Ind. Code ch. 27-1-50.3

Ind. Code ch. 27-1-50.3
in effect

Ind. Code § 27-1-50.3-1 Definitions

Sec. 1. The following definitions apply throughout this chapter: (1) "Business day" means a day other than Saturday or Sunday, or a legal holiday listed in IC 1-1-9-1. (2) "Commissioner" refers to the insurance commissioner appointed under IC 27-1-1-2. (3) "Department" refers to the department of insurance created by IC 27-1-1-1. (4) "Fee" refers to the fee on managed care organizations authorized by this chapter. (5) "Managed care organization" means an organization that holds a certificate of authority, license, or other similar authorization issued by the department and that is a managed care organization for purposes of 42 U.S.C. 1396b(w)(7)(A)(viii) and 42 CFR 433.56(a)(8). The term does not include an organization that only offers a policy, plan, or coverage set forth in IC 27-8-5-2.5(a). (6) "Office" refers to the office of Medicaid policy and planning established by IC 12-8-6.5-1. (7) "Secretary" refers to the secretary of family and social services appointed under IC 12-8-1.5-2. (8) "State's share" means the portion of allowable Medicaid expenses funded by the state, by other units of government, or, as permitted by federal Medicaid laws, by other entities other than the federal government. As added by P.L.216-2025, SEC.47.

Ind. Code § 27-1-50.3-2 Authorization of fee; required approval; cessation of fee

Sec. 2. (a) Subject to subsections (b) and (c) and this chapter, a fee is authorized. (b) The fee may not be assessed without approval from the United States Department of Health and Human Services. (c) The assessment of the fee shall cease upon the United States Department of Health and Human Services' determination that the fee is no longer a permissible health care related tax that is eligible for federal financial participation. As added by P.L.216-2025, SEC.47.

Ind. Code § 27-1-50.3-3 Assessment of fee; purpose

Sec. 3. The office may, subject to section 6 of this chapter, assess a fee upon managed care organizations to support administration of the state Medicaid program. As added by P.L.216-2025, SEC.47.

Ind. Code § 27-1-50.3-4 Use of fee

Sec. 4. The fee collected under this chapter may only be used to pay the state's share of the cost of Medicaid services provided under the Medicaid program (42 U.S.C. 1396 et seq.). As added by P.L.216-2025, SEC.47.

Ind. Code § 27-1-50.3-5 Provision of list of managed care organizations; update of list

Sec. 5. (a) Not later than May 30, 2025, and after consulting with the secretary or the secretary's designee regarding compliance with 42 U.S.C. 1396b(w)(7)(A)(viii) and 42 CFR 433.56(a)(8) and the types of managed care organizations recognized under Indiana law, the commissioner or the commissioner's designee shall provide the secretary or the secretary's designee with a list of the managed care organizations that hold a certificate of authority, license, or other similar authorization issued by the department and that are managed care organizations for purposes of 42 U.S.C. 1396b(w)(7)(A)(viii) and 42 CFR 433.56(a)(8). (b) The commissioner or the commissioner's designee shall update this list to the secretary or the secretary's designee not sooner than one hundred twenty (120) days, and not later than ninety (90) days, from the start of each state fiscal year for which the fee is assessed. As added by P.L.216-2025, SEC.47.

Ind. Code § 27-1-50.3-6 Fee requirements; authorization to request waiver

Sec. 6. (a) The fee must meet the requirements of the federal Medicaid statutes and regulations for permissible health care related taxes. (b) The office may request a waiver from the United States Department of Health and Human Services of the broad based and uniformity requirements under 42 CFR 433.68 relating to the assessment under this chapter. (c) Subject to subsection (a): (1) the office may assess the fee on a tiered basis among the managed care organizations; and (2) the office may assess the fee based on member months, premium revenue, or any other methodology approved by the United States Department of Health and Human Services. As added by P.L.216-2025, SEC.47.

