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 6861 NOTE PREPARED: Jan 3, 2024
BILL NUMBER: SB 258 BILL AMENDED:
SUBJECT: Physician Referrals and Reimbursement Rates.
FIRST AUTHOR: Sen. Busch BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State
XDEDICATED
FEDERAL
Summary of Legislation: Physician Referrals: The bill prohibits a referring physician from receiving
compensation or an incentive from a health care entity or another physician, who is in the same health care
network as the referring physician, for referring a patient to the health care entity or other physician.
Physician Reimbursement Reporting: The bill also provides that the rules adopted by the Department of
Insurance regarding the all payer claims data base must include a requirement that health payers report
physician reimbursement rates for each contract and specify a process for health payers to report the
physician reimbursement rates. It requires the all payer claims data base to publish the physician
reimbursement rates as a separate line item for each contract instead of in the aggregate.
Effective Date: July 1, 2024.
Explanation of State Expenditures: Physician Reimbursement Reporting: The bill will increase the
workload of the Department of Insurance (DOI) to adopt rules and structure the database to provide the
disaggregated data. This is within the routine administrative functions of the DOI and 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.]
Physician Referrals: The Professional Licensing Agency (PLA) may need to update its website and notify
the affected providers of these changes. This is within the PLA’s routine administrative functions and should
be able to be implemented with no additional appropriations, assuming near customary agency staffing and
resource levels.
SB 258 1 Explanation of State Revenues:
Explanation of Local Expenditures:
Explanation of Local Revenues:
State Agencies Affected: Department of Insurance; Professional Licensing Agency.
Local Agencies Affected:
Information Sources:
Fiscal Analyst: Karen Rossen, 317-234-2106.
SB 258 2