SB 275

                                              *ES0275.2*
                                                                    Reprinted
                                                            February 24, 2026
             ENGROSSED
          SENATE BILL No. 275
                _____
  DIGEST OF SB 275 (Updated February 23, 2026 7:00 pm - DI 147)
Citations Affected: IC 12-8; IC 12-11; IC 12-15; IC 29-1.
Synopsis: FSSA fiscal matters. Amends the duties of the office of the
secretary of family and social services (office) concerning home and
community based services waivers (waiver). Requires: (1) a provider
of waiver services to provide certain documentation to a waiver
recipient; (2) a waiver recipient to review the documentation and report
errors or inconsistencies; and (3) the recipient's case manager to
provide assistance to the recipient in reviewing the documentation and
reporting any errors or inconsistencies. Establishes a time frame in
which the bureau of disabilities services must review and approve or
deny requests for an increase in service units provided to certain
individuals with a disability. Creates an exemption for presumptive
                      (Continued next page)
Effective: Upon passage; July 1, 2026.
Mishler, Garten, Randolph Lonnie M
              (HOUSE SPONSORS — LOPEZ, JORDAN)
   January 8, 2026, read first time and referred to Committee on Appropriations.
   January 20, 2026, amended, reported favorably — Do Pass.
   January 28, 2026, read second time, amended, ordered engrossed.
   January 29, 2026, engrossed. Read third time, passed. Yeas 39, nays 9.
                                 HOUSE ACTION
   February 2, 2026, read first time and referred to Committee on Ways and Means.
   February 18, 2026, amended, reported — Do Pass.
   February 23, 2026, read second time, amended, ordered engrossed.
ES 275—LS 7045/DI 129
Digest Continued
eligibility standards. Provides reimbursement exemptions under certain
Medicaid programs when operating under a value based health care
reimbursement agreement. Provides that a provision prohibiting the
office from reducing reimbursement for home health services expires
June 30, 2027. Requires the office to collaborate with certain entities
to develop a new reimbursement methodology for home health
services. Specifies that public notice of at least six months (rather than
one year) must be provided before a health facility service
reimbursement that results in a reduction in reimbursement may be
changed. Provides that a claim by the estate recovery unit of the office
of Medicaid policy and planning (estate recovery unit) is forever barred
unless the estate recovery unit files a claim in the court in which the
decedent's estate is being administered not later than nine months after
the date of death of the decedent.
ES 275—LS 7045/DI 129
                                                                                   Reprinted
                                                                           February 24, 2026
            Second Regular Session of the 124th General Assembly (2026)
 PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
 Constitution) is being amended, the text of the existing provision will appear in this style type,
 additions will appear in this style type, and deletions will appear in this style type.
   Additions: Whenever a new statutory provision is being enacted (or a new constitutional
 provision adopted), the text of the new provision will appear in this style type. Also, the
 word NEW will appear in that style type in the introductory clause of each SECTION that adds
 a new provision to the Indiana Code or the Indiana Constitution.
  Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
 between statutes enacted by the 2025 Regular Session of the General Assembly.
                      ENGROSSED
                   SENATE BILL No. 275
   A BILL FOR AN ACT to amend the Indiana Code concerning
 human services.
     Be it enacted by the General Assembly of the State of Indiana:
1    SECTION 1. IC 12-8-1.6-4, AS ADDED BY P.L.174-2025,
2 SECTION 14, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2026]: Sec. 4. (a) The office of the secretary has all powers
4 necessary and convenient to administer a home and community based
5 services waiver.
6    (b) The office of the secretary shall do the following:
7      (1) Administer money appropriated or allocated to the office of
8      the secretary by the state, including money appropriated or
9      allocated for a home and community based services waiver.
10      (2) Take any action necessary to implement a home and
11      community based services waiver, including applying to the
12      United States Department of Health and Human Services for
13      approval to amend or renew the waiver, implement a new
14      Medicaid waiver, or amend the Medicaid state plan.
15      (3) Ensure that a home and community based services waiver is
16      subject to funding available to the office of the secretary.
17      (4) Ensure, in coordination with the budget agency, that the cost
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                                   2
1     of a home and community based services waiver does not exceed
2     the total amount of funding available by the budget agency,
3     including state and federal funds, for the Medicaid programs
4     established to provide services under a home and community
5     based services waiver.
