Legislation aimed at health care costs moves forward

The Republican-controlled Indiana General Assembly moved forward all major remaining bills aimed at reducing health care costs on Tuesday, but the various pieces of legislation still have hurdles to clear before heading to Gov. Eric Holcomb.

The bills involve the creation of an all-payer claims database, surprise medical billing, hospital billing, non-compete agreements and underage smoking.

Senate Bill 5

The Indiana House approved Senate Bill 5, which—after amendments inserted in the House Public Health Committee—would establish an all-payer claims database and require hospitals, outpatient surgery centers and urgent care facilities to publish average prices of services to their websites.

The database is expected to provide cost information for specific procedures by facility name and allow individuals to shop around for the best price. More than 20 states have some type of all-payer claims database, but the extra transparency has not resulted in health care costs dropping, according to studies. Also in doubt is the depth of information that could be made available because the state cannot require companies in self-funded insurance plans to provide information to the database.

Supporters of the measure say it’s a step in the right direction.

“These important measures will help to bring more transparency,” said state Rep. Donna Schaibley, R-Carmel, who sponsored the bill in the House.

The House voted 94-0 to pass SB 5, which returns to the Senate for either more changes or a final vote.

House Bill 1004

In the Senate on Tuesday, lawmakers passed House Bill 1004, which would prevent a medical provider from charging a patient an out-of-network rate for any services at a facility—such as a hospital or outpatient surgery clinic—in the patient’s insurance network.

But the surprise billing protection is unlikely to apply to self-insured plans, which account for about 80% of the commercial insurance market and cover about 43% of Hoosiers.

The legislation allows an exception if the patient agrees to the out-of-network cost in writing in advance.

HB 1004 also would force hospitals to provide the address of where services occurred when submitting bills to insurers. This language is the compromise to the site-of-service billing issue that lawmakers sought to address to make sure hospital systems are determining charges appropriately.

The Senate voted 49-1 to pass HB 1004, and it returns to the House for further consideration.

Non-compete agreements

The discussion in the coming days will likely center on non-compete agreements, which are mentioned in two pieces of legislation that passed on Tuesday.

The language in Senate Bill 243, which the House passed Tuesday and will return to the Senate, now provides an option for a physician to be released from the non-compete terms if employment has been terminated or the contract has expired.

But language on non-compete agreements in HB 1004 is stricter and would prohibit hospital systems from entering into such agreements with physicians.

Lawmakers are expected to work out the discrepancy within the next week.

Underage smoking

Both chambers on Tuesday passed identical versions of legislation that would raise the smoking age from 18 to 21 and increase penalties on retailers selling to underaged individuals. But both bills—Senate Bill 1 and House Bill 1006—still need final approval in their originating chambers.

Lawmakers are expected to send one version of the tobacco legislation to Holcomb.