Advocacy

Legislative Update - October 31, 2024​​​​

​​​Outcomes of Health Care Cost Oversight Task Force Meeting​ 

Members of the legisla​tive Health Care Cost Oversight Task Force​ met this week to continue gathering information about the health care industry and assess the impact of the last several years of legislation aimed at addressing health care costs in Indiana. The committee, chaired by Brad Barrett, MD, (R-Richmond), heard presentations from Matt Bell of Hoosiers for Affordable Health Care and the Indiana Employers’ Forum, Luke Messer and Aparna Soni, PhD, on behalf of the Indiana Business Health Collaborative, and representatives from Pharmaceutical Care Management Association, PhRMA, and the state pharmacists’ association.

Hoosiers for Affordable Health Care and the Indiana Employers’ Forum presented the findings of the RAND 5.0 report​ and teased the release of RAND 5.1, which is expected to build on previous findings and be released in November. According to the RAND 5.1 report, Indiana has the 9th highest hospital fees nationally (an improvement from previous reports) and the 6th lowest professional fees, citing hospital consolidation and monopoly insurance markets as cost drivers. 

Messer and Dr. Soni, on behalf of the IBHC, presented the findings of a new report from the IU Richard M. F​airbanks School of Public Health​, which focuses on the wide range of factors impacting health care costs and outcomes in Indiana, including spending by industry, market characteristics, and Hoosiers’ health conditions. The report finds that Indiana is around the national average in total health care spending but has a higher percentage of self-insured employers and high-deductible health plans, which leads to higher out-of-pocket costs for employees. Lawmakers asked pointed questions about the data in the study, including publicly available datasets and self-insured plan data. As a member of the IBHC, IHA has helped spread awareness of the report among lawmakers and the public. IHA is committed to the work of the IBHC and being part of industry-based, free-market solutions to address challenges in the health care industry.

Ultimately, the committee adopted its final report summary​izing the committee’s work and findings​. Those findings include recognition that the General Assembly “has effectively increased transparency and moved the topic of health care costs to the forefront, thus allowing market corrections from the various stakeholder groups”; that its PBM audit revealed a lack of transparency in PBM practices and the need to gather additional information; that the Indiana Department of Insurance will receive information at the end of calendar year 2024 on hospital charge reporting as required by House Enrolled Act 1004-2023; and that according to FSSA, Indiana’s hospital Medicaid rates are “fairly average” when compared to other states, when accounting for base rates and supplemental payments.  ​

The IHA team will provide further updates as they become available. As always, thank you for all members' continued advocacy.

 

Legislative Update - May 15, 2024​​​​ 

​IHA Challenges Flawed and Outdated RAND 5.0 Report 

The RAND 5.0 report was released earlier this week at the National Healthcare Price Transparency Conference in Indianapolis. The report ranked Indiana 8th highest in total commercial hospital prices between 2020 and 2022. Indiana’s ranking improved slightly compared to RAND 4.0, in which Indiana ranked 7th highest; however, IHA continues to challenge the study’s validity and methodology. IHA released a statement from IHA President Brian Tabor to statewide media identifying the critical shortcomings of the RAND 5.0 report. 

Every RAND report on hospital prices has relied on incomplete, outdated data, excluded hospital affordability commitments, dismissed cost pressures facing hospitals, and presented Medicare rates as an appropriate benchmark despite Medicare paying far below the cost of care. Given the current state of Indiana’s health care system, in which hospitals’ financial sustainability remains at risk, the portrait they paint could not be further from reality. IHA will continue challenging the validity of such reports and advocate for comprehensive, meaningful policies that address affordability in an effective and equitable manner.  ​

A Game of Political Musical Chairs: The 2024 Primary Election  ​

In a decisive win, U.S. Senator Mike Braun emerged quickly from a crowded field to become the Republican nominee for Governor. Six candidates, including current Lieutenant Governor Suzanne Crouch and former Indiana Secretary of Commerce Brad Chambers, were in the race that concluded last Tuesday. About 24 hours after winning the Republican primary, Senator Braun announced that State Representative Julie McGuire is his preferred running mate to lead the next state administration. In a news release, Braun stated, “Julie shares my vision of making Indiana a national beacon of freedom and opportunity, and I’m proud to have her on the team.” Although Representative McGuire is Senator Braun’s preferred candidate, she will still face competition to become the Republican nominee for Lieutenant Governor during the party’s stat convention this summer. In Indiana, the party’s nomination for the position has to be approved by delegates from around the state during the party’s convention and Representative McGuire currently has one opponent for the bid - Micah Beckwith, a pastor in Hamilton County with a growing conservative following. Senator Braun will face off against Democrat Jennifer McCormick, former Indiana Superintendent of Public Instruction, in the November general election to determine who will serve as Indiana’s next governor.  