6     (5) Establish and administer a program for a home and
7     community based services waiver to provide an eligible
8     individual with care that does not cost more than services
9     provided to a similarly situated individual residing in an
10     institution.
11     (6) Within the limits of available resources, provide service
12     coordination services to individuals receiving services under a
13     home and community based services waiver, including the
14     development of an individual service plan that:
15(A) addresses an individual's needs;
16(B) identifies and considers family and community resources
17that are potentially available to meet the individual's needs;
18and
19(C) is consistent with the person centered care approach for
20receiving services under a waiver.
21     (7) Monitor services provided by a provider that:
22(A) provides services to an individual using funds provided by
23the office of the secretary or under the authority of the office
24of the secretary; or
25(B) entered into one (1) or more provider agreements to
26provide services under a home and community based services
27waiver.
28     (8) Establish and administer a confidential complaint process for:
29(A) an individual receiving; or
30(B) a provider described in subdivision (7) providing;
31     services under a home and community based services waiver.
32     (9) Establish a procedure for documenting compliance with
33     subdivision (6) in the individual service plan of an individual
34     receiving services under a home and community based
35     services waiver, which must include provider attestation that
36     services delivered to a recipient align with the recipient's
37     individual service plan.
38   (c) The office of the secretary may do the following:
39     (1) At the office's discretion, delegate any of its authority under
40     this chapter to any division or office within the office of the
41     secretary.
42     (2) Issue administrative orders under IC 4-21.5-3-6 regarding the
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                                     3
1      provision of a home and community based services waiver.
2    SECTION 2. IC 12-8-1.6-9.5 IS ADDED TO THE INDIANA
3 CODE AS A NEW SECTION TO READ AS FOLLOWS
4 [EFFECTIVE JULY 1, 2026]: Sec. 9.5. (a) An individual receiving
5 services under a home and community based services waiver shall
6 do the following:
7      (1) Review any record or statement the individual receives
8      under IC 12-15-11-11.
9      (2) Not later than forty-five (45) days after receiving a record
10      or statement described in subdivision (1), report to the office
11      of the secretary or other appropriate entity any:
12(A) error in the record or statement; or
13(B) inconsistency between the record or statement and
14services received.
15    (b) Upon request, the case manager of a recipient described in
16 subsection (a) shall do the following:
17      (1) Assist the recipient in reviewing the recipient's record or
18      statement described in subsection (a)(1).
19      (2) Assist in reporting and resolving any error or
20      inconsistency under subsection (a).
21    SECTION 3. IC 12-11-2.1-3, AS AMENDED BY P.L.99-2007,
22 SECTION 78, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
23 JULY 1, 2026]: Sec. 3. (a) All services provided to an individual must
24 be provided under the individual service plan of the individual with a
25 disability. To the extent that services described in IC 12-11-1.1-1(e) are
26 available and meet the individual's needs, services provided to an
27 individual shall be provided in the least restrictive environment
28 possible.
29    (b) Pursuant to the applicable home and community based
30 services waiver, a request to increase service units on an
31 individual's approved service plan must be submitted to the bureau
32 for review and approval or denial not later than forty-five (45)
33 calendar days from the first day of the qualifying event, as
34 prescribed by the bureau.
35    SECTION 4. IC 12-15-4-1.5, AS ADDED BY P.L.126-2025,
36 SECTION 7, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
37 JULY 1, 2026]: Sec. 1.5. (a) This section does not apply to a
38 presumptive eligibility determination for an involuntary
39 detainment or commitment under a statute specified in
40 IC 12-26-1-1.
41    (b) The office of the secretary shall establish the following:
42      (1) Performance standards for hospitals to use in making
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                                     4
1presumptive eligibility determinations.
2(2) An appeals process for a hospital that disputes a determination
3that a presumptive eligibility standard was violated.
4 The office of the secretary shall limit presumptive eligibility
5 determination to qualified hospitals.
6    (b) (c) A hospital shall do the following when making a presumptive
7 eligibility determination:
8(1) Notify the office of the secretary of each presumptive
9eligibility determination not later than five (5) business days after
10the date of the determination.
11(2) Assist individuals whom the hospital determines are
12presumptively eligible with completing and submitting a full
13Medicaid application.