Ind. Code § 27-1-50.3-7 Submission of request for approval of fee; authorization to negotiate

Sec. 7. The office shall submit a written request to the United States Department of Health and Human Services for approval of the managed care assessment fee on or after June 30, 2025. Subject to the requirements of this chapter, the office is authorized to negotiate with the United States Department of Health and Human Services regarding the terms and conditions for the implementation and maintenance of the fee. As added by P.L.216-2025, SEC.47.

Ind. Code § 27-1-50.3-8 Payment of fee; notification of assessment

Sec. 8. (a) A managed care organization that is assessed under this chapter for a state fiscal year shall pay the assessment in monthly installments, each equaling one-twelfth (1/12) of the assessment for the state fiscal year, on the first business day of each calendar month of the state fiscal year. (b) Not later than thirty (30) days before the start of each state fiscal year, the office shall notify each managed care organization of the managed care organization's annual assessment and the installment due dates for the assessment. As added by P.L.216-2025, SEC.47.

Ind. Code § 27-1-50.3-9 Managed care assessment fee holding fund

Sec. 9. (a) The managed care assessment fee holding fund is established for the purpose of holding the fees collected under this chapter. (b) The office shall administer the fund. (c) Money in the fund consists of the following: (1) Fees collected under this chapter, including penalty payments under section 11 of this chapter. (2) Donations, gifts, appropriations by the general assembly, and money received from any other source. (3) Interest accrued under this section. (d) Money remaining in the fund at the end of a state fiscal year reverts to the state general fund. (e) 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. Interest that accrues from these investments shall be deposited in the fund. As added by P.L.216-2025, SEC.47.

Ind. Code § 27-1-50.3-10 Records and documents; audit

Sec. 10. (a) A managed care organization that is liable for an assessment under this chapter shall keep accurate and complete records and pertinent documents that are relevant to the organization's assessment under this chapter, as may be required by the department or the office. (b) The department or the office may audit all records necessary to ensure compliance with this chapter and make adjustments to assessment amounts previously calculated based on the results of the audit. As added by P.L.216-2025, SEC.47.

Ind. Code § 27-1-50.3-11 Authorization to grant grace period for payment of fee; penalty; sanctions

Sec. 11. (a) For good cause shown by a managed care organization due to financial or other difficulties, as determined by the office, the office is authorized to grant grace periods, of up to thirty (30) days, for the managed care organization's payment of an installment payment due under this chapter. (b) If a managed care organization that is liable for an assessment under this chapter fails to make an installment payment by the payment's due date, and no grace period has been granted to the managed care organization for the payment of the installment payment, the managed care organization shall pay a penalty of ten percent (10%) of the amount of the installment payment not paid, plus ten percent (10%) of the portion remaining unpaid on the last day of every thirty (30) day period thereafter. These penalty payments shall be deposited into the managed care assessment fee holding fund. (c) If a managed care organization that is liable for an assessment under this chapter is granted a grace period but fails to make its installment payment by the end of the grace period, the managed care organization shall pay a penalty of five percent (5%) of the amount of the installment payment not paid, plus five percent (5%) of the portion remaining unpaid on the last day of every thirty (30) day period thereafter. These penalty payments shall be deposited into the managed care assessment fee holding fund. (d) Notwithstanding subsections (b) and (c), with respect to a managed care organization that has a comprehensive risk contract with the office under IC 12-15 that fails to make an installment payment not later than sixty (60) days after the due date or, if applicable, not later than sixty (60) days after the end of a grace period, the office may additionally impose a contractual sanction allowed against the managed care organization, and may terminate the contract with the office. (e) Notwithstanding subsections (b) through (d), with respect to a managed care organization that fails to make an installment payment not later than sixty (60) days after the due date or, if applicable, not later than sixty (60) days after the end of a grace period, the department may suspend or revoke, after notice and hearing, the managed care organization's certificate of authority, license, or other authority to operate in Indiana. As added by P.L.216-2025, SEC.47.

Ind. Code § 27-1-50.3-12 Rules

Sec. 12. The office may adopt rules under IC 4-22-2 to implement this chapter. As added by P.L.216-2025, SEC.47.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://iga.in.gov/laws/2026/ic/titles/27Fetched: 10/17/2026

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