Legislation


HB 1597 – Indiana

Status: Inactive / Dead
Year Introduced: 2023
Link: https://iga.in.gov/legislative/2023/bills/house/1597/

State employee health plan hospital payment limits. Limits the amount that a state employee health plan may pay for a medical facility service provided to a covered individual to: (1) 200% of the amount paid by the Medicare program for that type of medical facility service or for a medical facility service of a similar type, if the medical facility service is provided by an in network provider; and (2) 185% of the amount paid by the Medicare program for that type of medical facility service or for a medical facility service of a similar type, if the medical facility service is provided by an out of network provider. Provides that a determination of the state personnel department, a state employee health plan, or a firm providing administrative services to a state employee health plan that a medical facility service provided to a covered individual is of a type similar to a particular type of medical facility service covered by the Medicare program is conclusive. Requires a medical facility that provides drugs to a covered individual, in billing a state employee health plan for the cost of the drugs, to include in the billing the same “JG” modifier that the medical facility would include in the billing if the medical facility were billing the Medicare program for the drugs.


Return to Database Search

© 2018- The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

Associated Litigation:

No items found