Indiana 2024 Regular Session

Indiana House Bill HB1266 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2	Introduced Version
3	3	HOUSE BILL No. 1266
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 16-18; IC 27-2-30; IC 34-30-2.1.
7	7	Synopsis: Freedom of conscience in health care. Provides that a health
8	8	care provider, health care entity, and a health carrier may not be
9	9	required to provide or refer an individual for a health care service that
10	10	violates the conscience of the health care provider, health care entity,
11	11	or health carrier. Establishes an exception for a health carrier. Specifies
12	12	that a health care provider, health care entity, or a health carrier may
13	13	not be subject to discrimination and certain other acts and liability for
14	14	declining to provide the health care service. Establishes a civil action
15	15	for a violation of these provisions. Provides that a person who prevails
16	16	in a civil action is entitled to certain relief.
17	17	Effective: July 1, 2024.
18	18	Miller D
19	19	January 9, 2024, read first time and referred to Committee on Public Health.
20	20	2024 IN 1266—LS 6312/DI 147 Introduced
21	21	Second Regular Session of the 123rd General Assembly (2024)
22	22	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
23	23	Constitution) is being amended, the text of the existing provision will appear in this style type,
24	24	additions will appear in this style type, and deletions will appear in this style type.
25	25	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
26	26	provision adopted), the text of the new provision will appear in this style type. Also, the
27	27	word NEW will appear in that style type in the introductory clause of each SECTION that adds
28	28	a new provision to the Indiana Code or the Indiana Constitution.
29	29	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
30	30	between statutes enacted by the 2023 Regular Session of the General Assembly.
31	31	HOUSE BILL No. 1266
32	32	A BILL FOR AN ACT to amend the Indiana Code concerning
33	33	health.
34	34	Be it enacted by the General Assembly of the State of Indiana:
35	35	1 SECTION 1. IC 16-18-2-68.8 IS ADDED TO THE INDIANA
36	36	2 CODE AS A NEW SECTION TO READ AS FOLLOWS
37	37	3 [EFFECTIVE JULY 1, 2024]: Sec. 68.8. "Conscience", for purposes
38	38	4 of IC 16-18-5, has the meaning set forth in IC 16-18-5-1.
39	39	5 SECTION 2. IC 16-18-2-160.5, AS AMENDED BY P.L.3-2008,
40	40	6 SECTION 107, IS AMENDED TO READ AS FOLLOWS
41	41	7 [EFFECTIVE JULY 1, 2024]: Sec. 160.5. (a) "Health care entity",
42	42	8 for purposes of IC 16-18-5, has the meaning set forth in
43	43	9 IC 16-18-5-2.
44	44	10 (b) "Health care entity", for purposes of IC 16-41-42.1, has the
45	45	11 meaning set forth in IC 16-41-42.1-1.
46	46	12 SECTION 3. IC 16-18-2-163, AS AMENDED BY
47	47	13 P.L.179-2022(ss), SECTION 4, IS AMENDED TO READ AS
48	48	14 FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 163. (a) Except as
49	49	15 provided in subsection (c), "health care provider", for purposes of
50	50	16 IC 16-21 and IC 16-41, means any of the following:
51	51	17 (1) An individual, a partnership, a corporation, a professional
52	52	2024 IN 1266—LS 6312/DI 147 2
53	53	1 corporation, a facility, or an institution licensed or legally
54	54	2 authorized by this state to provide health care or professional
55	55	3 services as a licensed physician, a psychiatric hospital, a hospital,
56	56	4 a health facility, an emergency ambulance service (IC 16-31-3),
57	57	5 a dentist, a registered or licensed practical nurse, a midwife, an
58	58	6 optometrist, a pharmacist, a podiatrist, a chiropractor, a physical
59	59	7 therapist, a respiratory care practitioner, an occupational therapist,
60	60	8 a psychologist, a paramedic, an emergency medical technician, an
61	61	9 advanced emergency medical technician, an athletic trainer, or a
62	62	10 person who is an officer, employee, or agent of the individual,
63	63	11 partnership, corporation, professional corporation, facility, or
64	64	12 institution acting in the course and scope of the person's
65	65	13 employment.
66	66	14 (2) A college, university, or junior college that provides health
67	67	15 care to a student, a faculty member, or an employee, and the
68	68	16 governing board or a person who is an officer, employee, or agent
69	69	17 of the college, university, or junior college acting in the course
70	70	18 and scope of the person's employment.