Several retirements from the Indiana General Assembly made for a very interesting primary for candidates looking to serve in the Statehouse. In the House of Representatives, there were eight open seats due to retirements and 26 contested races in total. State Representative Chuck Goodrich, who announced he would vacate his seat to run for Congress, was unsuccessful in his challenge to incumbent Congresswoman Victoria Spartz, even though Spartz had previously announced she would not seek re-election before abruptly rescinding that commitment and running. Alaina Shonkwiler, a former district director for Spartz, was victorious in securing the Republican nomination to fill the seat vacated by Goodrich. Shonkwiler now faces Democrat Christopher Hartig for the seat. In House District 24, covering parts of Boone and Hamilton Counties, State Representative Donna Schaibley’s retirement opened the door for a Republican primary victory for Hunter Smith, former Colts punter. Republican Tonya Isa was able to pull off a victory in northeast Indiana’s House District 51 due to the retirement of Representative Denny Zent. The only retirement in the Senate was John Crane from Avon, which led to a victory for Brett Clark, Navy veteran and former Hendricks County Sheriff in the Republican primary for Senate District 24, covering parts of Hendricks and Putnam counties. Even after the primary, retirements are impacting the future makeup of the Indiana General Assembly. State Representative Rita Fleming, a retired physician from southern Indiana, announced her retirement a week after the primary, so the Indiana Democratic Party will hold a caucus to select her replacement. 

The future makeup of Indiana’s congressional delegation was not immune from changes either. In the primary for the Third Congressional District, voters selected a familiar face, Marlin Stutzman, who held the seat from 2010 to 2017 to seek election to the position vacated by current Congressman Jim Banks, who walked away from Tuesday as the Republican nominee for the U.S. Senate seat left open by Mike Braun due to his candidacy for governor. Stutzman will go up against Democrat Kiley Adolph in the general election. Additionally, in the wake of Congressman Larry Bucshon’s announcement to retire from his position representing the Eighth Congressional District, we saw State Senator Mark Messmer win the primary to be the Republican nominee for the open seat. Messmer will face Democrat Erik Hurt, who defeated three others in the primary, in November.

​The Friends of Indiana Hospitals Political Action Committee remains engaged and will continue to prioritize the hospital industry’s best interests in such an active political environment. If you have any questions about races not covered here, please do not hesitate to reach out to IHA’s Government Relations team.

Interim Study Committee Topics Assigned  

The Indiana General Assembly’s Legislative Council convened Tuesday, May 14 to approve various procedures and topics to be studied during the legislative interim. Interim Study Committees, which are comprised of members of both the House and Senate, meet throughout the summer and fall to study the issues assigned to them, the work product of which often informs legislative proposals in the upcoming session, which for 2025 will begin in January and adjourn by the end of April. The Interim Study Committee topics assigned for the 2024 interim can be foun​d here,​ and highlights are as follows: 

Interim Committee on Public Health, Behavioral Health, and Human Services: 

• Approval of agreements with private attorneys and private entities when the Child Support Bureau determines that a reasonable contract cannot be entered into with a prosecuting attorney to administer the child support provisions of Title IV-D of the Federal Social Security Act

Health Care Cost Oversight Task Force: 

• Oversight of health care costs. 
• Review corporate practice of medicine. 

