluding other state funding). The office may receive and administer grants on behalf of the prekindergarten pilot program. The grants shall be distributed by the office to fulfill the requirements of this subsection.
(c) The amount of a grant made under the pilot program to an eligible or limited eligibility child:
(1) who attends a prekindergarten program full time must equal at least two thousand five hundred dollars ($2,500) during the state fiscal year; and
(2) may not exceed six thousand eight hundred dollars ($6,800) from state money provided under this chapter during the state fiscal year.
As added by P.L.202-2014, SEC.2. Amended by P.L.85-2017, SEC.61; P.L.184-2017, SEC.27; P.L.268-2019, SEC.13.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-8.1. Grants for Limited Eligibility Children; Maximum Amount

Sec. 8.1. (a) If funds are appropriated by the general assembly, grants to limited eligibility children may not exceed:
(1) twenty percent (20%) of the amount appropriated for a particular state fiscal year if families with children four (4) years of age are on the waiting list for funds available under the Child Care Development Fund; or
(2) forty percent (40%) of the amount appropriated for a particular state fiscal year if there is no waiting list for children four (4) years of age for funds available under the Child Care Development Fund.
(b) During the priority enrollment period, the office shall provide grants to eligible children in the prekindergarten program on a first-come, first-served basis. The office shall date stamp and reserve applications for limited eligibility children received during the priority enrollment period for processing during the extended enrollment period.
(c) During the extended enrollment period, the office shall provide grants to eligible children and limited eligibility children in the prekindergarten program on a first-come, first-served basis to the extent of available funding and in accordance with the limit established by subsection (a).
As added by P.L.268-2019, SEC.14. Amended by P.L.216-2021, SEC.5; P.L.246-2023, SEC.16.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-10. Application for Federal Waivers

Sec. 10. The office shall apply for any available waivers under the federal Child Care and Development Fund (CCDF) grant program and the federal Head Start program.
As added by P.L.202-2014, SEC.2.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-11. Determination of Eligibility for Choice Scholarships

Note: This version of section amended by P.L.201-2023, SEC.139, effective 6-29-2023. See also following version of this section amended by P.L.246-2023, SEC.17, effective 7-1-2023.
Sec. 11. The receipt of a grant under the pilot program does not qualify, nor have an effect on the qualification or eligibility, of a child for a choice scholarship under IC 20-51-4.
As added by P.L.202-2014, SEC.2. Amended by P.L.184-2017, SEC.28; P.L.165-2021, SEC.142; P.L.201-2023, SEC.139.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-11-b. Determination of Eligibility for Choice Scholarships

Note: This version of section amended by P.L.246-2023, SEC.17, effective 7-1-2023. See also preceding version of this section amended by P.L.201-2023, SEC.139, effective 6-29-2023.
Sec. 11. Except as provided under IC 20-51-1-4.3(4)(E), the receipt of a grant under the prekindergarten program does not qualify, nor have an effect on the qualification or eligibility, of a child for a choice scholarship under IC 20-51-4.
As added by P.L.202-2014, SEC.2. Amended by P.L.184-2017, SEC.28; P.L.165-2021, SEC.142; P.L.246-2023, SEC.17.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-12. Requirement for Longitudinal Study

Sec. 12. (a) At least once every five (5) years, the office, in cooperation with the department of education, shall carry out a longitudinal study of students who participate in the prekindergarten program to determine the achievement levels of those students in kindergarten and later grades.
(b) The longitudinal study must include a comparison of test and assessment results in grade 3 of:
(1) the eligible children who participated in the prekindergarten program; and
(2) a control group determined by the office that consists of children who did not participate in the prekindergarten program.
(c) The office may, after consulting with the state board of education, enter into a contract with one (1) or more persons to carry out the longitudinal study under this section. The office may expend not more than one million dollars ($1,000,000) from the funds appropriated under section 9 of this chapter (repealed) to carry out the longitudinal study.
As added by P.L.202-2014, SEC.2. Amended by P.L.85-2017, SEC.63; P.L.184-2017, SEC.29; P.L.246-2023, SEC.18.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-13. Reporting Requirements

Sec. 13. (a) The office shall, before November 1 of each year, submit a report to the governor, the budget committee, the state board of education, the department of education, and, in an electronic format under IC 5-14-6, the general assembly regarding the prekindergarten program.
(b) The report under subsection (a) must include the following:
(1) The total number of children who received a grant under the prekindergarten program for the immediately preceding state fiscal year, disaggregated by county.
(2) The total amount of funds budgeted for and spent under the prekindergarten program during the immediately preceding state fiscal year.
(3) The balance remaining in the fund at the end of the immediately preceding state fiscal year.
As added by P.L.202-2014, SEC.2. Amended by P.L.184-2017, SEC.30; P.L.268-2019, SEC.15; P.L.246-2023, SEC.19.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-13.1. Monthly Informational Report

