Introduced Version
HOUSE BILL No. 1271
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 16-21-9-3.5; IC 27-2-26.
Synopsis: Nonprofit hospital and insurer reporting. Requires a
nonprofit hospital and a health carrier to post and provide certain
information at least 45 days before a public forum. Modifies
requirements concerning the: (1) date on which a public forum must be
held; (2) topics that must be discussed at a public forum; (3)
requirements of a public forum; and (4) use of technology to allow
attendance at a public forum through real time audio and video through
the Internet. Requires the Indiana department of health and the
department of insurance to post specified information concerning
public forums on the agency website.
Effective: Upon passage.
Schaibley, Harris
January 11, 2023, read first time and referred to Committee on Public Health.
2023 IN 1271—LS 7317/DI 104 Introduced
First Regular Session of the 123rd General Assembly (2023)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type. Also, the
word NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
between statutes enacted by the 2022 Regular Session of the General Assembly.
HOUSE BILL No. 1271
A BILL FOR AN ACT to amend the Indiana Code concerning
health.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 16-21-9-3.5, AS AMENDED BY P.L.199-2021,
2 SECTION 8, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 UPON PASSAGE]: Sec. 3.5. (a) This section does not apply to the
4 following:
5 (1) A nonprofit critical access hospital that is not:
6 (A) part of a hospital system; or
7 (B) an affiliate of a hospital or hospital system.
8 (2) A hospital that is established and operated under IC 16-22 or
9 IC 16-23.
10 (b) Before December 31 November 15 of each year, a nonprofit
11 hospital shall hold a public forum within fifteen (15) miles of the
12 nonprofit hospital, in which the nonprofit hospital, including the
13 nonprofit hospital's board of directors, shall:
14 (1) obtain feedback from the community about the nonprofit
15 hospital's performance in the previous year;
16 (2) discuss the pricing of inpatient and outpatient health
17 services provided at:
2023 IN 1271—LS 7317/DI 104 2
1 (A) the nonprofit hospital; and
2 (B) affiliates of the nonprofit hospital;
3 (3) discuss the contributions made by the nonprofit hospital to the
4 community, including uncompensated care, charitable
5 contributions, and any other charitable assistance programs; and
6 (4) discuss, at the hospital system level and at the individual
7 hospital level by hospital federal Centers for Medicare and
8 Medicaid certification number, the following financial
9 statements for the preceding three (3) years, using generally
10 accepted accounting principles:
11 (A) Income statements.
12 (B) Balance sheets.
13 (C) Cash flow statements.
14 (c) At least fourteen (14) forty-five (45) days before the forum held
15 under subsection (b), the nonprofit hospital shall post on the home
16 page of the nonprofit hospital's Internet web site website the following:
17 (1) A printed notice that:
18 (A) is designed, lettered, and featured on the Internet web site
19 website so as to be conspicuous to and readable by any
20 individual with normal vision who visits the Internet web site;
21 website;
22 (B) states the date, time, and location of the public forum to be
23 held under subsection (b); and
24 (C) provides:
25 (i) instructions that describe how members of the
26 community and the public can attend and participate in
27 the public forum through real time audio and video
28 technology through the Internet; and
29 (ii) a link to the real time audio and video technology
30 that will be used for the public forum; and
31 (C) (D) states that the purpose of the public forum is to
32 provide members of the community with an opportunity to:
33 (i) comment on the nonprofit hospital's performance in the
previous year;34
35 (ii) discuss the pricing of inpatient and outpatient health
36 services provided at the nonprofit hospital and affiliates of
37 the nonprofit hospital; and
38 (iii) discuss the contributions made by the hospital to the
39 community, including uncompensated care, charitable
contributions, and any other charitable assistance programs.40
41 (2) The following information relating to the subjects to be
42 presented and discussed at the public forum held under
2023 IN 1271—LS 7317/DI 104 3
1 subsection (b):
2 (A) The nonprofit hospital's Indiana specific:
3 (i) income statement;
4 (ii) balance sheet; and
5 (iii) cash flow statement;
6 as set forth in subsection (b)(4) for the previous three (3)
7 calendar year years and that is prepared according to
8 generally accepted accounting principles.
