Indiana

SUMMARY

In most recent legislative term, Indiana introduced legislation aimed at promoting price transparency and lowering healthcare costs. However, each of these bills died in committee. The state legislature introduced a bill that would require healthcare providers to publish the prices for their services and products beginning in 2020. Indiana introduced a bill that would allow out-of-state insurance providers to sell insurance to individuals living in Indiana. The out-of-state insurers would have to pay in-state taxes, but would be exempt from Indiana insurance law.

 

LEGISLATION/REGULATION

Legislative Calendar

Indiana’s regular legislative session has ended.

 

Recent Legislative Developments

Healthcare Transparency

2017 HB 1011 HEALTHCARE CHARGES: Beginning in 2018, requires healthcare providers to publish and provide to patients the chargers for procedures rendered by the health care provider. Beginning in 2020, requires healthcare providers to publish and provide to patients the charges for each product or service rendered by the healthcare provider Inactive -Died in Committee.
HB 1486  HEALTH INSURANCE COVERAGE AND COST INFORMATION: Requires health care providers and health plans to provide to covered individuals and patients certain information concerning the cost of health care services. Requires health care providers to publish a payment policy for medically necessary health care services not covered by a third party payment source. Requires the department of insurance to establish, post, and maintain on the department’s Internet web site a standardized prior authorization form for notice or authorization for health care services. Inactive – Died in Committee.

Healthcare Cost

2017 SB 481 TAX DEDUCTION FOR HEALTH CARE SHARING EXPENSES: Allows a taxpayer who is an Indiana resident and a member of a health care sharing ministry to deduct from the taxpayer’s adjusted gross income the total amount of qualified health care sharing expenses incurred by the taxpayer in a particular taxable year. Inactive -Died in Committee.

 

Healthcare Markets

2017 SB 304 INDIVIDUAL OUT-OF-STATE HEALTH INSURANCE: Allows an accident and sickness insurer that is licensed in certain other states, but is not licensed in Indiana, and complies with the state examination and premium tax requirements, to issue or deliver an individual policy of accident and sickness insurance to an individual resident of Indiana without complying with other Indiana insurance law. Inactive – Died in Committee.

 

Key Statutes

We compile state statutes relate to healthcare price and competition, including healthcare transparency, markets, and costs. For a complete listing of all health related statutes visit the State Health Practice Database for Research.

 

Transparency in Healthcare

  • Code. Ann. § 16-21-6 requires that each hospital file a report detailing the hospital’s financial position at the end of each fiscal year, including net patient revenue broken down by payer source. Additionally, hospitals must submit after each calendar quarter a uniform patient information report based on discharge information, to include the following data: patient’s length of stay; diagnoses and surgical procedures performed; data of birth, admission and discharge; admission source; gender and race; discharge disposition; payer source; the total charge for the patient’s stay; the zip code of the patient’s residence; and all diagnoses external causes of injury codes. The state health commissioner is directed to make a compilation of the data obtained from the foregoing reports and issue recommendations and findings to the general assembly annually. Further, the state department is directed to publish a consumer guide to Indiana hospitals based on the reports “in an understandable format that assists the consuming public in making both financial and utilization comparisons between hospitals.”

 

  • Code. Ann. § 16-39-5 states that the original health record of a patient is the property of the provider and may be used by the provider without specific written authorization for legitimate business purposes, to include peer review, scientific, statistical and educational purposes.

 

Healthcare Contracting

  • Code. Ann. § 27-8-11-9 prohibits most favored nation clauses, or clauses having a similar effect, in an agreement between an insurance carrier and a participating provider. A most favored nation clause is an agreement between a payer and a provider that typically requires a provider to give the payer the lowest rate granted to any other comparable payer, which can be anticompetitive by encouraging oligopolistic pricing by large payers and increasing barriers for new entrants.

 

Healthcare Markets

 

LITIGATION/ENFORCEMENT

  • None identified

  

KEY RESOURCES

Indiana State General Assembly

Indiana Office of the Attorney General