*SB0119.2*
Reprinted
February 20, 2025
SENATE BILL No. 119
_____
DIGEST OF SB 119 (Updated February 19, 2025 2:32 pm - DI 104)
Citations Affected: IC 4-6; IC 16-21.
Synopsis: Certificate of public advantage. Prohibits the submission of
an application for a certificate of public advantage (application) after
February 15, 2025. Changes the time frame in which the Indiana
department of health has to review and make a determination on an
application filed during a specified time frame.
Effective: Upon passage.
Charbonneau, Johnson T,
Randolph Lonnie M
January 8, 2025, read first time and referred to Committee on Health and Provider
Services.
February 13, 2025, reported favorably — Do Pass.
February 19, 2025, read second time, amended, ordered engrossed.
SB 119—LS 6493/DI 104 Reprinted
February 20, 2025
First Regular Session of the 124th General Assembly (2025)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type. Also, the
word NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
between statutes enacted by the 2024 Regular Session of the General Assembly.
SENATE BILL No. 119
A BILL FOR AN ACT to amend the Indiana Code concerning
health.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 4-6-3-3, AS AMENDED BY P.L.198-2021,
2 SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 UPON PASSAGE]: Sec. 3. (a) If the attorney general has reasonable
4 cause to believe that a person may be in possession, custody, or control
5 of documentary material, or may have knowledge of a fact that is
6 relevant to an investigation conducted to determine if a person is or has
7 been engaged in a violation of IC 4-6-9, IC 4-6-10, IC 13-14-10,
8 IC 13-14-12, IC 13-24-2, IC 13-30-4, IC 13-30-5, IC 13-30-8,
9 IC 16-21-15, IC 23-7-8, IC 24-1-2, IC 24-5-0.5, IC 24-5-7, IC 24-5-8,
10 IC 24-9, IC 25-1-7, IC 27-1-37-8, IC 32-34-1.5, or any other statute
11 enforced by the attorney general or is or has been engaged in a criminal
12 violation of IC 13, only the attorney general may issue in writing, and
13 cause to be served upon the person or the person's representative or
14 agent, an investigative demand that requires that the person served do
15 any combination of the following:
16 (1) Produce the documentary material for inspection and copying
17 or reproduction.
SB 119—LS 6493/DI 104 2
1 (2) Answer under oath and in writing written interrogatories.
2 (3) Appear and testify under oath before the attorney general or
3 the attorney general's duly authorized representative.
4 (b) The office of the attorney general may consult with the
5 Indiana department of health in the review of an application for a
6 certificate of public advantage under IC 16-21-15.
7 SECTION 2. IC 16-21-15-3, AS AMENDED BY P.L.62-2022,
8 SECTION 4, AND P.L.143-2022, SECTION 43, IS AMENDED TO
9 READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 3. (a)
10 Any hospital entering into a merger agreement with another hospital
11 may submit an application to the state department for a certificate of
12 public advantage to govern the merger agreement in the manner
13 prescribed by the state department. However, a hospital may not submit
14 an application under this chapter after July 1, 2026. February 15,
15 2025.
16 (b) The application for a certificate of public advantage must
17 include the following:
18 (1) A written copy of the merger agreement.
19 (2) A written description of the nature and scope of the merger.
20 (c) Any documentation submitted under this section with the
21 application that is deemed to be proprietary information shall be clearly
22 identified as proprietary information and a copy of the application with
23 the proprietary information redacted for public records must be
24 submitted by the applicant.
25 (d) An applicant must also file a complete copy of the application
26 for a certificate of public advantage with:
27 (1) the office of the secretary of family and social services in a
28 manner prescribed by the office of the secretary; and
29 (2) the office of the attorney general in a manner prescribed by the
30 office of the attorney general.
31 (e) The state department shall assess a filing fee for an application
32 for a certificate of public advantage that is reasonably sufficient to fully
33 fund the costs of the review of the application and ongoing supervision
34 if the application is granted, including any fees for consultants and
35 experts. The state department may not spend any money on the
36 implementation of this chapter until the state department has received
37 a filed application and received the filing fee.