Medicaid Oversight Committee: 

• Review, consider, and make recommendations concerning the Medicaid program. ​

 

Legislative Update - March 29, 2024

2024 Legislative Session Adjourned​​

The 2024 legislative session adjourned for the year on Mar. 8, earlier than the statutory adjournment deadline of Mar. 14, resulting in an even quicker “short session” as legislative leaders predicted. IHA brought forth a wholistic plan to modernize the state’s Hospital Assessment Fee to leverage all available federal funds at the outset of the legislative session, but following an unexpected Medicaid shortfall in December, legislative leaders conveyed their desire to wait until the 2025 legislative session for a comprehensive Medicaid redesign. The 2025 legislative session will be a long, budget-writing session, in which hospital base rates will also be reviewed. IHA looks forward to working with legislative leaders, the Indiana Family and Social Services Administration, and IHA’s members on the redesign throughout the remainder of the year heading into the 2025 legislative session.​

End-of-Session Overview​

Read the overview of  bills enacted this session in IHA’s full 2024 Legislative Session Report​. Items of note include:​

• Reinstatement of the ability of the Indiana Department of Health to grant time extensions for hospital fiscal reports (HEA 1259 and SEA 132​).
• Additional flexibility for clinical nurse preceptors and nursing program faculty (HEA 1259).
• Additional pathways for foreign-educated nurses to become licensed in Indiana (SEA 132).
• A study of emergency medical services across Indiana so recommendations may be provided to the Indiana General Assembly ahead of the budget session (HEA 1302).
• The repeal of the requirement that out-of-state practitioners must provide the Indiana Professional Licensing Agency a certification to practice telehealth in Indiana (SEA 132​)
• Updated language that ensures Medicaid reimbursement for individuals under emergency detention orders (HEA 1216​).​

There were several bills that did not make it across the finish line as well, following IHA’s advocacy due to their harmful provisions. Items of note include:​

• HB 1200, which would have imposed price caps for the State Employee Health Plan;
• HB 1327, which would have created new ownership reporting requirements on hospitals;
• HB 1414, which would have allowed Medicaid-managed care organizations to pay below the Medicaid rate; and
• SB 168​, which would have created additional 340B program reporting.​

View IHA’s full 2024 Legislative Session Report​

 

Legislative Update - March 1, 2024

Mergers and Acquisitions Legislation Moves Closer to Final Passage

Earlier this week, the House passed Sen​ate Bill 9​ which requires certain mergers and acquisitions between health care entities to be reported to the Attorney General's office. The bill was sent back to the Senate as a motion to concur with the amendments adopted by the House Public Health Committee. Early next week, the full Senate will consider whether they agree with the changes. IHA remains opposed to the legislation and still contends that the current federal framework, which is currently being strengthened through the FTC, is adequate and protects consumers.  The current federal process has safeguards built in that ensure the review does not negatively impact a community's access to health care. IHA continues to advocate for further changes to be made before the motion to concur is voted on next week. IHA is in communication with relevant lawmakers and will provide an update next week on whether that happens. ​

Senate Terminates Ownership Disclosure Bill and Keeps LARC Alive

The Senate Health and Provider Services Committee decided not to consider House Bill (HB) 1327​ this week. The bill would have required health care entities to report ownership information to their respective regulatory bodies and would have required insurers to provide the employer consumers with specific claims data. This week's committee hearing was the last chance to consider the bill, therefore it is dead. However, language from the bill is still eligible to be amended into another bill through a conference committee so IHA will continue to monitor. HB 14​26​, which requires hospitals to offer long-acting reversible contraceptives to Medicaid patients and requires the Family and Social Services Administration (FSSA) to ensure reimbursement is provided if such services are delivered, was amended by the Senate Appropriations Committee this week. The amendment adopted by the committee sunsets the bill's requirements on June 30, 2025, then requires the FSSA to explore available federal funds to use for such services going forward. The bill will now head to the full Senate for further consideration.

Workforce and Fiscal Report Bill Heads to Governor's Desk​

The Senate voted to approve amendments adopted in the House on Senate B​​ill (SB) 132​ this week. The bill includes various professional occupation provisions, specifically allowing foreign-educated nurses to benefit from all avenues to become licensed in Indiana, which builds on IHA’s efforts from 2022 under the ‘Nursing Indiana Back to Health’ initiative​.  Additionally, IHA was successful in advocating for language to reinstate the ability for hospitals to obtain extensions granted by the Indiana Department of Health to the deadline for submitting annual fiscal reports. Last year, under House Enrolled Act (HEA) 1004, such deadline extensions were prohibited, so we are pleased to report this language will be reinstated for necessary flexibility in submitting fiscal reports. The bill now heads to the Governor for his signature.

