IN HB1597 | 2023 | Regular Session

Status

Spectrum: Partisan Bill (Republican 2-0)
Status: Introduced on January 19 2023 - 25% progression, died in committee
Action: 2023-01-19 - First reading: referred to Committee on Insurance
Pending: House Insurance Committee
Text: Latest bill text (Introduced) [PDF]

Summary

State employee health plan hospital payment limits. Limits the amount that a state employee health plan may pay for a medical facility service provided to a covered individual to: (1) 200% of the amount paid by the Medicare program for that type of medical facility service or for a medical facility service of a similar type, if the medical facility service is provided by an in network provider; and (2) 185% of the amount paid by the Medicare program for that type of medical facility service or for a medical facility service of a similar type, if the medical facility service is provided by an out of network provider. Provides that a determination of the state personnel department, a state employee health plan, or a firm providing administrative services to a state employee health plan that a medical facility service provided to a covered individual is of a type similar to a particular type of medical facility service covered by the Medicare program is conclusive. Requires a medical facility that provides drugs to a covered individual, in billing a state employee health plan for the cost of the drugs, to include in the billing the same "JG" modifier that the medical facility would include in the billing if the medical facility were billing the Medicare program for the drugs.

Tracking Information

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Title

State employee health plan hospital payment limits.

Sponsors


History

DateChamberAction
2023-01-19HouseFirst reading: referred to Committee on Insurance
2023-01-19HouseAuthored by Representative McGuire
2023-01-19HouseCoauthored by Representative Schaibley

Subjects


Indiana State Sources


Bill Comments

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