71	71	19 (3) A blood bank, community mental health center, community
72	72	20 intellectual disability center, community health center, or migrant
73	73	21 health center.
74	74	22 (4) A home health agency (as defined in IC 16-27-1-2).
75	75	23 (5) A health maintenance organization (as defined in
76	76	24 IC 27-13-1-19).
77	77	25 (6) A health care organization whose members, shareholders, or
78	78	26 partners are health care providers under subdivision (1).
79	79	27 (7) A corporation, partnership, or professional corporation not
80	80	28 otherwise qualified under this subsection that:
81	81	29 (A) provides health care as one (1) of the corporation's,
82	82	30 partnership's, or professional corporation's functions;
83	83	31 (B) is organized or registered under state law; and
84	84	32 (C) is determined to be eligible for coverage as a health care
85	85	33 provider under IC 34-18 for the corporation's, partnership's, or
86	86	34 professional corporation's health care function.
87	87	35 Coverage for a health care provider qualified under this subdivision is
88	88	36 limited to the health care provider's health care functions and does not
89	89	37 extend to other causes of action.
90	90	38 (b) "Health care provider", for purposes of IC 16-35, has the
91	91	39 meaning set forth in subsection (a). However, for purposes of IC 16-35,
92	92	40 the term also includes a health facility (as defined in section 167 of this
93	93	41 chapter).
94	94	42 (c) "Health care provider", for purposes of IC 16-32-5, IC 16-36-5,
95	95	2024 IN 1266—LS 6312/DI 147 3
96	96	1 IC 16-36-6, and IC 16-41-10 means an individual licensed or
97	97	2 authorized by this state to provide health care or professional services
98	98	3 as:
99	99	4 (1) a licensed physician;
100	100	5 (2) a registered nurse;
101	101	6 (3) a licensed practical nurse;
102	102	7 (4) an advanced practice registered nurse;
103	103	8 (5) a certified nurse midwife;
104	104	9 (6) a paramedic;
105	105	10 (7) an emergency medical technician;
106	106	11 (8) an advanced emergency medical technician;
107	107	12 (9) an emergency medical responder, as defined by section 109.8
108	108	13 of this chapter;
109	109	14 (10) a licensed dentist;
110	110	15 (11) a home health aide, as defined by section 174 of this chapter;
111	111	16 or
112	112	17 (12) a licensed physician assistant.
113	113	18 The term includes an individual who is an employee or agent of a
114	114	19 health care provider acting in the course and scope of the individual's
115	115	20 employment.
116	116	21 (d) "Health care provider", for purposes of IC 16-36-7, has the
117	117	22 meaning set forth in IC 16-36-7-12.
118	118	23 (e) "Health care provider", for purposes of IC 16-40-4, means any
119	119	24 of the following:
120	120	25 (1) An individual, a partnership, a corporation, a professional
121	121	26 corporation, a facility, or an institution licensed or authorized by
122	122	27 the state to provide health care or professional services as a
123	123	28 licensed physician, a psychiatric hospital, a hospital, a health
124	124	29 facility, an emergency ambulance service (IC 16-31-3), an
125	125	30 ambulatory outpatient surgical center, a dentist, an optometrist, a
126	126	31 pharmacist, a podiatrist, a chiropractor, a psychologist, or a
127	127	32 person who is an officer, employee, or agent of the individual,
128	128	33 partnership, corporation, professional corporation, facility, or
129	129	34 institution acting in the course and scope of the person's
130	130	35 employment.
131	131	36 (2) A blood bank, laboratory, community mental health center,
132	132	37 community intellectual disability center, community health
133	133	38 center, or migrant health center.
134	134	39 (3) A home health agency (as defined in IC 16-27-1-2).
135	135	40 (4) A health maintenance organization (as defined in
136	136	41 IC 27-13-1-19).
137	137	42 (5) A health care organization whose members, shareholders, or
138	138	2024 IN 1266—LS 6312/DI 147 4
139	139	1 partners are health care providers under subdivision (1).