 

Legislative Update - February 23, 2024

IHA Announces Pledge to Support State’s Health First Indiana Initiative

Hundreds of public health advocates gathered earlier this week for Public Health Day hosted by the Indiana Department of Health to promote the importance of public health in Hoosiers’ lives and raise awareness of current initiatives to improve the delivery of services around the state. Steve Holman, Union Health CEO, and 2024 IHA Board Chair, presented to the group and publicly announced IHA’s pledge to support the State’s Health First Indiana initiative. Holman stated, “IHA and its member hospitals are fully committed to partnering with our state and local health leaders to ensure each and every Hoosier has access to the critical services they need to achieve their highest quality of life. This is our opportunity to improve the health of our citizens and the overall delivery of care in communities large and small across the state.” Vanessa Green Sinders, President and CEO of the Indiana Chamber of Commerce also presented the case for improving public health services as a factor in keeping Indiana’s business climate competitive. During the event, the Indiana Department of Health recognized Representative Brad Barrett (R-Richmond) and Senator Ed Charbonneau (R-Valparaiso) who played a crucial role in launching these initiatives through Senate Enrolled Act 4 last session. IHA is grateful for their efforts and stands ready to build on these partnerships to ensure Indiana is in the best possible position to improve the health of every Hoosier. Read the IHA p​ress release.

Senate Considers Long-Acting Reversible Contraceptives and Employers’ Access to Claims Data​

Earlier this week, the Senate Committee on Health and Provider Services voted to approve House ​Bill 1426​ which requires hospitals to offer long-acting reversible contraceptives to Medicaid patients and requires the Family and Social Services Administration to ensure reimbursement is provided if such services are delivered. The bill was recommitted to the Senate Appropriations Committee due to its fiscal impact on the State and we are unsure it will survive due to the scrutiny given to Medicaid expenditures currently. In addition to HB 1426, the committee considered HB ​1327​ which requires health care entities to report ownership information to their respective regulatory bodies and requires insurers to provide ​employer consumers with specific claims data. That bill was held without a vote in order to address the ownership disclosure requirements through an amendment next week. IHA is engaged on this issue and will continue working with the bill sponsor and committee members on a favorable amendment.

Merger and Acquisition Notification Bill Moves Forward

Earlier this week, the House Public Committee voted to approve Senate Bill ​9​ which requires certain mergers and acquisitions between health care entities to be reported to the Attorney General’s office. The bill was then engrossed on second reading by the full House on Thursday which means it will up for its third and final vote in the House on Monday. IHA testified in opposition to the bill in committee as we still contend that the current federal framework, which is currently being strengthened through the FTC, is adequate and protects consumers.  The current federal process has safeguards built in that ensure the review does not negatively impact a community's access to health care. IHA will continue to advocate against this legislation and provide updates as session continues.​

 

Legislative Update - February 16, 2024

Health Care Workforce Legislation Continues to Move

House Bill (HB) 1259, which builds upon the efforts of IHA's “Nursing Indiana Back to Health" initiative through House Enrolled Act (HEA) 1003 in 2022, was approved by the Senate Health and Human Provider Services Committee this week. It is no secret that Indiana, like all other states, is suffering from a shortage of nurses, and IHA applauds efforts such as HB 1259 to take steps to address this crisis. It is estimated that Indiana will need an additional 5,000 nurses by the year 2031 which means an additional 1,300 nurses would need to enter the workforce annually by then. The bill specifically streamlines the licensure process for foreign-educated nurses by allowing them to benefit from the licensure pathways improved by the legislation passed in 2022. The bill now moves to the full Senate for further consideration and IHA expects continued support for the measure.​

Insurance Payment for Ambulances Still Being Deliberated

Earlier this week, the Senate Committee on Insurance and Financial Institutions approved a measure aimed at ensuring insurance companies pay for ambulance services at an appropriate rate. The bill, HB 1385​, authored by Representative Brad Barrett (R-Richmond) and sponsored by Senator Tyler Johnson (R-Leo), would require insurance companies to pay out-of-network ambulance service providers at any rate set by local ordinance within the municipality in which the transport begins or, absent such rate, 400% of Medicare for such services, whichever is less. A study completed by the Rural Health Research and Policy Centers shows that half of Indiana's counties contain what are known as “ambulance deserts" which means individuals live more than 25 minutes from an ambulance station. The committee adopted an amendment removing the state employee health plan. The IHA advocacy team continues to monitor this and communicate with the author and sponsor to ensure this legislation will not negatively impact arrangements between hospitals and ambulance service providers.     