14(3) Notify the applicant in writing and on all relevant forms with
15plain language and large print that if the applicant:
16(A) does not file a full Medicaid application with the office of
17the secretary before the last day of the following month,
18presumptive eligibility will end on that last day; and
19(B) files a full Medicaid application with the office of the
20secretary before the last day of the following month,
21presumptive eligibility will continue until an eligibility
22determination is made concerning the application.
23    (c) (d) The office of the secretary shall use the following
24 performance standards to establish and ensure accurate presumptive
25 eligibility determinations by a qualified hospital:
26(1) Determine whether each presumptive eligibility determination
27received from the hospital complied with the time requirement set
28forth in subsection (b)(1). (c)(1).
29(2) Determine whether the office of the secretary received before
30the expiration of each presumptive eligibility period the full
31application from the individual determined by the hospital to be
32presumptively eligible.
33(3) Determine whether each applicant who was determined by the
34hospital to be presumptively eligible was determined to be
35eligible for Medicaid after the full application was received.
36    (d) (e) Each single violation by a hospital of any of the performance
37 standards under subsection (c) (d) counts as one (1) violation for the
38 presumptive eligibility determination. Each subsequent violation of a
39 performance standard is an additional violation for purposes of this
40 section.
41    (e) (f) For the first violation of a presumptive eligibility standard
42 under this section that a hospital receives in a calendar year, the office
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                                      5
1 of the secretary shall notify the hospital in writing not later than five (5)
2 days after the determination of a violation is made. The notice must
3 include the following:
4(1) A description of the standard that was not met and an
5explanation of why the hospital did not meet the standard.
6(2) Notice that a second finding on noncompliance with a
7standard will result in a requirement that the hospital's applicable
8staff participate in mandatory training on hospital presumptive
9eligibility rules and standards that is performed by the office of
10the secretary.
11(3) A description of the available appeal procedures that the
12hospital may use to dispute the finding of a violation of
13presumptive eligibility standards.
14     (f) (g) If the office of the secretary determines that a hospital has
15 failed to meet any of the presumptive eligibility standards under this
16 section in any presumptive eligibility determination by the hospital for
17 a second time within a twelve (12) month period of a first violation, the
18 office of the secretary shall notify the hospital in writing not later than
19 five (5) days after the determination that a second violation has
20 occurred. The written notice must include the following:
21(1) A description of the standard that was not met and an
22explanation of why the hospital did not meet the standard.
23(2) Notice that the hospital's applicable staff must participate in
24mandatory training on hospital presumptive eligibility rules and
25standards that is performed by the office of the secretary, and
26information concerning the date, time, and location of the training
27by the office.
28(3) A description of the available appeal procedures that the
29hospital may use to dispute the finding of a violation of
30presumptive eligibility standards.
31(4) Notice that a third violation by the hospital of a presumptive
32eligibility standard within a twelve (12) month period from the
33second violation will result in the hospital no longer being
34qualified to make presumptive eligibility determinations.
35 If a hospital appeals a finding of a violation of presumptive eligibility
36 standards described in this subsection, the hospital must provide clear
37 and convincing evidence during the appeals process that the standard
38 was met by the hospital.
39     (g) (h) If the office of the secretary determines that a hospital has
40 failed to meet any of the presumptive eligibility standards under this
41 section in any presumptive eligibility determination by the hospital for
42 a third time within a twelve (12) month period of the second violation
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                                    6
1 by the hospital, the office of the secretary shall notify the hospital in
2 writing not later than five (5) days from a determination that a
3 presumptive eligibility standard was violated by the hospital for the
4 third time. The written notice must include the following:
5(1) A description of the standard that was not met and an
6explanation of why the hospital did not meet the standard.
7(2) A description of the available appeal procedures that the
8hospital may use to dispute the finding of a violation of
9presumptive eligibility standards.
10(3) Notice that, effective immediately from receipt of the notice,
11the hospital is no longer qualified to make presumptive eligibility
12determinations for the Medicaid program.
13     (h) (i) If a hospital appeals a finding of a violation of presumptive
14 eligibility standards described in subsection (g), (h), the hospital must
15 provide clear and convincing evidence during the appeals process that
16 the standard was met by the hospital.
