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 6486 NOTE PREPARED: Jan 25, 2024
BILL NUMBER: SB 142 BILL AMENDED: Jan 25, 2024
SUBJECT: Coverage for Mobile Integrated Healthcare Services.
FIRST AUTHOR: Sen. Buchanan BILL STATUS: CR Adopted - 1
st
House
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State
XDEDICATED
FEDERAL
Summary of Legislation: (Amended) The bill provides that: (1) a state employee health plan (SEHP); (2)
a policy of accident and sickness policy; and (3) an individual or group contract; must provide reimbursement
beginning July 1, 2024, and ending June 30, 2027, for emergency medical services that are performed or
provided in specified counties by a mobile integrated healthcare program.
Effective Date: July 1, 2024.
Explanation of State Expenditures: (Revised) State Employee Health Plan (SEHP): The SEHP will be
required to reimburse for services provided by an emergency medical services provider organization as part
of a mobile integrated healthcare (MIH) program. The bill restricts this program to Delaware, White, and
Montgomery counties and is in effect from July 1, 2024, to June 30, 2027. Any increase or decrease in
expenditures is indeterminate. The difference in overall expenditures to the SEHP will be determined by the
cost of services provided by an emergency medical services provider under a MIH program as compared to
cost of emergency services that would otherwise be provided.
(Revised) State Personnel Department (SPD): The bill requires SPD to prepare and submit a report to the
Legislative Council, no later than July 1, 2026, regarding MIH 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.
(Revised) Department of Insurance (DOI): The bill requires the DOI to prepare and submit a report to the
Legislative Council, no later than July 1, 2026, regarding reimbursement for emergency medical services as
part of a MIH program. The bill’s requirements are within the agency’s routine administrative functions and
SB 142 1 should be able to be implemented with no additional appropriations, assuming near customary agency
staffing and resource levels. [The DOI is funded through a dedicated agency fund.]
Additional Information: MIH is a patient-centered model that focuses on delivering needs-based care and
preventative services in the patient’s home or mobile environment. The main focus of MIH is to better
coordinate care, reduce unnecessary medical spending, and improve quality while reducing the number of
911 calls, emergency room visits, and hospital admissions. In 2019, Indiana passed SEA 498-2019 which
established MIH/community paramedicine (CP) programs and provided MIH/CP reimbursement for
Medicaid recipients. In 2020, Indiana passed HEA 1209-2020 which required health plans to reimburse for
the specified emergency medical services.
The Department of Homeland Security (DHS) established a MIH program dashboard which filters by service,
and county/provider. Out of 92 counties, 20 have established MIH/CP programs. Offered services include:
hospital dismissal/post-discharge follow up, post response follow-up for certain emergencies, diabetic
counseling, chronic disease management, mental illness mitigation, OB/newborn management, elderly
management, substance abuse management, immunization and vaccination, and decreased utilization of EMS
by high frequency patients.
The DHS does not require MIH providers to report the number of calls received and does not track the
number of 911 calls that are mitigated by the MIH system.
Explanation of State Revenues:
Explanation of Local Expenditures:
Explanation of Local Revenues:
State Agencies Affected: State Personnel Department; Department of Insurance.
Local Agencies Affected:
Information Sources: Christy Tittle, State Personnel Department; Alyssa Schroeder, Department of
Homeland Security;
Legislative Services Agency, Indiana Handbook of Taxes, Revenues, and Appropriations, FY 2023;
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6161318/;
https://www.ncsl.org/state-legislatures-news/details/community-paramedicine-connecting-patients-to-car
e-and-reducing-costs;
https://ingov.maps.arcgis.com/apps/dashboards/95ad27d611a74212bc992d5c72d6a17b;
https://www.chcf.org/wp-content/uploads/2019/11/LeftBehindCaliforniaComparingCommunityParamedi
cine.pdf.
Fiscal Analyst: Jasmine Noel, 317-234-1360.
SB 142 2