38 (f) If the state department incurs costs of the review of the
39 application and administration of the program that exceed the
40 application fee collected, the applicant for a certificate of public
41 advantage shall pay the reasonable charges incurred by the state
42 department, as determined by the state department.
SB 119—LS 6493/DI 104 3
1 (g) The reasonable costs of services concerning the program:
2 (1) include the cost of fees for consultants and experts; and
3 (2) must be commensurate with the usual compensation for like
4 services.
5 SECTION 3. IC 16-21-15-4, AS AMENDED BY P.L.11-2023,
6 SECTION 58, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
7 UPON PASSAGE]: Sec. 4. (a) The state department, in consultation
8 with the office of the secretary of family and social services, shall
9 review an application for a certificate of public advantage and the
10 documentation filed under section 3 of this chapter to determine
11 whether there is clear evidence that the proposed merger agreement:
12 (1) would benefit the population's health outcomes, health care
13 access, and quality of health care; and
14 (2) meets the standards described in this section.
15 (b) The state department shall consider in the review of the
16 application and documentation the effect of the merger agreement on
17 the following:
18 (1) The quality and price of hospital and health care services
19 provided to Indiana residents, including the demonstration of
20 population health improvement of the region serviced and the
21 extent to which medically underserved populations have access
22 to and are projected to use the proposed services.
23 (2) The preservation of sufficient health care services within the
24 geographic area to ensure public access to acute care.
25 (3) The cost efficiency of services, resources, and equipment
26 provided or used by the hospitals that are a party to the merger
27 agreement, including avoidance of duplication of services to
28 better meet the needs of the community.
29 (4) The ability of health care payors to negotiate payments and
30 service agreements with hospitals proposed to be merged under
31 the merger agreement.
32 (5) Employment.
33 (6) Economic impact.
34 (c) The state department shall grant the certification if the state
35 department determines in the review of the application and
36 documentation that, under the totality of the circumstances, the
37 following apply:
38 (1) There is clear evidence that the proposed merger would
39 benefit the population's health outcomes, health care access, and
40 quality of care in the county.
41 (2) The likely benefits resulting from the proposed merger
42 agreement outweigh any disadvantages attributable to a potential
SB 119—LS 6493/DI 104 4
1 reduction in competition that may result from the proposed
2 merger.
3 The holder of a certificate of public advantage issued by the state
4 department under this chapter receives immunity from claims made
5 pursuant to federal or state antitrust laws for the duration of the
6 certificate.
7 (d) The state department has must review and make a
8 determination on an application filed under this chapter not later
9 than:
10 (1) one hundred twenty (120) days from the filing of the
11 application; or
12 (2) for an application filed under this chapter between
13 January 1, 2025, through February 15, 2025, August 13, 2025.
14 to review and make a determination on the application.
15 (e) The state department's determination on whether to grant the
16 application must:
17 (1) be in writing;
18 (2) specify the basis for the determination; and
19 (3) be provided to the applicant on the date of the determination.
20 (e) (f) The state department may include terms or conditions of
21 compliance with the issuance of a certificate of public advantage under
22 this chapter.
23 (f) (g) The state department shall maintain records of all of the
24 applications filed under this chapter, including records of any terms or
25 conditions of issuing a certificate of public advantage that are imposed
26 by the state department.
27 (g) (h) The office of the attorney general may, at any time after an
28 application is filed under this chapter and before the state department
29 makes a determination on the application, require by civil investigative
30 demand the attendance of witnesses and the production of documents
31 for purposes of investigating whether the merger agreement satisfies
32 the requirements of this chapter. Any documents produced or testimony
33 given under this subsection are subject to confidentiality if the
34 information is deemed proprietary information. The attorney general
35 may seek compliance with the issuance of a civil investigative demand
36 with the appropriate district court of the county in which the merger is
37 to occur.