Sec. 13.1. The office shall post monthly on the office's website the total enrollment of and number of grants awarded to:
(1) all eligible children (before January 1, 2020); and
(2) after December 31, 2019, both:
(A) all eligible children; and
(B) all limited eligibility children;
for each county that participates in the prekindergarten program.
As added by P.L.268-2019, SEC.16. Amended by P.L.246-2023, SEC.20.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.2. Prekindergarten Pilot Program › 12-17.2-7.2-13.5. Prekindergarten Program Fund

Sec. 13.5. (a) The prekindergarten program fund is established to:
(1) provide grants to eligible or limited eligibility children for qualified early education services under this chapter;
(2) carry out the longitudinal study described in section 12 of this chapter;
(3) provide grants to potential eligible providers and existing eligible providers as set forth in section 7.4 of this chapter; and
(4) make payments to reimburse costs incurred to provide in-home early education services under IC 12-17.2-7.5.
(b) The fund consists of:
(1) money appropriated to the fund by the general assembly; and
(2) grants or gifts to the fund.
(c) The fund shall be administered by the office.
(d) The expenses of administering the fund shall be paid from money in the fund.
(e) Money in the fund is continuously appropriated for the purposes provided under this article.
(f) The treasurer of state shall invest the money in the fund not currently needed to meet the obligations of the fund in the same manner as other public funds may be invested.
As added by P.L.184-2017, SEC.31. Amended by P.L.268-2019, SEC.17; P.L.108-2019, SEC.200; P.L.156-2020, SEC.60; P.L.246-2023, SEC.21.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.5. Technology Based In-Home Early Education › 12-17.2-7.5-1. "In-Home Early Education Services"

Sec. 1. As used in this chapter, "in-home early education services" means a technology based program of early education that:
(1) is designed to improve a child's transition into elementary education;
(2) includes a parental engagement and involvement component;
(3) is provided to a child at the child's home or a similar home setting; and
(4) meets the design parameters for inclusion in the longitudinal study described in section 5 of this chapter, as determined by the office.
As added by P.L.184-2017, SEC.32.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.5. Technology Based In-Home Early Education › 12-17.2-7.5-4. Reimbursement Program; Reimbursement Rates; Funding

Sec. 4. (a) After completing the review under section 3 of this chapter, the office may develop and implement a reimbursement program to reimburse costs that are incurred by a parent or guardian of a child to provide in-home early education services to the child.
(b) If the office develops and implements a reimbursement program under subsection (a), the office may not give preference to a child located in a county that does not have a child care provider that meets the standards of quality recognized by a Level 3 or Level 4 Paths to QUALITY program rating located in the county.
(c) The office may develop reimbursement rates for the reimbursement of in-home early education services.
(d) Reimbursement by the office under this section may be funded from any of the following sources:
(1) Federal grants.
(2) State appropriations.
(3) Money from a political subdivision (as defined in IC 36-1-2-13).
(4) Money from the prekindergarten program fund established by IC 12-17.2-7.2-13.5.
As added by P.L.184-2017, SEC.32. Amended by P.L.165-2021, SEC.143; P.L.246-2023, SEC.23.
2023 Indiana Code › Title 12. Human Services › Article 17.2. Day Care Regulation › Chapter 7.5. Technology Based In-Home Early Education › 12-17.2-7.5-5. Longitudinal Study; Costs; Requirements

Sec. 5. (a) If the office implements a reimbursement program under section 4(a) of this chapter, the office shall require the provider of the in-home early education services to contract with a third party to conduct a longitudinal study, as prescribed by the office, of students who receive the in-home early education services to determine the achievement levels of those students in kindergarten and later grades. The cost of the longitudinal study may not be paid by the office.
(b) The longitudinal study under this section must include a comparison of test and assessment results in grade 3 of:
(1) the children who received in-home early education services; and
(2) a control group that consists of children who did not receive in-home early education services.
(c) The provider of the in-home early education services shall provide the results of the longitudinal study under this section to the office.
As added by P.L.184-2017, SEC.32.
2023 Indiana Code › Title 12. Human Services › Article 17.6. Children's Health Insurance Program › Chapter 1. Definitions › 12-17.6-1-2. "Crowd Out"