17     SECTION 5. IC 12-15-11-11 IS ADDED TO THE INDIANA
18 CODE AS A NEW SECTION TO READ AS FOLLOWS
19 [EFFECTIVE JULY 1, 2026]: Sec. 11. A provider of services under
20 a home and community based services waiver (as defined in
21 IC 12-8-1.6-2) shall do the following:
22(1) Upon request by an individual receiving services under the
23waiver or the individual's legal guardian, but not more than
24once per calendar quarter, provide to the individual or the
25individual's legal guardian the provider's accounting records
26of service delivery for the recipient.
27(2) Upon request, but not more than twice per calendar year,
28provide to an individual receiving services under the waiver
29an itemized statement of the services billed by the provider
30for the recipient. The statement must be in plain language.
31     SECTION 6. IC 12-15-12.7-2, AS ADDED BY P.L.174-2025,
32 SECTION 41, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
33 JULY 1, 2026]: Sec. 2. (a) The office of the secretary shall determine
34 the base reimbursement rate structure, methodology, and
35 reimbursement rates that may be paid to a provider for the services
36 rendered under the program.
37     (b) This subsection does not apply to a value based health care
38 reimbursement agreement (as defined in IC 27-1-37.6-15) entered
39 into between a managed care organization and a provider. A
40 managed care organization may not pay a provider less than the
41 reimbursement rates established by the office of the secretary under
42 this section.
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                                    7
1     SECTION 7. IC 12-15-14-8, AS AMENDED BY P.L.241-2023,
2 SECTION 15, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 UPON PASSAGE]: Sec. 8. (a) The office may implement an end of
4 therapy reclassification methodology in the RUG-IV, 48-Group model
5 or its successor for payment of nursing facility services.
6     (b) Before the office changes a health facility service reimbursement
7 that results in a reduction in reimbursement, the office shall provide
8 public notice of at least one (1) year. six (6) months. The public notice
9 under this subsection:
10(1) is not a rulemaking action or part of the administrative
11rulemaking process under IC 4-22; and
12(2) must include the fiscal impact of the proposed reimbursement
13change.
14     SECTION 8. IC 12-15-34-14.5, AS ADDED BY P.L.217-2017,
15 SECTION 79, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
16 JULY 1, 2026]: Sec. 14.5. (a) This section is effective beginning July
17 1, 2017.
18     (b) The office of the secretary may not reduce reimbursement for
19 home health services.
20     (c) 405 IAC 1-4.2-4(l) and any successor rule concerning reducing
21 home health services reimbursement are void and may not be renewed
22 or otherwise implemented.
23     (d) This section expires June 30, 2027.
24     SECTION 9. IC 12-15-34-14.6 IS ADDED TO THE INDIANA
25 CODE AS A NEW SECTION TO READ AS FOLLOWS
26 [EFFECTIVE UPON PASSAGE]: Sec. 14.6. (a) The office of the
27 secretary shall, in partnership and collaboration with a home
28 health services association and providers of home health services,
29 develop a new reimbursement methodology for home health
30 services and, not later than November 30, 2026, submit the new
31 reimbursement methodology for home health services to the
32 legislative council in an electronic format under IC 5-14-6.
33     (b) This section expires December 31, 2027.
34     SECTION 10. IC 12-15-44.5-5, AS AMENDED BY P.L.201-2023,
35 SECTION 136, IS AMENDED TO READ AS FOLLOWS
36 [EFFECTIVE JULY 1, 2026]: Sec. 5. (a) A managed care organization
37 that contracts with the office to provide health coverage, dental
38 coverage, or vision coverage to an individual who participates in the
39 plan:
40(1) is responsible for the claim processing for the coverage;
41(2) shall, except in the case of a value based health care
42reimbursement agreement (as defined in IC 27-1-37.6-15)
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                                     8
1entered into between the managed care organization and a
2provider, reimburse providers at a rate that is not less than the
3rate established by the secretary; and
4(3) may not deny coverage to an eligible individual who has been
5approved by the office to participate in the plan.
6     (b) A managed care organization that contracts with the office to
7 provide health coverage under the plan must incorporate cultural
8 competency standards established by the office. The standards must
9 include standards for non-English speaking, minority, and disabled
10 populations.
