Indiana 2025 Regular Session

Indiana House Bill HB1024 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	EH1024.2
	2	+	March 28, 2025
	3	+	ENGROSSED
	4	+	HOUSE BILL No. 1024
	5	+	_____
	6	+	DIGEST OF HB 1024 (Updated March 27, 2025 10:21 am - DI 120)
	7	+	Citations Affected: IC 12-15.
	8	+	Synopsis: Medicaid reimbursement for children's hospitals. Extends
	9	+	the expiration date of language specifying Medicaid reimbursement for
	10	+	certain out-of-state children's hospitals from July 1, 2025, to July 1,
	11	+	2027.
	12	+	Effective: Upon passage.
	13	+	Slager, Porter, Jackson C
	14	+	(SENATE SPONSORS — NIEMEYER, BOHA CEK, CHARBONNEAU,
	15	+	BECKER, JACKSON L, LEISING)
	16	+	January 8, 2025, read first time and referred to Committee on Public Health.
	17	+	January 27, 2025, reported — Do Pass. Referred to Committee on Ways and Means
	18	+	pursuant to Rule 126.3.
	19	+	February 6, 2025, reported — Do Pass.
	20	+	February 10, 2025, read second time, ordered engrossed.
	21	+	February 11, 2025, engrossed.
	22	+	February 13, 2025, read third time, passed. Yeas 92, nays 0.
	23	+	SENATE ACTION
	24	+	February 19, 2025, read first time and referred to Committee on Health and Provider
	25	+	Services.
	26	+	March 13, 2025, reported favorably — Do Pass; reassigned to Committee on
	27	+	Appropriations.
	28	+	March 27, 2025, amended, reported favorably — Do Pass.
	29	+	EH 1024—LS 6385/DI 104 March 28, 2025
1	30		First Regular Session of the 124th General Assembly (2025)
2	31		PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
3	32		Constitution) is being amended, the text of the existing provision will appear in this style type,
4	33		additions will appear in this style type, and deletions will appear in this style type.
5	34		Additions: Whenever a new statutory provision is being enacted (or a new constitutional
6	35		provision adopted), the text of the new provision will appear in this style type. Also, the
7	36		word NEW will appear in that style type in the introductory clause of each SECTION that adds
8	37		a new provision to the Indiana Code or the Indiana Constitution.
9	38		Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
10	39		between statutes enacted by the 2024 Regular Session of the General Assembly.
11		-	HOUSE ENROLLED ACT No. 1024
12		-	AN ACT to amend the Indiana Code concerning Medicaid.
	40	+	ENGROSSED
	41	+	HOUSE BILL No. 1024
	42	+	A BILL FOR AN ACT to amend the Indiana Code concerning
	43	+	Medicaid.
13	44		Be it enacted by the General Assembly of the State of Indiana:
14		-	SECTION 1. IC 12-15-15-1.2, AS AMENDED BY P.L.76-2023,
15		-	SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
16		-	UPON PASSAGE]: Sec. 1.2. (a) As used in this section, "children's
17		-	hospital" means:
18		-	(1) a freestanding general acute care hospital that:
19		-	(A) is designated by the Medicare program as a children's
20		-	hospital; or
21		-	(B) furnishes inpatient and outpatient health care services to
22		-	patients who are predominantly individuals less than nineteen
23		-	(19) years of age; or
24		-	(2) a facility located within a freestanding general acute care
25		-	hospital that:
26		-	(A) is designated by the Medicare program as a children's
27		-	hospital; or
28		-	(B) furnishes inpatient and outpatient health care services to
29		-	patients who are predominately individuals less than nineteen
30		-	(19) years of age.
31		-	(b) This section applies to reimbursement for inpatient Medicaid
32		-	services and outpatient Medicaid services provided to a Medicaid
33		-	recipient who is less than nineteen (19) years of age at a children's
34		-	hospital that is located in a state bordering Indiana. This section does
35		-	not apply to reimbursement for non-emergency medical transportation.