Psilocybin Legislation Receives Committee Approval

This week, the House Public Health Committee voted to approve a measure that would allow Indiana to look further into the possible benefits of psilocybin on various mental health conditions. SB 139, authored by Senator Ed Charbonneau (R-Valparaiso), would establish the therapeutic psilocybin research fund to provide funds for research and require those receiving funds to conduct clinical studies and then report to the Interim Committee on Public Health, Behavioral Health, and Human Services for further review. The institutions selected to conduct such trials under this legislation would focus on research on psilocybin's effectiveness at treating conditions such as post-traumatic stress disorder, anxiety, depression, bipolar disorder, chronic pain, alcohol use disorder, and tobacco use disorder. Committee members discussed many issues, including the flexibility provided by the federal government in allowing such research to take place which they believe is an important step before legalizing or decriminalizing the substance. Additionally, one committee member raised the issue of cost and whether the steps taken to study and regulate would increase the cost of the treatment should it be permitted. The bill now heads to the full House for further consideration.      ​

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Legislative Update - February 9, 2024

​​Legislature Reaches Session Halftime

This week marks the halfway point of the 2024 legislative session. All bills have made their way through their chamber of origin: Senate bills through the Senate, and House bills through the House. If a bill has not been voted on in its chamber of origin by this point, it is considered "dead" and will not advance further. 

However, there ​is an opportunity for language from dead bills to be revived and placed into bills that are still moving via an amendment. The IHA team will continue to be vigilant in fighting against any harmful language being added to bills. 

Out of the 297 bills that were introduced in the Senate this session, 110 passed with 88% receiving bipartisan support and 58% receiving unanimous support. In the House, 111 bills passed out of 442 filed.

A helpful tool for determining whether bills are still working through the process is the Indiana General Assembly website. The website provides a complete list of bills filed this session. Bills listed in blue font are still alive and going through the process. Bills that have failed to advance and are effectively "dead" are in grey font.

The IHA advocacy team will continue monitoring issues diligently in the second half of session and report developments as they become available.

Concerning Legislation Not Moving Forward

IHA is proud to announce some concerning legislation that will not be advancing out of each chamber. Most of the bills listed below not only proposed restrictions or reporting requirements that go beyond what is federally required, but also could have jeopardized a patient’s access to quality care.​ 

Senate Bill 258​  would have put in place punitive physician referral restrictions beyond what current federal law requires. Senate Bi​ll 168​ would have required an entity authorized to participate in the federal 340B Drug Pricing Program to annually report additional data to the Indiana Department of Health. This proposed legislation would have created burdensome reporting requirements inconsistent with federal requirements. Senate Bill 276​ would have inconsistently duplicated several federal regulations governing the provision of charity care in hospitals. 

Lastly, House Bill 1​200​ would have capped prices for hospitals providing services to state employees at 200% of Medicare. As the bill was drafted and amended, it would jeopardize access to quality care for state employees including state police, prison employees, highway workers, state hospitals and health care workers, their families, and many more on the state employee health plan. 

Although the above legislation is dead this session, IHA will continue to monitor these topics in case similar concepts arise in another bill during the second half of session.

IHA’s Continues to Work with the State on HAF Modernization Proposal

The firs​t step in modernizing Indian​a's Medicaid system was the introduction of House​ Bill 1393​, specifically looking at the Hospital Assessment Fee (HAF) program and establishing a Managed Care Assessment Fee (MCAF). The bill received its initial hearing at the end of January, and the supporters who testified answered questions from legislators who were interested in the modernization plan. Although the bill unfortunately did not receive a vote, IHA continues to work with legislative leadership and the Family and Social Services Administration (FSSA) on possible alternatives as the legislation session begins its second half.

The updated HAF program would allow hospitals to be assessed up to the federally allowable maximum to increase the overall benefit of the HAF program and protect access to quality care across the state. In addition to protecting access, our proposal will help reduce the cost shift to commercial insurance.

IHA remains committed to working with the administration and lawmakers to enact a plan to achieve our goal of improving reimbursement at no additional cost to the state.