11     SECTION 11. IC 29-1-14-1, AS AMENDED BY P.L.99-2024,
12 SECTION 9, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
13 JULY 1, 2026]: Sec. 1. (a) Except as provided in IC 29-1-7-7, all
14 claims against a decedent's estate, other than expenses of
15 administration and claims of the United States, the state, or a
16 subdivision of the state, whether due or to become due, absolute or
17 contingent, liquidated or unliquidated, founded on contract or
18 otherwise, shall be forever barred against the estate, the personal
19 representative, the heirs, devisees, and legatees of the decedent, unless
20 filed with the court in which such estate is being administered within:
21(1) three (3) months after the date of the first published notice to
22creditors; or
23(2) three (3) months after the court has revoked probate of a will,
24in accordance with IC 29-1-7-21, if the claimant was named as a
25beneficiary in that revoked will;
26 whichever is later.
27     (b) No claim shall be allowed which was barred by any statute of
28 limitations at the time of decedent's death.
29     (c) No claim shall be barred by the statute of limitations which was
30 not barred at the time of the decedent's death, if the claim shall be filed
31 within:
32(1) three (3) months after the date of the first published notice to
33creditors; or
34(2) three (3) months after the court has revoked probate of a will,
35in accordance with IC 29-1-7-21, if the claimant was named as a
36beneficiary in that revoked will;
37 whichever is later.
38     (d) All claims barrable under subsection (a) shall be barred if not
39 filed within nine (9) months after the death of the decedent.
40     (e) Nothing in this section shall affect or prevent any action or
41 proceeding to enforce any mortgage, pledge, or other lien upon
42 property of the estate.
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                                      9
1     (f) Nothing in this section shall affect or prevent the enforcement of
2 a claim for injury to person or damage to property arising out of
3 negligence against the estate of a deceased tort feasor within the period
4 of the statute of limitations provided for the tort action. A tort claim
5 against the estate of the tort feasor may be opened or reopened and suit
6 filed against the special representative of the estate within the period
7 of the statute of limitations of the tort. Any recovery against the tort
8 feasor's estate shall not affect any interest in the assets of the estate
9 unless the suit was filed within the time allowed for filing claims
10 against the estate. The rules of pleading and procedure in such cases
11 shall be the same as apply in ordinary civil actions.
12     (g) A claim by the unit against a decedent's estate is forever barred
13 unless:
14(1) the unit files a claim in the court in which the decedent's estate
15is being administered; or
16(2) the unit opens an estate for the decedent and files a claim
17against the decedent in the estate;
18 not later than one hundred twenty (120) days nine (9) months after the
19 date of death of the decedent.
20     SECTION 12. An emergency is declared for this act.
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                                10
                    COMMITTEE REPORT
   Mr. President: The Senate Committee on Appropriations, to which
was referred Senate Bill No. 275, has had the same under consideration
and begs leave to report the same back to the Senate with the
recommendation that said bill be AMENDED as follows:
   Page 4, delete lines 32 through 39, begin a new paragraph and
insert:
   "(g) A claim by the unit against a decedent's estate is forever barred
unless
 (1) the unit files a claim in the court in which the decedent's estate
 is being administered or
 (2) the unit opens an estate for the decedent and files a claim
 against the decedent in the estate;
not later than one hundred twenty (120) days one hundred eighty
(180) days after the date of death of the decedent. estate has been
opened.".
and when so amended that said bill do pass.
   (Reference is to SB 275 as introduced.)
                                             MISHLER, Chairperson
Committee Vote: Yeas 9, Nays 2.
                            _____
                       SENATE MOTION
Mr. President: I move that Senate Bill 275 be amended to read as
follows:
Page 4, delete lines 32 through 40, begin a new paragraph and
insert:
"(g) A claim by the unit against a decedent's estate is forever barred
unless:
  (1) the unit files a claim in the court in which the decedent's estate
  is being administered; or
  (2) the unit opens an estate for the decedent and files a claim
  against the decedent in the estate;
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                             11
not later than one hundred twenty (120) three hundred sixty-five
(365) days after the date of death of the decedent.".
   (Reference is to SB 275 as printed January 21, 2026.)
                                                       MISHLER
                         _____
                  COMMITTEE REPORT
   Mr. Speaker: Your Committee on Ways and Means, to which was
referred Senate Bill 275, has had the same under consideration and
begs leave to report the same back to the House with the
recommendation that said bill be amended as follows:
   Page 1, delete lines 15 through 17.
   Delete page 2.