9 (B) Information concerning:
10 (i) the nonprofit hospital's pricing of health services in
11 comparison to the amounts of reimbursement for the health
12 services under the Medicare program;
13 (ii) the rationale for any pricing of health services by the
14 nonprofit hospital that is higher than the corresponding
15 reimbursement for the health services under the Medicare
16 program; and
17 (iii) any increase in the nonprofit hospital's pricing of health
18 services that occurred in the previous year.
19 (d) At the public forum held under this section, a nonprofit
20 hospital must do the following:
21 (1) Allow participants to do the following during the public
22 forum:
23 (A) Ask questions.
24 (B) Provide feedback.
25 (C) Record and share recordings of the public forum.
26 (2) Announce the names of the corporate and local board
27 members, and introduce any of the board members who are
28 present at the public forum.
29 (3) Provide feedback concerning the participants' comments
30 during the public forum.
31 A nonprofit hospital may allow, but may not require, members of
32 the community to submit questions and feedback in advance of the
33 public forum. A nonprofit hospital may not require an individual
34 to register or otherwise disclose the individual's name to attend the
35 public forum.
36 (d) (e) The public forum requirement held under this section may
37 be held, either all or in part, must be accessible through an interactive
38 real time audio and video meeting that is accessible to the community
39 technology through the Internet. The technology must allow:
40 (1) at least one hundred (100) members of the community to
41 hear, see, and participate in the public forum in real time; and
42 (2) the public to hear, see, and participate in the public forum
2023 IN 1271—LS 7317/DI 104 4
1 in real time.
2 (f) At least forty-five (45) days before the public forum held
3 under subsection (b), the nonprofit hospital shall provide the state
4 department with:
5 (1) the printed notice described in subsection (c)(1); and
6 (2) a copy of the documents specified in subsection (b)(4).
7 The state department shall post the information concerning the
8 public forum on the state department's website not later than
9 thirty (30) days before the scheduled public forum. The nonprofit
10 hospital shall provide the state department with any changes made
11 concerning the public forum or the documentation and the state
12 department shall update the state department's website with the
13 changes.
14 (g) Not later than thirty (30) days after a public forum is held,
15 the nonprofit hospital shall do the following:
16 (1) Post:
17 (A) a link to an unedited recording of the public forum;
18 and
19 (B) all presentation materials;
20 on the hospital's website
21 (2) Provide the state department with:
22 (A) the link described in subdivision (1)(A); and
23 (B) all of the presentation materials;
24 for posting on the state department's website.
25 The state department shall post the link to the unedited recording
26 of the public forum and all of the presentation materials on the
27 state department's website for at least seven (7) years.
28 (h) The state department may assess a civil penalty for violation
29 of this section.
30 SECTION 2. IC 27-2-26-2, AS ADDED BY P.L.151-2021,
31 SECTION 15, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
32 UPON PASSAGE]: Sec. 2. (a) Before December 31 November 15 of
33 each year, a health carrier shall hold a public forum in which the health
34 carrier shall:
35 (1) obtain feedback from the community about the health carrier's
36 performance in the previous year; and
37 (2) discuss the premiums (as defined in IC 27-1-2-3(w)) charged
38 by the health carrier; and
39 (3) discuss, at the corporate level and at the Indiana market
40 level, financial information concerning the health carrier,
41 including the financial documents specified in section 3(a)(2)
42 of this chapter.
2023 IN 1271—LS 7317/DI 104 5
1 (b) The public forum required under subsection (a) may be held
2 under this section either all or in part, must be accessible through an
3 interactive real time audio and video meeting that is accessible to the
4 community through the Internet. The technology must allow:
5 (1) at least one hundred (100) members of the community to
6 hear, see, and participate in the public forum in real time; and
7 (2) the public to hear, see, and participate in the public forum
8 in real time.