Sec. 2. "Crowd out" means the extent to which:
(1) families substitute coverage offered under the program for employer sponsored health insurance coverage for children; or
(2) employers:
(A) reduce or eliminate health insurance benefits for children under an employer based health insurance plan; or
(B) increase the employee's share of the cost of benefits for children under an employer based health insurance plan relative to the total cost of the plan;
as a result of the program.
As added by P.L.273-1999, SEC.177.
2023 Indiana Code › Title 12. Human Services › Article 17.6. Children's Health Insurance Program › Chapter 1. Definitions › 12-17.6-1-2.6. "Emergency"

Sec. 2.6. "Emergency" means a medical condition that manifests itself by acute symptoms of such severity, including severe pain, that the absence of immediate medical attention could reasonably be expected by a prudent lay person who possesses an average knowledge of health and medicine to:
(1) place an individual's health in serious jeopardy;
(2) result in serious impairment to the individual's bodily functions; or
(3) result in serious dysfunction of a bodily organ or part of the individual.
As added by P.L.95-2000, SEC.2. Amended by P.L.223-2001, SEC.12 and P.L.283-2001, SEC.32.
2023 Indiana Code › Title 12. Human Services › Article 17.6. Children's Health Insurance Program › Chapter 1. Definitions › 12-17.6-1-4. "Office"

Sec. 4. "Office" refers to the office of Medicaid policy and planning established by IC 12-8-6.5-1.
As added by P.L.273-1999, SEC.177. Amended by P.L.35-2016, SEC.50.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 Indiana Code › Title 12. Human Services › Article 17.6. Children's Health Insurance Program › Chapter 3. Eligibility, Outreach, and Enrollment › 12-17.6-3-2.4. Assistance to Child or Pregnant Woman Who Is Not Lawful Permanent Resident

Sec. 2.4. (a) An individual who:
(1) is less than nineteen (19) years of age;
(2) is lawfully residing in the United States, as set forth in 42 U.S.C. 1396b(v)(4);
(3) is otherwise eligible for the program under this article; and
(4) meets any other requirement under federal law;
is entitled to receive assistance under this article without a waiting period as allowed under 42 U.S.C. 1397gg(e)(1).
(b) The office of the secretary shall apply for any amendment to the state's children's health insurance program or waiver necessary to implement this section.
As added by P.L.213-2023, SEC.3.
2023 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.
2023 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 19 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 nineteen (19) 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 nineteen (19) 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; P.L.213-2023, SEC.4.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 Indiana Code › Title 12. Human Services › Article 17.6. Children's Health Insurance Program › Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes › 12-17.6-6-8. Conditions for Reinstatement of Provider Under Sanction

Sec. 8. Except as provided in section 10 of this chapter, a provider sanctioned under section 2 of this chapter may not be declared reinstated as a provider under this article until the office has received the following:
(1) Full repayment of the amount paid to the provider in excess of the proper and legal amount due, including any interest charge assessed by the office.
(2) Full payment of a civil penalty assessed under section 2(4) of this chapter.
As added by P.L.273-1999, SEC.177.
2023 Indiana Code › Title 12. Human Services › Article 17.6. Children's Health Insurance Program › Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes › 12-17.6-6-9. Provider Filing Agreements Under Sanction

Sec. 9. Except as provided in section 10 of this chapter, a provider sanctioned under section 2 of this chapter may file an agreement as provided in IC 12-17.6-5.
As added by P.L.273-1999, SEC.177.
2023 Indiana Code › Title 12. Human Services › Article 17.6. Children's Health Insurance Program › Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes › 12-17.6-6-10. Ineligibility of Provider Under Sanction to Submit Claims

Sec. 10. A provider who has been:
(1) convicted of a crime relating to the provision of services under this chapter; or
(2) subjected to a sanction under section 2 of this chapter on three (3) separate occasions by directive of the office;
is ineligible to submit claims for the program.
As added by P.L.273-1999, SEC.177.
2023 Indiana Code › Title 12. Human Services › Article 17.6. Children's Health Insurance Program › Chapter 6. Provider Sanctions, Theft, Kickbacks, and Bribes › 12-17.6-6-11. Prima Facie Evidence of Intent to Deprive State of Value

Sec. 11. Evidence that a person or provider received money or other benefits as a result of a violation of:
(1) a provision of this article; or
(2) a rule established by the office under this article;
constitutes prima facie evidence, for purposes of IC 35-43-4-2, that the person or provider intended to deprive the state of a part of the value of the money or benefits.
As added by P.L.273-1999, SEC.177.