   Page 3, delete lines 1 through 9, begin a new paragraph and insert:
   "SECTION 2. IC 12-15-11-11 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2026]: Sec. 11. A provider of services under
a home and community based services waiver (as defined in
IC 12-8-1.6-2) shall do the following:
  (1) Upon request by an individual receiving services under the
  waiver or the individual's legal guardian, but not more than
  once per calendar quarter, provide to the individual or the
  individual's legal guardian the provider's accounting records
  of service delivery for the recipient.
  (2) Upon request, but not more than twice per calendar year,
  provide to an individual receiving services under the waiver
  an itemized statement of the services billed by the provider
  for the recipient. The statement must be in plain language.".
   Page 3, delete lines 23 through 30, begin a new paragraph and
insert:
   "SECTION 4. IC 12-15-34-14.5, AS ADDED BY P.L.217-2017,
SECTION 79, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2026]: Sec. 14.5. (a) This section is effective beginning July
1, 2017.
   (b) The office of the secretary may not reduce reimbursement for
home health services.
   (c) 405 IAC 1-4.2-4(l) and any successor rule concerning reducing
home health services reimbursement are void and may not be renewed
or otherwise implemented.
ES 275—LS 7045/DI 129
                             12
   (d) This section expires June 30, 2027.
   SECTION 5. IC 12-15-34-14.6 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE UPON PASSAGE]: Sec. 14.6. (a) The office of the
secretary shall, in partnership and collaboration with a home
health services association and providers of home health services,
develop a new reimbursement methodology for home health
services and, not later than November 30, 2026, submit the new
reimbursement methodology for home health services to the
legislative council in an electronic format under IC 5-14-6.
   (b) This section expires December 31, 2027.".
   Renumber all SECTIONS consecutively.
and when so amended that said bill do pass.
   (Reference is to SB 275 as reprinted January 29, 2026.)
                                                   THOMPSON
Committee Vote: yeas 24, nays 0.
                         _____
                     HOUSE MOTION
   Mr. Speaker: I move that Engrossed Senate Bill 275 be amended to
read as follows:
   Page 1, between the enacting clause and line 1, begin a new
paragraph and insert:
   "SECTION 1. IC 12-8-1.6-4, AS ADDED BY P.L.174-2025,
SECTION 14, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2026]: Sec. 4. (a) The office of the secretary has all powers
necessary and convenient to administer a home and community based
services waiver.
   (b) The office of the secretary shall do the following:
 (1) Administer money appropriated or allocated to the office of
 the secretary by the state, including money appropriated or
 allocated for a home and community based services waiver.
 (2) Take any action necessary to implement a home and
 community based services waiver, including applying to the
 United States Department of Health and Human Services for
 approval to amend or renew the waiver, implement a new
 Medicaid waiver, or amend the Medicaid state plan.
 (3) Ensure that a home and community based services waiver is
ES 275—LS 7045/DI 129
                             13
subject to funding available to the office of the secretary.
(4) Ensure, in coordination with the budget agency, that the cost
of a home and community based services waiver does not exceed
the total amount of funding available by the budget agency,
including state and federal funds, for the Medicaid programs
established to provide services under a home and community
based services waiver.
(5) Establish and administer a program for a home and
community based services waiver to provide an eligible
individual with care that does not cost more than services
provided to a similarly situated individual residing in an
institution.
(6) Within the limits of available resources, provide service
coordination services to individuals receiving services under a
home and community based services waiver, including the
development of an individual service plan that:
    (A) addresses an individual's needs;
    (B) identifies and considers family and community resources
    that are potentially available to meet the individual's needs;
    and
    (C) is consistent with the person centered care approach for
    receiving services under a waiver.
(7) Monitor services provided by a provider that:
    (A) provides services to an individual using funds provided by
    the office of the secretary or under the authority of the office
    of the secretary; or
    (B) entered into one (1) or more provider agreements to
    provide services under a home and community based services
    waiver.
(8) Establish and administer a confidential complaint process for:
    (A) an individual receiving; or
    (B) a provider described in subdivision (7) providing;
services under a home and community based services waiver.
(9) Establish a procedure for documenting compliance with
subdivision (6) in the individual service plan of an individual
receiving services under a home and community based
services waiver, which must include provider attestation that
services delivered to a recipient align with the recipient's
individual service plan.