9 (c) At the public forum held under this section, a health carrier
10 must do the following:
11 (1) Allow participants to do the following:
12 (A) Ask questions.
13 (B) Provide feedback during the public forum.
14 (C) Record and share a recording of the public forum.
15 (2) Announce the names of the corporate and local board
16 members, and introduce any of the board members who are
17 present at the public forum.
18 (3) Provide feedback concerning the participants' comments
19 during the public forum.
20 A health carrier may allow, but may not require, members of the
21 community to submit questions and feedback in advance of the
22 public forum. A health carrier may not require an individual to
23 register or otherwise disclose the individual's name to attend the
24 public forum.
25 SECTION 3. IC 27-2-26-3, AS ADDED BY P.L.151-2021,
26 SECTION 15, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
27 UPON PASSAGE]: Sec. 3. (a) At least fourteen (14) forty-five (45)
28 days before the public forum required by this chapter is held, the health
29 carrier shall post on the home page of the health carrier's Internet web
30 site website the following:
31 (1) A printed notice that:
32 (A) is designed, lettered, and featured on the Internet web site
33 website in a manner that is conspicuous to and readable by
34 any individual with normal vision who visits the Internet web
35 site; website;
36 (B) states the date, time, and location of the public forum; and
37 (C) provides:
38 (i) instructions that describe how members of the
39 community and the public can attend and participate in
40 the public forum through real time audio and video
41 technology through the Internet; and
42 (ii) a link to the real time audio and video technology
2023 IN 1271—LS 7317/DI 104 6
1 that will be used for the public forum; and
2 (C) (D) states that the purpose of the public forum is to
3 provide members of the community with an opportunity to:
4 (i) comment on the health carrier's performance in the
5 previous year; and
6 (ii) discuss the premiums (as defined in IC 27-1-2-3(w))
7 charged by the health carrier.
8 (2) The following information concerning the subjects to be
9 presented and discussed at the public forum:
10 (A) The health carrier's Indiana based profits, if the health
11 carrier is publicly traded.
12 (B) The premiums (as defined in IC 27-1-2-3(w)) charged by
13 the health carrier.
14 (C) The health carrier's strategy to lower health care costs.
15 (D) Any increase in the health carrier's premiums, on average
16 statewide, that occurred in the previous year for each health
17 carrier.
18 (E) Annual audited financial reports, if required under
19 IC 27-1-3.5-6 and if the health carrier is publicly traded.
20 (F) The following financial statements for the preceding
21 three (3) calendar years, using generally accepted
22 accounting principles, at the corporate level and at the
23 Indiana market level:
24 (i) Income statements.
25 (ii) Balance sheets.
26 (iii) Cash flow statements.
27 (b) At least forty-five (45) days before the public forum, the
28 health carrier shall provide the department with information
29 described in subsection (a)(1) and (a)(2)(F). The department shall
30 post the information submitted to the department's website
31 concerning the public forum not later than thirty (30) days before
32 the scheduled public forum. The health carrier shall provide the
33 department with any changes made concerning the public forum
34 or the documents and the department shall update the
35 department's website with the changes.
36 (c) Not later than thirty (30) days after a public forum is held,
37 the health carrier shall do the following:
38 (1) Post:
39 (A) a link to an unedited recording of the public forum;
40 and
41 (B) all:
42 (i) presentation materials; and
2023 IN 1271—LS 7317/DI 104 7
1 (ii) financial documents described in subsection (a)(2)
2 and section 2 of this chapter;
3 on the health carrier's website.
4 (2) Provide the department with:
5 (A) the link described in subdivision (1)(A);
6 (B) all presentation materials; and
7 (C) financial statements described in subsection (a)(2)(E)
8 and (a)(2)(F);
9 for posting on the department's website.
10 The department shall post the link to the unedited recording of the
11 public forum and all presentation materials and financial
12 statements on the department's website for at least seven (7) years.
13 (d) The department may assess a civil penalty for a violation of
14 this section and section 2 of this chapter.
15 SECTION 4. An emergency is declared for this act.
2023 IN 1271—LS 7317/DI 104