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 7005 NOTE PREPARED: Jan 7, 2024
BILL NUMBER: HB 1374 BILL AMENDED:
SUBJECT: Medicaid Claim Payments for Nursing Facilities.
FIRST AUTHOR: Rep. Karickhoff BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
DEDICATED
XFEDERAL
Summary of Legislation: Beginning July 1, 2024, and ending December 31, 2024, the bill requires the
Office of the Secretary of Family and Social Services (FSSA) and a managed care organization to pay 87.5%
of a claim to a nursing facility if the claim is not paid within a specified time. It also requires the FSSA to
assess a managed care organization a fine of $4,800 per claim for failure to pay a nursing facility claim
within the required time.
The bill also repeals a provision concerning reporting that has expired.
Effective Date: July 1, 2024.
Explanation of State Expenditures: The FSSA may have additional workload to reconcile claims after
December 31, 2024, as all claims during the effective period are considered clean claims. 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.
Explanation of State Revenues: If a managed care organization does not pay a claim within 21 days of
receiving the claim, the FSSA may impose a fine of $4,800 per claim. Penalty revenue to the state General
Fund could increase by an indeterminate amount between July 1, 2024, and December 31, 2024.
Explanation of Local Expenditures:
Explanation of Local Revenues: Most nursing facilities in the state are owned by county hospitals directly
or through long term lease arrangements. The FSSA or a managed care organization must pay at least 87.5%
HB 1374 1 of a claim 22 days after the claim is filed during the specified period of the bill.
State Agencies Affected: Office of the Secretary of Family and Social Services.
Local Agencies Affected: Nursing facilities owned by county hospitals.
Information Sources:
Fiscal Analyst: Karen Rossen, 317-234-2106.
HB 1374 2