IN
Indiana House Bill HB1271

Indiana 2023 Regular Session

Indiana House Bill HB1271 Compare Versions

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22 Introduced Version
33 HOUSE BILL No. 1271
44 _____
55 DIGEST OF INTRODUCED BILL
66 Citations Affected: IC 16-21-9-3.5; IC 27-2-26.
77 Synopsis: Nonprofit hospital and insurer reporting. Requires a
88 nonprofit hospital and a health carrier to post and provide certain
99 information at least 45 days before a public forum. Modifies
1010 requirements concerning the: (1) date on which a public forum must be
1111 held; (2) topics that must be discussed at a public forum; (3)
1212 requirements of a public forum; and (4) use of technology to allow
1313 attendance at a public forum through real time audio and video through
1414 the Internet. Requires the Indiana department of health and the
1515 department of insurance to post specified information concerning
1616 public forums on the agency website.
1717 Effective: Upon passage.
1818 Schaibley, Harris
1919 January 11, 2023, read first time and referred to Committee on Public Health.
2020 2023 IN 1271—LS 7317/DI 104 Introduced
2121 First Regular Session of the 123rd General Assembly (2023)
2222 PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
2323 Constitution) is being amended, the text of the existing provision will appear in this style type,
2424 additions will appear in this style type, and deletions will appear in this style type.
2525 Additions: Whenever a new statutory provision is being enacted (or a new constitutional
2626 provision adopted), the text of the new provision will appear in this style type. Also, the
2727 word NEW will appear in that style type in the introductory clause of each SECTION that adds
2828 a new provision to the Indiana Code or the Indiana Constitution.
2929 Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
3030 between statutes enacted by the 2022 Regular Session of the General Assembly.
3131 HOUSE BILL No. 1271
3232 A BILL FOR AN ACT to amend the Indiana Code concerning
3333 health.
3434 Be it enacted by the General Assembly of the State of Indiana:
3535 1 SECTION 1. IC 16-21-9-3.5, AS AMENDED BY P.L.199-2021,
3636 2 SECTION 8, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3737 3 UPON PASSAGE]: Sec. 3.5. (a) This section does not apply to the
3838 4 following:
3939 5 (1) A nonprofit critical access hospital that is not:
4040 6 (A) part of a hospital system; or
4141 7 (B) an affiliate of a hospital or hospital system.
4242 8 (2) A hospital that is established and operated under IC 16-22 or
4343 9 IC 16-23.
4444 10 (b) Before December 31 November 15 of each year, a nonprofit
4545 11 hospital shall hold a public forum within fifteen (15) miles of the
4646 12 nonprofit hospital, in which the nonprofit hospital, including the
4747 13 nonprofit hospital's board of directors, shall:
4848 14 (1) obtain feedback from the community about the nonprofit
4949 15 hospital's performance in the previous year;
5050 16 (2) discuss the pricing of inpatient and outpatient health
5151 17 services provided at:
5252 2023 IN 1271—LS 7317/DI 104 2
5353 1 (A) the nonprofit hospital; and
5454 2 (B) affiliates of the nonprofit hospital;
5555 3 (3) discuss the contributions made by the nonprofit hospital to the
5656 4 community, including uncompensated care, charitable
5757 5 contributions, and any other charitable assistance programs; and
5858 6 (4) discuss, at the hospital system level and at the individual
5959 7 hospital level by hospital federal Centers for Medicare and
6060 8 Medicaid certification number, the following financial
6161 9 statements for the preceding three (3) years, using generally
6262 10 accepted accounting principles:
6363 11 (A) Income statements.
6464 12 (B) Balance sheets.
6565 13 (C) Cash flow statements.
6666 14 (c) At least fourteen (14) forty-five (45) days before the forum held
6767 15 under subsection (b), the nonprofit hospital shall post on the home
6868 16 page of the nonprofit hospital's Internet web site website the following:
6969 17 (1) A printed notice that:
7070 18 (A) is designed, lettered, and featured on the Internet web site
7171 19 website so as to be conspicuous to and readable by any
7272 20 individual with normal vision who visits the Internet web site;
7373 21 website;
7474 22 (B) states the date, time, and location of the public forum to be
7575 23 held under subsection (b); and
7676 24 (C) provides:
7777 25 (i) instructions that describe how members of the
7878 26 community and the public can attend and participate in
7979 27 the public forum through real time audio and video
8080 28 technology through the Internet; and
8181 29 (ii) a link to the real time audio and video technology
8282 30 that will be used for the public forum; and
8383 31 (C) (D) states that the purpose of the public forum is to
8484 32 provide members of the community with an opportunity to:
8585 33 (i) comment on the nonprofit hospital's performance in the
8686 previous year;34
8787 35 (ii) discuss the pricing of inpatient and outpatient health
8888 36 services provided at the nonprofit hospital and affiliates of
8989 37 the nonprofit hospital; and
9090 38 (iii) discuss the contributions made by the hospital to the
9191 39 community, including uncompensated care, charitable
9292 contributions, and any other charitable assistance programs.40
9393 41 (2) The following information relating to the subjects to be
9494 42 presented and discussed at the public forum held under
9595 2023 IN 1271—LS 7317/DI 104 3
9696 1 subsection (b):
9797 2 (A) The nonprofit hospital's Indiana specific:
9898 3 (i) income statement;
9999 4 (ii) balance sheet; and
100100 5 (iii) cash flow statement;
101101 6 as set forth in subsection (b)(4) for the previous three (3)
102102 7 calendar year years and that is prepared according to
103103 8 generally accepted accounting principles.
