HB 1004 – Out-of-Network Billing for Health Care Services
Authored by Rep. Ben Smaltz (R-Auburn)

Prohibits a patient from being billed an amount that exceeds the in-network rates paid by the patient’s insurance plus any deductibles, co-payments and co-insurance amounts when the service is provided at an in-network facility. The bill also allows an amount greater than the in-network amount rate if the patient signs a notification to agree to pay the increased out-of-network charges.

Chamber position: Support

The latest: The bill was held for possible amendments.

Indiana Chamber action/commentary: Lengthy testimony was allowed for HB 1004. Joining the Chamber in support were the Indiana Hospital Association, St. Vincent Health, Indiana State Medical Association, Indiana Radiological Society, Hoosiers for Affordable Healthcare, Indiana Employers Forum, Indiana Manufacturers Association, CareSource and Corydon Group. Everyone agrees that the patient should not receive a surprise out-of-network bill. Where the differences occur is the method to determine the reimbursement for those out-of-network services. Providers tend to support an arbitration process to determine those rates. The Chamber and the Indiana Employers Forum testified against a dispute resolution/arbitration process because research suggests that it will actually drive up cost.

SB 3 – Health Care Provider Billing
Authored by Sen. Ed Charbonneau (R-Valparaiso)

Prohibits billing a patient who receives services: (1) from an out-of-network provider; and (2) at specified facilities that are in network; for amounts that exceed the cost paid by the patient’s insurance plus any deductibles, co-pays and co-insurance amounts. Requires certain health care providers to provide, at least five days before a health care service or procedure, a good faith estimate to the patient for the cost of care.

Chamber position: Support

The latest: Lengthy testimony was taken but the bill was held for a vote.

Indiana Chamber action/commentary: Many of the same players, including the Indiana Chamber, that testified in favor of the House version also supported the Senate version. At this juncture, either measure could be effective.

Resource: Mike Ripley at (317) 264-6883 or email: [email protected]