LEGISLATIVE SERVICES AGENCY OFFICE OF FISCAL AND MANAGEMENT ANALYSIS 200 W. Washington St., Suite 301 Indianapolis, IN 46204 (317) 233-0696 iga.in.gov FISCAL IMPACT STATEMENT LS 6860 NOTE PREPARED: Jan 6, 2022 BILL NUMBER: HB 1270 BILL AMENDED: SUBJECT: Nonprofit Hospital and Insurer Reporting. FIRST AUTHOR: Rep. Schaibley BILL STATUS: As Introduced FIRST SPONSOR: FUNDS AFFECTED:XGENERAL IMPACT: State XDEDICATED FEDERAL Summary of Legislation: Hospital Financial Reporting - This bill requires a nonprofit hospital with more than 100 beds to report annually specified financial information to the State Department of Health. Public Forums - The bill requires a nonprofit hospital and a health carrier to post and send certain information at least 45 days before a public forum. It modifies requirements concerning the: (1) date on which the public forum must be held; (2) topics that must be discussed at a public forum; (3) submission of questions and feedback at a public forum; and (4) use of technology to allow attendance through real time audio and video through the Internet. Health Coverage Transparency - The bill requires the Insurance Commissioner to report to the Legislative Council if the federal Transparency in Health Coverage rule (federal rule) is repealed or enforcement is stopped. It requires health payers to continue to post pricing information in compliance with the federal rule after the federal rule is repealed or stopped. All Payer Claims Database - The bill modifies the definition of "health payer" for purposes of the all payer claims data base. Effective Date: Upon passage; July 1, 2022. Explanation of State Expenditures: Agency Workload - Beginning in FY 2023, the bill may require a minor increase in workload and administrative costs for the Indiana Department of Health (IDOH) to collect and store the IRS Form 990 information required by the bill from certain nonprofit hospitals in addition to their HB 1270 1 regular financial reporting. The IDOH could also potentially experience additional workload to investigate reported violations and enforce corrective action pertaining to the nonprofit hospital public forum requirements modified by the bill. Additionally, in the event that the federal Transparency in Health Coverage rule is repealed or enforcement is stopped, the Department of Insurance (DOI) would be required to notify the Legislative Council, adopt rules, and enforce health plan compliance with the federal rule’s price transparency requirements as in effect during 2021. These activities are considered routine administrative functions of the IDOH and DOI and are expected to be completed within existing staffing and resource levels. [IDOH and DOI administrative expenditures are currently paid from dedicated agency fund appropriations.] All Payer Claims Database - The number of records in the all payer claims database (APCD) will increase by adding claims from health plans that are no longer excluded from APCD reporting as a result of the bill. The APCD is currently in the design and development stage, allowing additional records to be accommodated. The costs of storage and processing may be marginally higher than would have been estimated without these additional records. This project is funded through appropriations to a dedicated fund. Explanation of State Revenues: If nonprofit hospitals are found to be acting in violation of the public forum requirements as modified by the bill, the IDOH could potentially impose civil penalties of up to $10,000 per violation. Revenue collected from civil penalties would be deposited in the General Fund. Any additional revenue collected as a result of the bill is expected to be minimal. Explanation of Local Expenditures: Explanation of Local Revenues: State Agencies Affected: Department of Health; Department of Insurance. Local Agencies Affected: Information Sources: IC 16-21-3-1 Fiscal Analyst: Adam White, 317-234-1360; Karen Rossen, 317-234-2106. HB 1270 2