104104 9 (B) Information concerning:
105105 10 (i) the nonprofit hospital's pricing of health services in
106106 11 comparison to the amounts of reimbursement for the health
107107 12 services under the Medicare program;
108108 13 (ii) the rationale for any pricing of health services by the
109109 14 nonprofit hospital that is higher than the corresponding
110110 15 reimbursement for the health services under the Medicare
111111 16 program; and
112112 17 (iii) any increase in the nonprofit hospital's pricing of health
113113 18 services that occurred in the previous year.
114114 19 (d) At the public forum held under this section, a nonprofit
115115 20 hospital must do the following:
116116 21 (1) Allow participants to do the following during the public
117117 22 forum:
118118 23 (A) Ask questions.
119119 24 (B) Provide feedback.
120120 25 (C) Record and share recordings of the public forum.
121121 26 (2) Announce the names of the corporate and local board
122122 27 members, and introduce any of the board members who are
123123 28 present at the public forum.
124124 29 (3) Provide feedback concerning the participants' comments
125125 30 during the public forum.
126126 31 A nonprofit hospital may allow, but may not require, members of
127127 32 the community to submit questions and feedback in advance of the
128128 33 public forum. A nonprofit hospital may not require an individual
129129 34 to register or otherwise disclose the individual's name to attend the
130130 35 public forum.
131131 36 (d) (e) The public forum requirement held under this section may
132132 37 be held, either all or in part, must be accessible through an interactive
133133 38 real time audio and video meeting that is accessible to the community
134134 39 technology through the Internet. The technology must allow:
135135 40 (1) at least one hundred (100) members of the community to
136136 41 hear, see, and participate in the public forum in real time; and
137137 42 (2) the public to hear, see, and participate in the public forum
138138 2023 IN 1271—LS 7317/DI 104 4
139139 1 in real time.
140140 2 (f) At least forty-five (45) days before the public forum held
141141 3 under subsection (b), the nonprofit hospital shall provide the state
142142 4 department with:
143143 5 (1) the printed notice described in subsection (c)(1); and
144144 6 (2) a copy of the documents specified in subsection (b)(4).
145145 7 The state department shall post the information concerning the
146146 8 public forum on the state department's website not later than
147147 9 thirty (30) days before the scheduled public forum. The nonprofit
148148 10 hospital shall provide the state department with any changes made
149149 11 concerning the public forum or the documentation and the state
150150 12 department shall update the state department's website with the
151151 13 changes.
152152 14 (g) Not later than thirty (30) days after a public forum is held,
153153 15 the nonprofit hospital shall do the following:
154154 16 (1) Post:
155155 17 (A) a link to an unedited recording of the public forum;
156156 18 and
157157 19 (B) all presentation materials;
158158 20 on the hospital's website
159159 21 (2) Provide the state department with:
160160 22 (A) the link described in subdivision (1)(A); and
161161 23 (B) all of the presentation materials;
162162 24 for posting on the state department's website.
163163 25 The state department shall post the link to the unedited recording
164164 26 of the public forum and all of the presentation materials on the
165165 27 state department's website for at least seven (7) years.
166166 28 (h) The state department may assess a civil penalty for violation
167167 29 of this section.
168168 30 SECTION 2. IC 27-2-26-2, AS ADDED BY P.L.151-2021,
169169 31 SECTION 15, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
170170 32 UPON PASSAGE]: Sec. 2. (a) Before December 31 November 15 of
171171 33 each year, a health carrier shall hold a public forum in which the health
172172 34 carrier shall:
173173 35 (1) obtain feedback from the community about the health carrier's
174174 36 performance in the previous year; and
175175 37 (2) discuss the premiums (as defined in IC 27-1-2-3(w)) charged
176176 38 by the health carrier; and
177177 39 (3) discuss, at the corporate level and at the Indiana market
178178 40 level, financial information concerning the health carrier,
179179 41 including the financial documents specified in section 3(a)(2)
180180 42 of this chapter.
181181 2023 IN 1271—LS 7317/DI 104 5
182182 1 (b) The public forum required under subsection (a) may be held
183183 2 under this section either all or in part, must be accessible through an
184184 3 interactive real time audio and video meeting that is accessible to the
185185 4 community through the Internet. The technology must allow:
186186 5 (1) at least one hundred (100) members of the community to
187187 6 hear, see, and participate in the public forum in real time; and
188188 7 (2) the public to hear, see, and participate in the public forum
189189 8 in real time.
