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 6295 NOTE PREPARED: Dec 5, 2023
BILL NUMBER: HB 1028 BILL AMENDED:
SUBJECT: Medicaid Coverage for Pregnancy Services.
FIRST AUTHOR: Rep. Bauer M BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State
DEDICATED
XFEDERAL
Summary of Legislation: The bill requires Medicaid pregnancy services to include reimbursement for: (1)
delivery services provided in a birthing center; and (2) a home birth performed by a physician or certified
nurse midwife.
Effective Date: July 1, 2024.
Explanation of State Expenditures: Generally, the number of births paid by Medicaid would not change
as a result of an additional location (home) for these services. The overall cost of delivery may be impacted.
The bill will increase the workload for the Family and Social Services Administration (FSSA) to prepare and
submit a state plan amendment or waiver to cover these services. The bill’s requirements are within the
agency’s routine administrative functions and should be able to be implemented with no additional
appropriations, assuming near customary agency staffing and resource levels. Medicaid is a shared state and
federal program and state administrative costs are reimbursed 50% by the federal government.
Additional Information - In CY 2021, there were 79,946 births in Indiana in 2021, and Medicaid paid for
40,413 (51%). Medicaid programs in 25 states covered home births according to a 2021 survey.
There are seven birthing centers licensed in Indiana and Medicaid pays for births at these facilities under
current policy. Birthing centers are paid at an all-inclusive rate and the physician or certified nurse midwife
are paid for their services separately.
Explanation of State Revenues:
HB 1028 1 Explanation of Local Expenditures:
Explanation of Local Revenues:
State Agencies Affected:
Local Agencies Affected:
Information Sources: https://www.cdc.gov/nchs//data/nvsr/nvsr72/nvsr72-01.pdf, FSSA Data Center,
Birth Count by Medicaid Program, Ranji, Usha et al, Medicaid Coverage of Pregnancy-Related Services:
Findings from a 2021 State Survey, KFF and Health Management Associates, May 2022, Indiana Health
Coverage Programs, Provider Manual, Obstetrical and Gynecological Services, published April 27, 2023.
Fiscal Analyst: Karen Rossen, 317-234-2106.
HB 1028 2