 

​Legislative Update - February 2, 2024

Price Cap Legislation Stalls

Thanks to the advocacy effor​ts of IHA and its members, House Bill (HB) 1200​ was removed from consideration by the House of Representatives, therefore it is dead for this legislation session. There is still a possibility that the provisions in the bill could resurface through an amendment to another bill, but lawmakers heard your voices through our recent push to oppose the legislation. The bill would have capped prices for hospitals providing services to state employees at 200% of Medicare.  We understand that price caps are never acceptable and doing so at any level this year just means that are likely to get lowered in subsequent years. Furthermore, any type of government rate setting will immediately impact marketplace negotiations and result in a significant cost shift to other plans across the state. Although HB 1200 is dead this session, IHA will continue to monitor this topic in case similar concepts arise in another bill. IHA will also continue educating lawmakers on the dangers of using data from the National Academy of State Health Policy (NASHP)​ which is deeply flawed and has been used by various advocacy groups to inaccurately characterize hospital margins to push their own heavy-handed agenda.

Merger Notification Bill Sent to the House

This week, the S​enate passed Senate Bill (SB) 9​ on third reading by a vote of 49-0 which sends it to the House for consideration. The bill was amended in the Senate Health and Provider Ser​vices Committee to now require a 90-day notice of merger or acquisition to the Attorney General's office. As we have discussed, this bill stems from a recommendation adopted by the Health Care Cost Oversight Task Force that met over the interim and reviewed a variety of topics, market concentration being one of its main focuses. IHA continues to oppose the legislation, but we are communicating with the bill's author, Senator Chris Garten, and sponsor, Representative Donna Schaibley, to improve the legislation and ensure that if it is enacted into law, it is done so in the least burdensome manner possible.

340B Reporting Legislation Does Not Move Forward

A bill proposing new requirements for entities participating in the federal 340B drug pricing program has been removed from consideration this session as it did not receive a committee hearing in the first half. The bill, SB 168 which was authored by Senator Ed Charbonneau, would have established several new reporting requirements on covered entities that go much further than those required currently under federal law. IHA is truly appreciative of its members who voiced concern over the bill which ultimately resulted in it being removed from the committee schedule this week. The 340B program will continue to be scrutinized by policymakers, in Indiana, and across the country, so IHA will continue monitoring any movement in this area and prepare for ongoing discussions in anticipation of future proposal in this space.

 

Legislative Update - January 27, 2024

House Committee on Public Health Considers IHA's HAF Modernization Proposal

The House Committee on Public He​alth this week heard House Bill (HB) 1393 which is the first step in modernizing Indiana's Medicaid system, specifically looking at the Hospital Assessment Fee (HAF) program and establishing a Managed Care Assessment Fee (MCAF).

IHA's Deputy General Counsel, Laura Brown, opened the testimony by explaining the updated HAF program would allow hospitals to be assessed up to the federally allowable maximum to increase the overall benefit of the HAF program and protect access to quality care across the state. In addition to protecting access, our proposal will help reduce the cost shift to commercial insurance. Others who testified in support of the bill include:

• Matt Doyle, Gary Methodist CEO
• Dr. Eric Fish, Schneck Medical Center CEO
• Dr. James Porter, Deaconess Hospital
• Julie Conrad, Eskenazi Health General Counsel
• Dr. Rick Sasso, Indiana Spine Group President

Although the bill did not receive a vote at this hearing, legislative leadership is continuing its consideration of the plan as the legislative session continues. IHA remains committed to working with the administration and lawmakers to enact a plan to achieve our goal of improving reimbursement at no cost to the state. 

In the meantime, please continue to reach out to your representatives and senators, asking them to vote “yes" on this bill. Please click the button below to send a pre-written message directly to the legislators who represent your district. Estimated time 2-3 minutes. 

 Here's how it works:

• Click the red button below to open the IHA Action Center.
• Once open, there will be a sample message drafted in the Message Body section —feel free to customize this message to reflect your individual hospital.
• Next, fill out your contact info in the boxes below the Message Body section.
• Once complete, hit the blue “send message" button to ensure your voice is heard. You will receive a confirmation email notifying you that your message was successfully sent and to which legislators. Note: First-time users will need to authenticate by verifying their email. Be sure to check your junk/spam if you do not see that message.

