HB 1003 IN

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Became Law

Specifies that the Medicaid fraud control unit's (MFCU) investigation of Medicaid fraud may include the investigation of provider fraud, insurer fraud, duplicate billing, and other instances of fraud. Permits the attorney general to enter into a data sharing agreement with specified state agencies and authorizes the MFCU to analyze this data to carry out its investigative duties. Provides that all complaints made to the MFCU are confidential until an action is filed concerning the complaint. Requires the office of the secretary of family and social services to establish: (1) metrics to assess the quality of care and patient outcomes; and (2) transparency and accountability safeguards; for a specified long term care risk based managed care program. Requires, not later than July 31, 2026, a clinical laboratory and diagnostic imaging facility to post certain pricing information for services determined by the department of insurance. Allows: (1) a manufacturer to provide; and (2) a patient to receive; individualized investigational treatment if certain conditions are met. Requires an Indiana nonprofit hospital system to report a list of facilities that may submit a bill on an institutional provider form and report the facility code for each facility. Adds provisions concerning payments by insurers, health maintenance organizations, employers, and other responsible persons to qualified providers that are providing services in an office setting. Requires good faith estimates for health care services to be provided at least two business days (rather than five business days) before the health care services are scheduled to be provided. Removes language concerning the disclosure of a trade secret from provisions that allow for a health plan sponsor to access and audit claims data. Provides that when a health carrier is in the process of negotiating a health provider contract with a health provider facility or provider, the health carrier must provide certain information to the health provider facility or provider. Prohibits certain provisions from being included in a health provider contract. Allows the department of insurance to: (1) enter into partnerships and joint ventures to encourage best practices in the appropriate and effective use of prior authorization in health care; and (2) receive information regarding prior authorization disputes. Requires the department of insurance to prepare a report with findings and recommendations related to the prior authorization dispute information. Requires, not later than September 1, 2025, the department of insurance to issue a request for information concerning ways to better enable medical consumers to compare and shop for medical and health care services. Provides that an insurer or a health maintenance organization may not deny a claim for reimbursement on the sole basis that the referring provider is an out of network provider. Requires, if a fully credentialed physician becomes employed with another employer or establishes or relocates a medical practice in Indiana, an insurer and health maintenance organization to provisionally credential the physician for 60 days or until the physician is fully credentialed, whichever is earlier. Requires the Indiana department of health, in consultation with the office of technology, to study the feasibility of developing certain standards regarding medical records and data.

• Brad Barrett Republican · author
• Ed Charbonneau Republican · sponsor
• Tyler Johnson Republican · sponsor

1. Jan 21, 2025 Coauthored by Representatives Lehman and Isa · lower
2. Jan 21, 2025 Authored by Representative Barrett · lower
3. Jan 21, 2025 First reading: referred to Committee on Insurance · lower
4. Feb 4, 2025 Recommitted to Committee on Ways and Means pursuant to House Rule 126.3 · lower
5. Feb 4, 2025 Committee report: amend do pass, adopted · lower
6. Feb 13, 2025 Committee report: amend do pass, adopted · lower
7. Feb 17, 2025 Second reading: amended, ordered engrossed · lower
8. Feb 17, 2025 Amendment #8 (Barrett) prevailed; voice vote · lower
9. Feb 18, 2025 Senate sponsors: Senators Charbonneau and Johnson T · lower
10. Feb 18, 2025 Third reading: passed; Roll Call 201: yeas 66, nays 32 · lower
11. Feb 19, 2025 Referred to the Senate · lower
12. Mar 3, 2025 Pursuant to Senate Rule 68(b); reassigned to Committee on Health and Provider Services · upper
13. Mar 3, 2025 First reading: referred to Committee on Insurance and Financial Institutions · upper
14. Apr 3, 2025 Committee report: amend do pass adopted; reassigned to Committee on Appropriations · upper
15. Apr 10, 2025 Committee report: amend do pass, adopted · upper
16. Apr 10, 2025 Senator Randolph added as cosponsor · upper
17. Apr 14, 2025 Amendment #19 (Charbonneau) prevailed; voice vote · upper
18. Apr 14, 2025 Amendment #13 (Johnson T) prevailed; voice vote · upper
19. Apr 14, 2025 Amendment #16 (Brown L) prevailed; voice vote · upper
20. Apr 14, 2025 Second reading: amended, ordered engrossed · upper
21. Apr 14, 2025 Amendment #8 (Johnson T) prevailed; voice vote · upper
22. Apr 14, 2025 Amendment #11 (Johnson T) prevailed; voice vote · upper
23. Apr 15, 2025 Third reading: passed; Roll Call 421: yeas 48, nays 1 · upper
24. Apr 16, 2025 Returned to the House with amendments · upper
25. Apr 17, 2025 Motion to dissent filed · lower
26. Apr 21, 2025 House dissented from Senate amendments · lower
27. Apr 21, 2025 Senate conferees appointed: Charbonneau and Yoder · upper
28. Apr 21, 2025 House conferees appointed: Barrett and Campbell · lower
29. Apr 21, 2025 House advisors appointed: Lehman, Isa, Carbaugh, Bauer and Dant Chesser · lower
30. Apr 21, 2025 Senate advisors appointed: Jackson L and Johnson T · upper
31. Apr 23, 2025 Senator Johnson T added as conferee · upper
32. Apr 23, 2025 Senator Johnson T removed as advisor · upper
33. Apr 23, 2025 Senator Yoder removed as conferee · upper
34. Apr 23, 2025 CCR # 1 filed in the House · lower
35. Apr 23, 2025 Representative Campbell removed as conferee · lower
36. Apr 23, 2025 CCR # 1 filed in the Senate · upper
37. Apr 23, 2025 Representative McGuire added as conferee · lower
38. Apr 24, 2025 Rules Suspended. Conference Committee Report 1: adopted by the House; Roll Call 544: yeas 67, nays 25 · lower
39. Apr 24, 2025 Signed by the Speaker · lower
40. May 6, 2025 Signed by the Governor · executive
41. May 6, 2025 Public Law 215 · lower
42. Apr 29, 2025 Signed by the President of the Senate · upper
43. Apr 24, 2025 Signed by the President Pro Tempore · upper
44. Apr 24, 2025 Rules Suspended. Conference Committee Report 1: adopted by the Senate; Roll Call 513: yeas 30, nays 20 · upper