140	140	2 (6) A corporation, partnership, or professional corporation not
141	141	3 otherwise specified in this subsection that:
142	142	4 (A) provides health care as one (1) of the corporation's,
143	143	5 partnership's, or professional corporation's functions;
144	144	6 (B) is organized or registered under state law; and
145	145	7 (C) is determined to be eligible for coverage as a health care
146	146	8 provider under IC 34-18 for the corporation's, partnership's, or
147	147	9 professional corporation's health care function.
148	148	10 (7) A person that is designated to maintain the records of a person
149	149	11 described in subdivisions (1) through (6).
150	150	12 (f) "Health care provider", for purposes of IC 16-45-4, has the
151	151	13 meaning set forth in 47 CFR 54.601(a).
152	152	14 (g) "Health care provider", for purposes of IC 16-18-5, has the
153	153	15 meaning set forth in IC 16-18-5-3.
154	154	16 SECTION 4. IC 16-18-2-163.7 IS ADDED TO THE INDIANA
155	155	17 CODE AS A NEW SECTION TO READ AS FOLLOWS
156	156	18 [EFFECTIVE JULY 1, 2024]: Sec. 163.7. "Health care service", for
157	157	19 purposes of IC 16-18-5, has the meaning set forth in IC 16-18-5-4.
158	158	20 SECTION 5. IC 16-18-5 IS ADDED TO THE INDIANA CODE AS
159	159	21 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
160	160	22 1, 2024]:
161	161	23 Chapter 5. Health Care Freedom of Conscience
162	162	24 Sec. 1. As used in this chapter, "conscience" means religious,
163	163	25 moral, or ethical beliefs or principles.
164	164	26 Sec. 2. As used in this chapter, "health care entity" means an
165	165	27 entity, a partnership, a corporation, a professional corporation, a
166	166	28 facility, or an institution licensed or legally authorized by this state
167	167	29 to provide a health care service.
168	168	30 Sec. 3. (a) As used in this chapter, "health care provider" means
169	169	31 an individual licensed or authorized by this state to provide health
170	170	32 care services.
171	171	33 (b) The term includes an individual who is an employee or agent
172	172	34 of a health care provider acting in the course and scope of the
173	173	35 individual's employment.
174	174	36 Sec. 4. As used in this chapter, "health care service" means any
175	175	37 health care related service, treatment, or procedure to maintain,
176	176	38 diagnose, or treat an individual's physical or mental condition.
177	177	39 Sec. 5. (a) A health care provider may not be required to:
178	178	40 (1) perform;
179	179	41 (2) provide;
180	180	42 (3) participate in; or
181	181	2024 IN 1266—LS 6312/DI 147 5
182	182	1 (4) refer an individual for;
183	183	2 a health care service that violates the health care provider's
184	184	3 conscience.
185	185	4 (b) A health care provider may not be subject to any of the
186	186	5 following for declining to perform, provide, participate in, or refer
187	187	6 an individual for a health care service described in subsection (a):
188	188	7 (1) Discrimination, including denial of, revocation of, or
189	189	8 disqualification for:
190	190	9 (A) licensure, staff privileges, board certification, or career
191	191	10 specialty;
192	192	11 (B) a grant, contract, or other program; or
193	193	12 (C) a residency or other training opportunity.
194	194	13 (2) Adverse employment action, including termination of
195	195	14 employment, transfer, demotion, reassignment to a different
196	196	15 shift, or loss or reduction of wages or benefits.
197	197	16 (3) Adverse administrative action.
198	198	17 (4) Disciplinary or retaliatory action.
199	199	18 (5) Criminal, administrative, or civil liability.
200	200	19 Sec. 6. (a) A health care entity may not be required to perform,
201	201	20 provide, participate in, or refer an individual for a health care
202	202	21 service that violates the health care entity's conscience, as
203	203	22 determined by the entity's existing or proposed:
204	204	23 (1) guidelines;
205	205	24 (2) mission statement;
206	206	25 (3) constitution;
207	207	26 (4) bylaws;
208	208	27 (5) articles of incorporation;
209	209	28 (6) regulations; or
210	210	29 (7) other documents.
211	211	30 (b) A health care entity that:
212	212	31 (1) declines to perform, provide, or participate in a health
213	213	32 care service described in subsection (a);
214	214	33 (2) discloses to the patient, in writing, that the health care
215	215	34 entity reserves the right to decline to perform, provide, or
216	216	35 participate in a health care service that violates the health
217	217	36 care entity's conscience; and
218	218	37 (3) obtains written consent from the patient before the patient
219	219	38 is admitted to the health care entity's facility;
220	220	39 may not be criminally prosecuted or held administratively or
221	221	40 civilly liable for refusing to perform, provide, participate in, or
222	222	41 refer the patient for the health care service.