 

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Price Caps for State Employees Health Plan Passes out of Committee

House Bill (HB) 1200 which is legislation that would counteract the work being done to pass HB 1​393, passed out of House Committee on Insurance this week with a vote of nine to four.

HB 12​00​ would arbitrarily set price caps for hospitals and Ambulatory Surgery Centers that care for individuals on the state employee health plan at 200% of Medicare. These price caps on reimbursement do not consider the payor mix and cost pressures, or the level of services being provided to state employees at each individual hospital. This bill would result in further cost-shifting to all other employers in the state.

Proponents of the legislation point to the limited scope of the bill, as the state employee health plan “only covers 60,000 lives," and the overall impact would be spread among hospitals. However, this would lead to an immediate cut of approximately $80 million to hospitals across the state each year.

Instead of pursuing price caps, which were debated and not pursued just last year, IHA is requesting the opportunity to partner with the State Personnel Department on their tiered network program HealthSync. This program was launched just a few years ago to incentivize state employees to schedule with preferred providers with lower visit costs through lower deductibles and lower out-of-pocket maximums.

IHA will continue working with legislators on a viable plan to reduce cost shift rather than a measure that would squeeze the proverbial balloon of health care costs. The bill will continue to be considered by the committee and IHA will update members on its status through the legislative process. 

Senate Bill 9 Passes Senate Committee on Health and Provider Services 

Senate Bill 9 would require health care entities to provide notice of certain mergers or acquisitions to the office of the Attorney General.

The bill was amended to require a 90-day notice to the AG's office, but IHA contends that the current federal framework, which is currently being strengthened through the FTC, is adequate and protects consumers. 

Currently, the federal process has safeguards built in that ensure the review does not negatively impact a community's access to health care. For example, if an institution is failing and a merger would otherwise save access for that community, there are processes built into the federal review. 

IHA will continue to fight against harmful legislation that negatively impacts hospitals and subsequently their community's access to health care. 

 

Legislative Update - January 19, 2024

Senate Health Committee Passes Prior Authorization Bill 

The Senate Committee on Health and Provider Services unanimously passed Senate Bill (SB) 3 on Wednesday. This bill, authored by Sen. Tyler Johnson (R- Leo), would place limitations on how health insurance providers use prior authorization in certain circumstances when making coverage decisions.  

IHA strongly supports this legislation and appreciates Senate leadership prioritizing a bill which would streamline the process to allow physicians to spend more time seeing patients, and less jumping through unnecessary hoops. This bill would significantly improve the system, putting the patient first. 

Dr. Elizabeth Wright, Chief Ambulatory Officer at Hendricks Regional Health, testified in support of the bill, saying patients deserve, and expect health coverage that does not interfere with care they discuss and decide upon with their physician. SB 3 prioritizes and protects the patient-physician relationship which is crucial to ensure the most appropriate care is delivered. 

Hospitals Still Need Your Help ​

Thank you for your advocacy on behalf of your hospital over the last week. 

IHA’s top priority for the 2024 session is HB 1393 which is the first step in modernizing Indiana’s Medicaid system, specifically looking at the Hospital Assessment Fee (HAF) program and establishing a Managed Care Assessment Fee (MCAF). 

Beacon Health System CEO Kreg Gruber, IU Health CEO Dennis Murphy, Deaconess Hospital CEO Shawn McCoy, and Union Health CEO Steve Holman joined the IHA advocacy team to meet with Speaker Todd Huston and the Governor’s office to continue education on HB 1393 and the urgent need to help our hospitals. 

The IHA advocacy team will continue to meet with legislators to discuss the importance of this bill, but we still need your help. Please reach out to your representatives and senators, asking them to vote “yes” on this bill. Please click the button below to send a pre-written message directly to the legislators who represent your district. Estimated time 2-3 minutes. 

Click the button below to send a pre-written message directly to the legislators who represent your district. Estimated time 2-3 minutes.​

 Here's how it works:

• Click the red button below to open the IHA Action Center.
• Once open, there will be a sample message drafted in the Message Body section —feel free to customize this message to reflect your individual hospital.
• Next, fill out your contact info in the boxes below the Message Body section.
• Once complete, hit the blue “send message" button to ensure your voice is heard. You will receive a confirmation email notifying you that your message was successfully sent and to which legislators. Note: First-time users will need to authenticate by verifying their email. Be sure to check your junk/spam if you do not see that message.

