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 6719 NOTE PREPARED: Dec 28, 2021
BILL NUMBER: SB 284 BILL AMENDED:
SUBJECT: Telehealth Matters.
FIRST AUTHOR: Sen. Charbonneau BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
XDEDICATED
XFEDERAL
Summary of Legislation: The bill consolidates Medicaid telehealth language.
It adds specified health care providers and students to the definition of "practitioner" for purposes of
practicing telehealth. It also allows behavior health analysts to temporarily perform telehealth during the time
when the Professional Licensing Agency (PLA) is preparing to implement licensure for the profession.
The bill exempts certain actions from the definition of "telehealth", allowing for a practitioner to delegate
consultation, treatment, and monitoring of a patient if the delegated health service is within the practitioner's
scope of practice and allowed to be delegated by the practitioner in an in-person setting.
Effective Date: July 1, 2022.
Explanation of State Expenditures: Certain telehealth services could potentially become more accessible
to state Medicaid enrollees or state employee health plan insureds as a result of the bill expanding the
definition of telehealth practitioners to include school psychologists, certain case managers, students directed
by license holders, and behavior analysts.
The PLA may have some minor workload increase to recognize behavior health analysts prior to a full
professional licensing program is implemented.
Additional Information -
Expansion of Telehealth Services: The bill’s impact on claims payments under state health programs will
SB 284 1 depend on the extent to which telehealth services add to or displace care that would have otherwise occurred.
An increase in telehealth visits may be mitigated by factors such as a reduced likelihood of emergency visits
and possible lower payment rates for practitioners with limited licenses or permits.
Medicaid Telehealth Services: The Medicaid state plan currently limits reimbursement for telehealth services
to certain eligible services and provider types. Payment for telehealth services rendered by students or
through delegated services as described by the bill would depend on determinations made by the FSSA and
its contracted managed care entities that the services are eligible for reimbursement.
Medicaid State Share: Medicaid and the Children’s Health Insurance Program (CHIP) are jointly funded
between the state and federal governments. The standard state share of costs for most Medicaid medical
services for FFY 2021 is 34%, or 10% for the age 19 to 64 expansion population within the Healthy Indiana
Plan. The standard state share of CHIP costs is 24%.
State Employee Health Plan: Costs for the state health plans are shared between the state and state employees
covered by the plan as determined in the plans’ designs, including premiums, coinsurance, copayments, and
deductibles. An increase in premiums cost may be mitigated with adjustments to other benefits or to
employee compensation packages, or through the division of premium costs between the state and state
employees.
Explanation of State Revenues: Insurance Premium Tax: An increase in private insurance claims for
telehealth services may create upward pressure on premiums collected in the state. Any increase in insurance
company premiums will increase General Fund revenue from either insurance premium tax collections or
Adjusted Gross Income (AGI) tax collections. This impact is expected to be minimal.
Explanation of Local Expenditures: Local Health Plans: The bill potentially impacts local units of
government who offer health insurance coverage for employees through a non-ERISA plan. Added local
health coverage costs may be mitigated with adjustments to other benefits or to the total employee
compensation packages, or through the division of costs between the local unit and employees. This impact
is expected to be minimal.
School Corporations: The bill could impact the hiring decisions of school corporations to the extent that it
facilitates the provision of certain school-based health services via telehealth.
Explanation of Local Revenues:
State Agencies Affected: Professional Licensing Agency; Family and Social Services Administration; State
Personnel Department; all state agencies.
Local Agencies Affected:
Information Sources: Family and Social Services Administration, Provider Reference Module: Telehealth
and Telemedicine Services;
https://www.in.gov/medicaid/providers/files/telemedicine-and-telehealth-services.pdf.
Fiscal Analyst: Karen Rossen, 317-234-2106; Adam White, 317-234-1360.
SB 284 2