223	223	42 (c) A health care entity or a prospective health care entity may
224	224	2024 IN 1266—LS 6312/DI 147 6
225	225	1 not be subject to any of the following for declining to perform,
226	226	2 provide, participate in, or refer an individual for a health care
227	227	3 service described in subsection (a):
228	228	4 (1) Discrimination.
229	229	5 (2) Denial of, revocation of, or disqualification for:
230	230	6 (A) licensure;
231	231	7 (B) staff privileges;
232	232	8 (C) a grant; or
233	233	9 (D) any form of aid, assistance, benefit, or privilege.
234	234	10 (3) Denial of authorization to establish, expand, improve,
235	235	11 acquire, affiliate, or merge with the health care entity.
236	236	12 Sec. 7. (a) A person injured by a violation of this chapter may
237	237	13 bring an action against the person who violated this chapter.
238	238	14 (b) It is not a defense in an action under this chapter that a
239	239	15 violation was necessary to prevent additional burden or expense on
240	240	16 a health care provider, a health care entity, an individual, or a
241	241	17 patient.
242	242	18 (c) A person whose rights have been violated by a violation of
243	243	19 this chapter may assert the violation or impending violation as a
244	244	20 claim or defense in a judicial, administrative, or other proceeding.
245	245	21 Sec. 8. A prevailing plaintiff in an action brought under section
246	246	22 7 of this chapter is entitled to the following:
247	247	23 (1) Injunctive relief.
248	248	24 (2) The greater of:
249	249	25 (A) an amount not to exceed three (3) times the actual
250	250	26 damages sustained; or
251	251	27 (B) liquidated damages of five thousand dollars ($5,000).
252	252	28 (3) Court costs and reasonable attorney's fees.
253	253	29 (4) Any other appropriate relief determined by the court.
254	254	30 SECTION 6. IC 27-2-30 IS ADDED TO THE INDIANA CODE AS
255	255	31 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
256	256	32 1, 2024]:
257	257	33 Chapter 30. Health Care Freedom of Conscience
258	258	34 Sec. 1. This chapter applies to a policy or a contract issued,
259	259	35 entered into, delivered, amended, or renewed by a health carrier
260	260	36 after June 30, 2024.
261	261	37 Sec. 2. As used in this chapter, "conscience" means religious,
262	262	38 moral, or ethical beliefs or principles.
263	263	39 Sec. 3. As used in this chapter, "health care service" means any
264	264	40 health care related service, treatment, or procedure to maintain,
265	265	41 diagnose, or treat an individual's physical or mental condition. The
266	266	42 term includes a patient referral for a health care service.
267	267	2024 IN 1266—LS 6312/DI 147 7
268	268	1 Sec. 4. (a) As used in this chapter, "health carrier" means an
269	269	2 entity:
270	270	3 (1) that is subject to IC 27 and the administrative rules
271	271	4 adopted under IC 27; and
272	272	5 (2) that enters into a contract to:
273	273	6 (A) provide health care services;
274	274	7 (B) deliver health care services;
275	275	8 (C) arrange for health care services; or
276	276	9 (D) pay for or reimburse any of the costs of health care
277	277	10 services.
278	278	11 (b) The term includes the following:
279	279	12 (1) An insurer, as defined in IC 27-1-2-3(x), that issues a
280	280	13 policy of accident and sickness insurance, as defined in
281	281	14 IC 27-8-5-1(a).
282	282	15 (2) A health maintenance organization, as defined in
283	283	16 IC 27-13-1-19.
284	284	17 (3) An administrator (as defined in IC 27-1-25-1(a)) that is
285	285	18 licensed under IC 27-1-25.
286	286	19 (4) A state employee health plan offered under IC 5-10-8.
287	287	20 (5) A short term insurance plan (as defined by IC 27-8-5.9-3).
288	288	21 (6) Any other entity that provides a plan of health insurance,
289	289	22 health benefits, or health care services.