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IHA Opposes Bill That Leads to More Cost Shifts 

Hospitals are opposing House Bill (HB) 1200 which is legislation that would counteract the work being done to pass HB 1393.  

HB 1200 would arbitrarily set caps on reimbursement that would not take into account the payor mix and cost pressures, or the level of services being provided to state employees at each individual hospital. This bill would result in further cost-shifting to all other employers in the state. 

Mike Schroyer, CEO of Baptist Health Floyd, testified on behalf of IHA in opposition to the bill and said to, “Instead of pursuing price caps, which were debated and not pursued just last year by this body, we would encourage the legislature to work with the State Personnel Department to learn more about their tiered network program HealthSync, was launched just a few years ago to incentive state employees to schedule with preferred providers with lower visit costs through lower deductibles and lower out-of-pocket maximums.” 

Shroyer continued to say incentivizing low-cost providers through a tiered network system is the right, pro-market approach for Indiana, and if further updates to that program would maximize the benefit, hospitals would welcome that discussion – but price caps are not the answer. 

 The bill was held by the Committee on Insurance, and IHA will continue working with legislators on a viable plan to reduce cost shift rather than a measure that would squeeze the proverbial balloon of health care costs. The bill will continue to be considered by the committee and IHA will update members on its status through the legislative process.  ​

 

Legislative Update - January 12, 2024

Governor Holcomb Releases 2024 Next Level Agenda

The 2024 legislative session kicked off with Gov. Holcomb announcing his 2024 Next Level Agenda for his final year as Indiana Governor. The agenda includes priorities for the legislative session and the implementation of other initiatives in state government. His health agenda items are as follows: The Holcomb administration's agenda includes prioritizing K-12 and higher education, making childcare more affordable, strengthening Indiana's economic outlook, additional workforce development measures, and improving services for aging Hoosiers. 

​For more information on Gov. Holcomb's 2024 Next Level, click here.

IHA 2024 Legislative Agenda

 IHA's top priority for the 2024 session is HB 1393 which is the first step in modernizing Indiana's Medicaid system, specifically looking at the Hospital Assessment Fee (HAF) program and establishing a Managed Care Assessment Fee (MCAF). IHA's proposal for the upcoming session is to update the HAF program to allow hospitals to be assessed up to the federally allowable maximum to increase the overall benefit of the HAF program and protect access to quality care across the state. In addition to protecting access, our proposal will help reduce the cost shift to commercial insurance. We look forward to partnering with policymakers to protect access to care at no cost to the state under this proposal while helping to reduce the cost shift paid for by employers and consumers.

ACT NOW: Please reach out to your lawmakers this week and ask them to vote yes on HB 1393. We have drafted a pre-written message to send to your legislators that can be customized to share what specific issues your hospital is facing.

Click the button below to send a pre-written message directly to the legislators who represent your district. Estimated time 2-3 minutes.

 Here's how it works:

•  Click the red button below to open the IHA Action Center.
• Once open, there will be a sample message drafted in the Message Body section —feel free to customize this message to reflect your individual hospital.
•  Next, fill out your contact info in the boxes below the Message Body section.
• Once complete, hit the blue “send message" button to ensure your voice is heard. You will receive a confirmation email notifying you that your message was successfully sent and to which legislators. Note: First-time users will need to authenticate by verifying their email. Be sure to check your junk/spam if you do not see that message.

 

Indiana General Assembly Announces Agenda​

The Indiana Senate and House released their agenda bills for the 2024 Legislative Session.

The Senate Republicans' agenda focused on improving Hoosier students' reading skills, childcare access, protecting patients, fiscal responsibility, government accountability, and upgrading water lines to protect Hoosiers' health.

The S​enate and House Democr​ats released a joint agenda​​ they hope to tackle this session. The agenda focused on increasing access to affordable, high-quality childcare, providing all homeowners with property tax relief, capping prescription drug costs, solving the third-grade reading proficiency crisis, and creating citizen-led ballot referendums.

The House Republicans released their ​agenda  which focuses on five key parts: Expanding work-placed learning, “stepping up" for retirees, boosting student reading proficiency, protecting taxpayers, and supporting Jewish students in Indiana.