  (c) The office of the secretary may do the following:
(1) At the office's discretion, delegate any of its authority under
this chapter to any division or office within the office of the
ES 275—LS 7045/DI 129
                              14
  secretary.
  (2) Issue administrative orders under IC 4-21.5-3-6 regarding the
  provision of a home and community based services waiver.
   SECTION 2. IC 12-8-1.6-9.5 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2026]: Sec. 9.5. (a) An individual receiving
services under a home and community based services waiver shall
do the following:
  (1) Review any record or statement the individual receives
  under IC 12-15-11-11.
  (2) Not later than forty-five (45) days after receiving a record
  or statement described in subdivision (1), report to the office
  of the secretary or other appropriate entity any:
      (A) error in the record or statement; or
      (B) inconsistency between the record or statement and
      services received.
   (b) Upon request, the case manager of a recipient described in
subsection (a) shall do the following:
  (1) Assist the recipient in reviewing the recipient's record or
  statement described in subsection (a)(1).
  (2) Assist in reporting and resolving any error or
  inconsistency under subsection (a).".
   Page 2, between lines 11 and 12, begin a new paragraph and insert:
   "SECTION 5. IC 12-15-12.7-2, AS ADDED BY P.L.174-2025,
SECTION 41, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2026]: Sec. 2. (a) The office of the secretary shall determine
the base reimbursement rate structure, methodology, and
reimbursement rates that may be paid to a provider for the services
rendered under the program.
   (b) This subsection does not apply to a value based health care
reimbursement agreement (as defined in IC 27-1-37.6-15) entered
into between a managed care organization and a provider. A
managed care organization may not pay a provider less than the
reimbursement rates established by the office of the secretary under
this section.".
   Page 3, between lines 2 and 3, begin a new paragraph and insert:
   "SECTION 9. IC 12-15-44.5-5, AS AMENDED BY P.L.201-2023,
SECTION 136, IS AMENDED TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2026]: Sec. 5. (a) A managed care organization
that contracts with the office to provide health coverage, dental
coverage, or vision coverage to an individual who participates in the
plan:
ES 275—LS 7045/DI 129
                             15
 (1) is responsible for the claim processing for the coverage;
 (2) shall, except in the case of a value based health care
 reimbursement agreement (as defined in IC 27-1-37.6-15)
 entered into between the managed care organization and a
 provider, reimburse providers at a rate that is not less than the
 rate established by the secretary; and
 (3) may not deny coverage to an eligible individual who has been
 approved by the office to participate in the plan.
   (b) A managed care organization that contracts with the office to
provide health coverage under the plan must incorporate cultural
competency standards established by the office. The standards must
include standards for non-English speaking, minority, and disabled
populations.".
   Renumber all SECTIONS consecutively.
   (Reference is to ESB 275 as printed February 18, 2026.)
                                                          LOPEZ
                         _____
                     HOUSE MOTION
   Mr. Speaker: I move that Engrossed Senate Bill 275 be amended to
read as follows:
   Page 4, line 10, delete "three hundred sixty-five".
   Page 4, line 11, delete "(365)".
   Page 4, line 11, strike "days" and insert "nine (9) months".
   (Reference is to ESB 275 as printed February 18, 2026.)
                                                      MELTZER
                         _____
                     HOUSE MOTION
   Mr. Speaker: I move that Engrossed Senate Bill 275 be amended to
read as follows:
   Page 1, between lines 14 and 15, begin a new paragraph and insert:
   "SECTION 2. IC 12-15-4-1.5, AS ADDED BY P.L.126-2025,
SECTION 7, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2026]: Sec. 1.5. (a) This section does not apply to a
presumptive eligibility determination for an involuntary
detainment or commitment under a statute specified in
ES 275—LS 7045/DI 129
                               16
IC 12-26-1-1.
   (b) The office of the secretary shall establish the following:
  (1) Performance standards for hospitals to use in making
  presumptive eligibility determinations.
  (2) An appeals process for a hospital that disputes a determination
  that a presumptive eligibility standard was violated.
The office of the secretary shall limit presumptive eligibility
determination to qualified hospitals.
   (b) (c) A hospital shall do the following when making a presumptive
eligibility determination:
  (1) Notify the office of the secretary of each presumptive
  eligibility determination not later than five (5) business days after
  the date of the determination.
  (2) Assist individuals whom the hospital determines are
  presumptively eligible with completing and submitting a full
  Medicaid application.
