HB 1372 – Various Insurance Matters
Authored by Rep. Martin Carbaugh (R-Fort Wayne)
Sponsored by Sen. Eric Bassler (R-Washington)

Authorizes a local unit to establish and maintain: (1) an individual self-insurance program to provide health care benefits to its employees; and (2) a health savings account program under which employees may set aside funds tax-free to pay for medical expenses. Provides that a provider of ambulance service that transports a covered individual to an in-network facility or from an in-network facility to another facility shall not charge more than the amount allowed under the network plan applying to the covered individual’s coverage. Makes changes in the law concerning the permissible investments of life insurance

Chamber position: Oppose

The latest: The introduced amendment (#15), if approved, would allow an assignment of benefit by the individual to the out-of-network emergency medical services (EMS) provider to bill the insurer for the service. The insurer would have the option to pay the amount billed or negotiate with the EMS provider.  If they were unable to resolve the matter within 30 days, then arbitration could be initiated.

Testimony was taken, but the bill was held.

Indiana Chamber action/commentary: The Indiana Chamber and Indiana Manufacturers Association were the only two organizations that opposed the amendment that, as drafted, would impact federal Employee Retirement Income Security Act (ERISA ) plans as well. The Chamber testified that while it may be written that way, we don’t believe that state law can pierce the veil of ERISA.

The Chamber has a long-standing policy that opposes assignment of benefits for any providers and while EMS (transportation) is a little different, we still oppose. The Senate Insurance Committee has not debated assignment of benefits previously because we haven’t talked about this issue for several years. An out-of-network provider is not entitled to receive a check because they are not a party to the contract as they aren’t in the network. In addition, this amendment allows for dispute resolution through arbitration. We have already said that is a line in the sand for employers – because if we allow it for EMS (though they are different than other providers), physicians have already said that they want arbitration to be a part of their disputes as well.

It is uncertain what the outcome of the amendment will be, but the Chamber will continue to stress its opposition and the reasons why that could impact employers all over the state.

Resource: Mike Ripley at (317) 264-6883 or email: mripley@indianachamber.com