SB 97 – Insurance Drug Coverage
Authored by Sen. Vaneta Becker (R-Evansville)

Prohibits a state employee health plan, a policy of accident and sickness insurance, or a health maintenance organization from modifying an enrollee’s coverage of a drug during the plan year.

Chamber position: Oppose

The latest: The bill was held by the chair of the Senate Health and Provider Services Committee to make it more specific.

The State Personnel Department reports the prohibitions of the bill could impact state employee health plan premiums between $2.3 million and $5.2 million per year beginning in plan year 2021. The state’s response to increased health benefit costs may include (1) greater employee cost sharing in health benefits; (2) reduction or elimination of other health benefits; and (3) passing costs onto workers in the form of lower wage increases than would otherwise occur.

Indiana Chamber action/commentary: In testimony, the Chamber pointed out that when a bill’s fiscal demonstrates a financial impact on the state health plan, you can be certain that it will impact fully insured plans in the same manner. In other words, this bill, in its current form, could prove costly for employers and employees throughout the state.

HB 1005 – Health and Insurance Matters
Authored by Rep. Donna Schaibley (R-Carmel)

Requires hospitals and ambulatory surgical outpatient centers to post certain health care services pricing information by billing code on the hospital’s web site and sets forth requirements. Requires a health carrier (including an insurer or a health maintenance organization) to provide to an individual who is entitled to coverage from the health carrier, not more than 24 hours after the individual requests the information, a good faith estimate of: (1) the amount of the cost of the nonemergency health care service that the health carrier will pay for or reimburse to the covered individual; or (2) the extent and nature of the ordered nonemergency health care service a covered individual is entitled to receive. Requires provider facilities and practitioners to post signs in waiting rooms and offices and to provide Internet web site notices about the availability of estimates of the amount the patient will be charged for medical services. Requires health carriers to provide web site notices about the availability of good faith estimates of coverage for nonemergency health care services. Provides penalties for noncompliance by provider facilities, practitioners, and health carriers. Requires an off-campus location of a hospital to apply for, obtain, and use on all claims for reimbursement or payment a national provider identifier separate and distinct from the national provider identifier of the hospital of which it is an off-campus location. Makes other provisions. See full details.

Chamber position: Support

The latest: The bill was held in the House Public Health Committee by Chairwoman Cindy Kirchhofer (R-Beech Grove) for potential amendments, but we expect significant action soon since this is a House Republican priority.

Indiana Chamber action/commentary:  The bill has considerable support from the business community: the Indiana Chamber, Indiana Manufacturers Association, Employers Forum of Indiana, Monarch Beverage and Purdue University, among others. It is uncertain as to whether the most controversial aspect of the bill – the requirement for an off-campus facility to obtain a national provider identifier separate from the main facility – will remain.

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