190190 9 (c) At the public forum held under this section, a health carrier
191191 10 must do the following:
192192 11 (1) Allow participants to do the following:
193193 12 (A) Ask questions.
194194 13 (B) Provide feedback during the public forum.
195195 14 (C) Record and share a recording of the public forum.
196196 15 (2) Announce the names of the corporate and local board
197197 16 members, and introduce any of the board members who are
198198 17 present at the public forum.
199199 18 (3) Provide feedback concerning the participants' comments
200200 19 during the public forum.
201201 20 A health carrier may allow, but may not require, members of the
202202 21 community to submit questions and feedback in advance of the
203203 22 public forum. A health carrier may not require an individual to
204204 23 register or otherwise disclose the individual's name to attend the
205205 24 public forum.
206206 25 SECTION 3. IC 27-2-26-3, AS ADDED BY P.L.151-2021,
207207 26 SECTION 15, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
208208 27 UPON PASSAGE]: Sec. 3. (a) At least fourteen (14) forty-five (45)
209209 28 days before the public forum required by this chapter is held, the health
210210 29 carrier shall post on the home page of the health carrier's Internet web
211211 30 site website the following:
212212 31 (1) A printed notice that:
213213 32 (A) is designed, lettered, and featured on the Internet web site
214214 33 website in a manner that is conspicuous to and readable by
215215 34 any individual with normal vision who visits the Internet web
216216 35 site; website;
217217 36 (B) states the date, time, and location of the public forum; and
218218 37 (C) provides:
219219 38 (i) instructions that describe how members of the
220220 39 community and the public can attend and participate in
221221 40 the public forum through real time audio and video
222222 41 technology through the Internet; and
223223 42 (ii) a link to the real time audio and video technology
224224 2023 IN 1271—LS 7317/DI 104 6
225225 1 that will be used for the public forum; and
226226 2 (C) (D) states that the purpose of the public forum is to
227227 3 provide members of the community with an opportunity to:
228228 4 (i) comment on the health carrier's performance in the
229229 5 previous year; and
230230 6 (ii) discuss the premiums (as defined in IC 27-1-2-3(w))
231231 7 charged by the health carrier.
232232 8 (2) The following information concerning the subjects to be
233233 9 presented and discussed at the public forum:
234234 10 (A) The health carrier's Indiana based profits, if the health
235235 11 carrier is publicly traded.
236236 12 (B) The premiums (as defined in IC 27-1-2-3(w)) charged by
237237 13 the health carrier.
238238 14 (C) The health carrier's strategy to lower health care costs.
239239 15 (D) Any increase in the health carrier's premiums, on average
240240 16 statewide, that occurred in the previous year for each health
241241 17 carrier.
242242 18 (E) Annual audited financial reports, if required under
243243 19 IC 27-1-3.5-6 and if the health carrier is publicly traded.
244244 20 (F) The following financial statements for the preceding
245245 21 three (3) calendar years, using generally accepted
246246 22 accounting principles, at the corporate level and at the
247247 23 Indiana market level:
248248 24 (i) Income statements.
249249 25 (ii) Balance sheets.
250250 26 (iii) Cash flow statements.
251251 27 (b) At least forty-five (45) days before the public forum, the
252252 28 health carrier shall provide the department with information
253253 29 described in subsection (a)(1) and (a)(2)(F). The department shall
254254 30 post the information submitted to the department's website
255255 31 concerning the public forum not later than thirty (30) days before
256256 32 the scheduled public forum. The health carrier shall provide the
257257 33 department with any changes made concerning the public forum
258258 34 or the documents and the department shall update the
259259 35 department's website with the changes.
260260 36 (c) Not later than thirty (30) days after a public forum is held,
261261 37 the health carrier shall do the following:
262262 38 (1) Post:
263263 39 (A) a link to an unedited recording of the public forum;
264264 40 and
265265 41 (B) all:
266266 42 (i) presentation materials; and
267267 2023 IN 1271—LS 7317/DI 104 7
268268 1 (ii) financial documents described in subsection (a)(2)
269269 2 and section 2 of this chapter;
270270 3 on the health carrier's website.
271271 4 (2) Provide the department with:
272272 5 (A) the link described in subdivision (1)(A);
273273 6 (B) all presentation materials; and
274274 7 (C) financial statements described in subsection (a)(2)(E)
275275 8 and (a)(2)(F);
276276 9 for posting on the department's website.
277277 10 The department shall post the link to the unedited recording of the
278278 11 public forum and all presentation materials and financial
279279 12 statements on the department's website for at least seven (7) years.
280280 13 (d) The department may assess a civil penalty for a violation of
281281 14 this section and section 2 of this chapter.
282282 15 SECTION 4. An emergency is declared for this act.
283283 2023 IN 1271—LS 7317/DI 104