290	290	23 (c) The term does not include:
291	291	24 (1) an insurer that issues a policy of accident and sickness
292	292	25 insurance;
293	293	26 (2) a limited service health maintenance organization (as
294	294	27 defined in IC 27-13-34-4); or
295	295	28 (3) an administrator;
296	296	29 that only provides coverage for, or processes claims for, dental or
297	297	30 vision care services.
298	298	31 Sec. 5. (a) Except as required by federal law, but
299	299	32 notwithstanding any other provision of this title, a health carrier
300	300	33 may not be required to provide, deliver, arrange for, pay for,
301	301	34 reimburse any of the costs of, or refer an individual for a health
302	302	35 care service that violates the health carrier's conscience, as
303	303	36 determined by the health carrier's existing or proposed:
304	304	37 (1) guidelines;
305	305	38 (2) mission statement;
306	306	39 (3) constitution;
307	307	40 (4) bylaws;
308	308	41 (5) articles of incorporation;
309	309	42 (6) regulations; or
310	310	2024 IN 1266—LS 6312/DI 147 8
311	311	1 (7) other documents.
312	312	2 (b) A health carrier that declines to provide, deliver, arrange
313	313	3 for, pay for, reimburse any of the costs of, or refer an individual
314	314	4 for a health care service described in subsection (a) may not be
315	315	5 held civilly or criminally liable for declining to provide, deliver,
316	316	6 arrange for, pay for, or reimburse any of the costs of a health care
317	317	7 service.
318	318	8 Sec. 6. A health carrier or prospective health carrier may not be
319	319	9 subject to any of the following for declining to provide, deliver,
320	320	10 arrange for, pay for, reimburse any of the costs of, or refer an
321	321	11 individual for a health care service that violates the conscience of
322	322	12 the health carrier or prospective health carrier:
323	323	13 (1) Discrimination.
324	324	14 (2) Denial of, revocation of, or disqualification for:
325	325	15 (A) licensure;
326	326	16 (B) a grant; or
327	327	17 (C) any form of aid, assistance, benefit, or privilege.
328	328	18 (3) Denial of authorization to establish, expand, improve,
329	329	19 acquire, affiliate, or merge with the health carrier.
330	330	20 (4) Criminal or civil liability.
331	331	21 Sec. 7. (a) A person injured by a violation of this chapter may
332	332	22 bring an action against the person who violated this chapter.
333	333	23 (b) It is not a defense in an action under this chapter that a
334	334	24 violation was necessary to prevent additional burden or expense on
335	335	25 a health care provider, a health care entity, an individual, or a
336	336	26 patient.
337	337	27 (c) A person whose rights have been violated by a violation of
338	338	28 this chapter may assert the violation or impending violation as a
339	339	29 claim or defense in a judicial, administrative, or other proceeding.
340	340	30 Sec. 8. A prevailing plaintiff in an action brought under section
341	341	31 7 of this chapter is entitled to the following:
342	342	32 (1) Injunctive relief.
343	343	33 (2) The greater of:
344	344	34 (A) an amount not to exceed three (3) times the actual
345	345	35 damages sustained; or
346	346	36 (B) liquidated damages of five thousand dollars ($5,000).
347	347	37 (3) Court costs and reasonable attorney's fees.
348	348	38 (4) Any other appropriate relief determined by the court.
349	349	39 SECTION 7. IC 34-30-2.1-195.5 IS ADDED TO THE INDIANA
350	350	40 CODE AS A NEW SECTION TO READ AS FOLLOWS
351	351	41 [EFFECTIVE JULY 1, 2024]: Sec. 195.5. IC 16-18-5-5 (Concerning
352	352	42 a health care provider or a health care entity that declines to
353	353	2024 IN 1266—LS 6312/DI 147 9
354	354	1 provide a health care service that violates the conscience of the
355	355	2 health care provider or health care entity).
356	356	3 SECTION 8. IC 34-30-2.1-420.5 IS ADDED TO THE INDIANA
357	357	4 CODE AS A NEW SECTION TO READ AS FOLLOWS
358	358	5 [EFFECTIVE JULY 1, 2024]: Sec. 420.5. IC 27-2-30-6 (Concerning
359	359	6 a health carrier that declines to provide a health care service that
360	360	7 violates the conscience of the health carrier or prospective health
361	361	8 carrier).
362	362	2024 IN 1266—LS 6312/DI 147