SB 5 – Indiana

Status: Enacted
Year Introduced: 2020

Health provider contracts. Requires hospitals, ambulatory outpatient surgical centers, and urgent care facilities to post certain information on their Internet web sites about health care services they provide, including the weighted average negotiated charges for the services. Provides that an insurer that issues a group health insurance policy or a health maintenance organization that enters into a group health maintenance organization contract shall disclose to the policyholder or subscriber: (1) the amount of the commission, service fee, or brokerage fee to be paid to an insurance producer for selling, soliciting, or negotiating the policy or contract; and (2) whether the commission or fee is based on a percentage of total plan premiums or a flat per member fee. Requires that this information be disclosed at the outset and upon renewal of the policy or contract. Prohibits the inclusion in a health provider contract of a provision under which a provider (an individual or entity licensed or authorized to provide health care services) would be prohibited from disclosing health care service claims data to an employer providing the coverage. States that the inclusion of such a provision in a health care provider contract is an unfair or deceptive act or practice in the business of insurance. Requires the department of insurance to submit a request for information and a request for proposals concerning the establishment and operation of an all payer claims data base, which will receive and contain information on claims paid by insurers, health maintenance organizations, pharmacy benefit managers, and other payers. Provides that a fully credentialed provider shall be reimbursed by an insurer or health maintenance organization for eligible services provided at an in-network hospital if certain conditions are met.

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