36		-	HEA 1024 — Concur 2
37		-	(c) As used in this subsection, "cost outlier case" means a Medicaid
38		-	stay that exceeds a predetermined threshold, defined as the greater of
39		-	twice the diagnosis-related group (DRG) rate or a fixed dollar amount
40		-	that has been established by the office. The office shall reimburse a
41		-	children's hospital for covered services provided to a Medicaid
42		-	recipient that is described in subsection (b) at a rate set by the secretary
43		-	that is based on a reimbursement formula that is:
44		-	(1) comparable to the current federal Medicare reimbursement
45		-	rate for the service provided by the children's hospital; or
46		-	(2) one hundred thirty percent (130%) of the Medicaid
47		-	reimbursement rate for a service that does not have a Medicare
48		-	reimbursement rate.
49		-	The reimbursement methodology under this subsection must factor in
50		-	any cost outlier case in a manner that results in the final reimbursement
51		-	rate made to a hospital meeting the reimbursement requirements
52		-	specified in this subsection. The office may, upon factoring in the cost
53		-	outlier case in determining the final reimbursement rate, make
54		-	retroactive reimbursements to an out of state children's hospital to the
55		-	date of the initial Medicaid waiver application.
56		-	(d) Before September 1, 2021, the office shall apply to the United
57		-	States Department of Health and Human Services for any state plan
58		-	amendment or Medicaid waiver necessary to implement and administer
59		-	this section. Before June 1, 2022, the office shall apply for an
60		-	amendment to the Medicaid waiver concerning reimbursement under
61		-	this section that is necessary to implement the changes required by
62		-	amendments made to this section concerning factoring in any cost
63		-	outlier case.
64		-	(e) The office may adopt rules under IC 4-22-2 necessary for the
65		-	implementation of this section.
66		-	(f) This section expires July 1, 2025. 2027.
67		-	SECTION 2. An emergency is declared for this act.
68		-	HEA 1024 — Concur Speaker of the House of Representatives
69		-	President of the Senate
70		-	President Pro Tempore
71		-	Governor of the State of Indiana
72		-	Date: Time:
73		-	HEA 1024 — Concur
	45	+	1 SECTION 1. IC 12-15-15-1.2, AS AMENDED BY P.L.76-2023,
	46	+	2 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	47	+	3 UPON PASSAGE]: Sec. 1.2. (a) As used in this section, "children's
	48	+	4 hospital" means:
	49	+	5 (1) a freestanding general acute care hospital that:
	50	+	6 (A) is designated by the Medicare program as a children's
	51	+	7 hospital; or
	52	+	8 (B) furnishes inpatient and outpatient health care services to
	53	+	9 patients who are predominantly individuals less than nineteen
	54	+	10 (19) years of age; or
	55	+	11 (2) a facility located within a freestanding general acute care
	56	+	12 hospital that:
	57	+	13 (A) is designated by the Medicare program as a children's
	58	+	14 hospital; or
	59	+	15 (B) furnishes inpatient and outpatient health care services to
	60	+	16 patients who are predominately individuals less than nineteen
	61	+	17 (19) years of age.
	62	+	EH 1024—LS 6385/DI 104 2
	63	+	1 (b) This section applies to reimbursement for inpatient Medicaid
	64	+	2 services and outpatient Medicaid services provided to a Medicaid
	65	+	3 recipient who is less than nineteen (19) years of age at a children's
	66	+	4 hospital that is located in a state bordering Indiana. This section does
	67	+	5 not apply to reimbursement for non-emergency medical transportation.
	68	+	6 (c) As used in this subsection, "cost outlier case" means a Medicaid
	69	+	7 stay that exceeds a predetermined threshold, defined as the greater of
	70	+	8 twice the diagnosis-related group (DRG) rate or a fixed dollar amount
	71	+	9 that has been established by the office. The office shall reimburse a
	72	+	10 children's hospital for covered services provided to a Medicaid
	73	+	11 recipient that is described in subsection (b) at a rate set by the secretary
	74	+	12 that is based on a reimbursement formula that is:
	75	+	13 (1) comparable to the current federal Medicare reimbursement
	76	+	14 rate for the service provided by the children's hospital; or
	77	+	15 (2) one hundred thirty percent (130%) of the Medicaid
	78	+	16 reimbursement rate for a service that does not have a Medicare
	79	+	17 reimbursement rate.
