Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Article 10 - HEALTHY INDIANA PLAN
Rule 10 - POWER Accounts and Copayments
Section 10-4 - POWER account contributions; state contributions; employer contributions

Universal Citation: 405 IN Admin Code 10-4

Current through September 18, 2024

Authority: IC 12-15-44.5-9

Affected: IC 12-15-44.5

Sec. 4.

(a) The state shall contribute the difference between:

(1) the member's annual contribution; and

(2) two thousand five hundred dollars ($2,500).

(b) Amounts may be contributed to a member's POWER account by:

(1) a member, including the use of incentive funds earned through a managed care organization if the member elects to do so;

(2) a member's employer, if the contribution is not from funds payable by the employer to the employee;

(3) any third party, subject to the restrictions in subsection (d); or

(4) the managed care organization, under which the member is enrolled, if the payment:
(A) is to provide a health incentive to the member; and

(B) does not count toward the member's required contributions as set forth in section 3(a) of this rule.

(c) In no event shall a member's POWER account balance exceed two thousand five hundred dollars ($2,500).

(d) A health care provider or provider-related entity may make a contribution to a member's POWER account in accordance with subsection (b)(3), provided:

(1) the provider or provider-related entity establishes criteria for providing assistance that do not distinguish between individuals based on whether they receive or will receive services from the contributing provider or providers or class of providers; and

(2) the provider or provider-related entity does not include the cost of such payments in either the cost of care for purposes of Medicare and Medicaid cost reporting or included as part of a Medicaid shortfall or uncompensated care for any purpose.

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