  (3) Notify the applicant in writing and on all relevant forms with
  plain language and large print that if the applicant:
      (A) does not file a full Medicaid application with the office of
      the secretary before the last day of the following month,
      presumptive eligibility will end on that last day; and
      (B) files a full Medicaid application with the office of the
      secretary before the last day of the following month,
      presumptive eligibility will continue until an eligibility
      determination is made concerning the application.
   (c) (d) The office of the secretary shall use the following
performance standards to establish and ensure accurate presumptive
eligibility determinations by a qualified hospital:
  (1) Determine whether each presumptive eligibility determination
  received from the hospital complied with the time requirement set
  forth in subsection (b)(1). (c)(1).
  (2) Determine whether the office of the secretary received before
  the expiration of each presumptive eligibility period the full
  application from the individual determined by the hospital to be
  presumptively eligible.
  (3) Determine whether each applicant who was determined by the
  hospital to be presumptively eligible was determined to be
  eligible for Medicaid after the full application was received.
   (d) (e) Each single violation by a hospital of any of the performance
standards under subsection (c) (d) counts as one (1) violation for the
presumptive eligibility determination. Each subsequent violation of a
performance standard is an additional violation for purposes of this
ES 275—LS 7045/DI 129
                                17
section.
(e) (f) For the first violation of a presumptive eligibility standard
under this section that a hospital receives in a calendar year, the office
of the secretary shall notify the hospital in writing not later than five (5)
days after the determination of a violation is made. The notice must
include the following:
   (1) A description of the standard that was not met and an
   explanation of why the hospital did not meet the standard.
   (2) Notice that a second finding on noncompliance with a
   standard will result in a requirement that the hospital's applicable
   staff participate in mandatory training on hospital presumptive
   eligibility rules and standards that is performed by the office of
   the secretary.
   (3) A description of the available appeal procedures that the
   hospital may use to dispute the finding of a violation of
   presumptive eligibility standards.
(f) (g) If the office of the secretary determines that a hospital has
failed to meet any of the presumptive eligibility standards under this
section in any presumptive eligibility determination by the hospital for
a second time within a twelve (12) month period of a first violation, the
office of the secretary shall notify the hospital in writing not later than
five (5) days after the determination that a second violation has
occurred. The written notice must include the following:
   (1) A description of the standard that was not met and an
   explanation of why the hospital did not meet the standard.
   (2) Notice that the hospital's applicable staff must participate in
   mandatory training on hospital presumptive eligibility rules and
   standards that is performed by the office of the secretary, and
   information concerning the date, time, and location of the training
   by the office.
   (3) A description of the available appeal procedures that the
   hospital may use to dispute the finding of a violation of
   presumptive eligibility standards.
   (4) Notice that a third violation by the hospital of a presumptive
   eligibility standard within a twelve (12) month period from the
   second violation will result in the hospital no longer being
   qualified to make presumptive eligibility determinations.
If a hospital appeals a finding of a violation of presumptive eligibility
standards described in this subsection, the hospital must provide clear
and convincing evidence during the appeals process that the standard
was met by the hospital.
(g) (h) If the office of the secretary determines that a hospital has
ES 275—LS 7045/DI 129
                               18
failed to meet any of the presumptive eligibility standards under this
section in any presumptive eligibility determination by the hospital for
a third time within a twelve (12) month period of the second violation
by the hospital, the office of the secretary shall notify the hospital in
writing not later than five (5) days from a determination that a
presumptive eligibility standard was violated by the hospital for the
third time. The written notice must include the following:
  (1) A description of the standard that was not met and an
  explanation of why the hospital did not meet the standard.
  (2) A description of the available appeal procedures that the
  hospital may use to dispute the finding of a violation of
  presumptive eligibility standards.
  (3) Notice that, effective immediately from receipt of the notice,
  the hospital is no longer qualified to make presumptive eligibility
  determinations for the Medicaid program.
(h) (i) If a hospital appeals a finding of a violation of presumptive
eligibility standards described in subsection (g), (h), the hospital must
provide clear and convincing evidence during the appeals process that
the standard was met by the hospital.".
Renumber all SECTIONS consecutively.
   (Reference is to ESB 275 as printed February 18, 2026.)
                                                   STEUERWALD
ES 275—LS 7045/DI 129