	80	+	18 The reimbursement methodology under this subsection must factor in
	81	+	19 any cost outlier case in a manner that results in the final reimbursement
	82	+	20 rate made to a hospital meeting the reimbursement requirements
	83	+	21 specified in this subsection. The office may, upon factoring in the cost
	84	+	22 outlier case in determining the final reimbursement rate, make
	85	+	23 retroactive reimbursements to an out of state children's hospital to the
	86	+	24 date of the initial Medicaid waiver application.
	87	+	25 (d) Before September 1, 2021, the office shall apply to the United
	88	+	26 States Department of Health and Human Services for any state plan
	89	+	27 amendment or Medicaid waiver necessary to implement and administer
	90	+	28 this section. Before June 1, 2022, the office shall apply for an
	91	+	29 amendment to the Medicaid waiver concerning reimbursement under
	92	+	30 this section that is necessary to implement the changes required by
	93	+	31 amendments made to this section concerning factoring in any cost
	94	+	32 outlier case.
	95	+	33 (e) The office may adopt rules under IC 4-22-2 necessary for the
	96	+	34 implementation of this section.
	97	+	35 (f) This section expires July 1, 2025. 2027.
	98	+	36 SECTION 2. An emergency is declared for this act.
	99	+	EH 1024—LS 6385/DI 104 3
	100	+	COMMITTEE REPORT
	101	+	Mr. Speaker: Your Committee on Public Health, to which was
	102	+	referred House Bill 1024, has had the same under consideration and
	103	+	begs leave to report the same back to the House with the
	104	+	recommendation that said bill do pass.
	105	+	(Reference is to HB 1024 as introduced.)
	106	+	BARRETT
	107	+	Committee Vote: Yeas 11, Nays 0
	108	+	_____
	109	+	COMMITTEE REPORT
	110	+	Mr. Speaker: Your Committee on Ways and Means, to which was
	111	+	referred House Bill 1024, has had the same under consideration and
	112	+	begs leave to report the same back to the House with the
	113	+	recommendation that said bill do pass.
	114	+	(Reference is to HB 1024 as printed January 27, 2025.)
	115	+	THOMPSON
	116	+	Committee Vote: Yeas 21, Nays 0
	117	+	_____
	118	+	COMMITTEE REPORT
	119	+	Mr. President: The Senate Committee on Health and Provider
	120	+	Services, to which was referred House Bill No. 1024, has had the same
	121	+	under consideration and begs leave to report the same back to the
	122	+	Senate with the recommendation that said bill DO PASS and be
	123	+	reassigned to the Senate Committee on Appropriations.
	124	+	(Reference is to HB 1024 as printed February 6, 2025.)
	125	+	CHARBONNEAU, Chairperson
	126	+	Committee Vote: Yeas 12, Nays 0
	127	+	EH 1024—LS 6385/DI 104 4
	128	+	COMMITTEE REPORT
	129	+	Mr. President: The Senate Committee on Appropriations, to which
	130	+	was referred Engrossed House Bill No. 1024, has had the same under
	131	+	consideration and begs leave to report the same back to the Senate with
	132	+	the recommendation that said bill be AMENDED as follows:
	133	+	Page 2, line 35, reset in roman "(f) This section expires July 1,".
	134	+	Page 2, line 35, after "2025." insert "2027.".
	135	+	and when so amended that said bill do pass.
	136	+	(Reference is to EHB 1024 as printed March 14, 2025.)
	137	+	MISHLER, Chairperson
	138	+	Committee Vote: Yeas 8, Nays 2.
	139	+	EH 1024—LS 6385/DI 104