HB 1434 – Nonemergency Ambulance Service and Physician Order
Authored by Rep. Beau Baird (R-Greencastle); sponsored by Sen. Andy Zay (R-Huntington)

Specifies that Medicaid may not deny payment for nonemergency advanced life support or basic life support ambulance services, when all policies and procedures have been followed, when rendered to a Medicaid recipient. Requires hospital boards to establish protocols concerning issuing orders for nonemergency transportation. Requires physicians to issue orders for nonemergency ambulance services and specifies contents of the order. Specifies individuals who are allowed to certify a physician’s order for nonemergency ambulance transport. Requires ambulance service providers to submit certain cost data to the Office of Family and Social Services. Requires the office to submit a report with the cost data to the legislative council before December 1, 2021.

Chamber position: Support

The latest: The bill was heard this week but held for a possible amendment.

Indiana Chamber action/commentary: Part of the bill stems from an out-of-network surprise billing situation. Emergency medical services, commonly called EMS, has four sources of revenue: Medicaid, Medicare, taxpayer and private insurance. The Chamber testified that we were involved because we opposed the original bill since it impacted small group health plans. It required assignment of benefits for out-of-network ambulance providers and mandated cost sharing requirements. After a meeting with Rep. Baird and Rep. Bradford Barrett (R-Richmond), the bill was amended to collect cost data of ambulance providers. We believe that is valuable information and support discussions going forward. We would have concerns if the data was used to justify the same funding mechanisms that the bill did as originally filed. Senator Ed Charbonneau (R-Valparaiso) had a concern about the way the data would be collected and planned to amend the bill. It most likely will be voted on next week.


Senate Bill 143 (Pharmacy Benefit Managers), authored by Rep. Andy Zay (R-Huntington), would bring more regulation on pharmacy benefit managers (PBMs) when the ink hasn’t dried on SEA 241, which gave the Indiana Department of Insurance the authority to license PBMs in 2020. The bill as it currently stands tips the scale toward pharmacies and may ultimately drive up health plan prescription drugs costs because of the new requirements on PBMs. That’s something the Chamber can’t support. Representative Matt Lehman (R-Berne), who is the House sponsor, will be working on a further amendment to address insurance and PBM concerns. At this time, it is uncertain as to what that amendment will look like.

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