38 SECTION 4. An emergency is declared for this act.
SB 119—LS 6493/DI 104 5
COMMITTEE REPORT
Mr. President: The Senate Committee on Health and Provider
Services, to which was referred Senate Bill No. 119, has had the same
under consideration and begs leave to report the same back to the
Senate with the recommendation that said bill DO PASS.
(Reference is to SB 119 as introduced.)
CHARBONNEAU, Chairperson
Committee Vote: Yeas 7, Nays 4
_____
SENATE MOTION
Mr. President: I move that Senate Bill 119 be amended to read as
follows:
Replace the effective date in SECTION 1 with "[EFFECTIVE
UPON PASSAGE]".
Page 1, line 3, after "3." insert "(a)".
Page 1, line 9, reset in roman "IC 16-21-15,".
Page 2, delete lines 4 through 13, begin a new paragraph and insert:
"(b) The office of the attorney general may consult with the
Indiana department of health in the review of an application for a
certificate of public advantage under IC 16-21-15.
SECTION 2. IC 16-21-15-3, AS AMENDED BY P.L.62-2022,
SECTION 4, AND P.L.143-2022, SECTION 43, IS AMENDED TO
READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 3. (a)
Any hospital entering into a merger agreement with another hospital
may submit an application to the state department for a certificate of
public advantage to govern the merger agreement in the manner
prescribed by the state department. However, a hospital may not submit
an application under this chapter after July 1, 2026. February 15,
2025.
(b) The application for a certificate of public advantage must
include the following:
(1) A written copy of the merger agreement.
(2) A written description of the nature and scope of the merger.
(c) Any documentation submitted under this section with the
application that is deemed to be proprietary information shall be clearly
identified as proprietary information and a copy of the application with
the proprietary information redacted for public records must be
SB 119—LS 6493/DI 104 6
submitted by the applicant.
(d) An applicant must also file a complete copy of the application
for a certificate of public advantage with:
(1) the office of the secretary of family and social services in a
manner prescribed by the office of the secretary; and
(2) the office of the attorney general in a manner prescribed by the
office of the attorney general.
(e) The state department shall assess a filing fee for an application
for a certificate of public advantage that is reasonably sufficient to fully
fund the costs of the review of the application and ongoing supervision
if the application is granted, including any fees for consultants and
experts. The state department may not spend any money on the
implementation of this chapter until the state department has received
a filed application and received the filing fee.
(f) If the state department incurs costs of the review of the
application and administration of the program that exceed the
application fee collected, the applicant for a certificate of public
advantage shall pay the reasonable charges incurred by the state
department, as determined by the state department.
(g) The reasonable costs of services concerning the program:
(1) include the cost of fees for consultants and experts; and
(2) must be commensurate with the usual compensation for like
services.
SECTION 3. IC 16-21-15-4, AS AMENDED BY P.L.11-2023,
SECTION 58, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]: Sec. 4. (a) The state department, in consultation
with the office of the secretary of family and social services, shall
review an application for a certificate of public advantage and the
documentation filed under section 3 of this chapter to determine
whether there is clear evidence that the proposed merger agreement:
(1) would benefit the population's health outcomes, health care
access, and quality of health care; and
(2) meets the standards described in this section.
(b) The state department shall consider in the review of the
application and documentation the effect of the merger agreement on
the following:
(1) The quality and price of hospital and health care services
provided to Indiana residents, including the demonstration of
population health improvement of the region serviced and the
extent to which medically underserved populations have access
to and are projected to use the proposed services.
(2) The preservation of sufficient health care services within the
SB 119—LS 6493/DI 104 7
geographic area to ensure public access to acute care.
(3) The cost efficiency of services, resources, and equipment
provided or used by the hospitals that are a party to the merger
agreement, including avoidance of duplication of services to
better meet the needs of the community.
(4) The ability of health care payors to negotiate payments and
service agreements with hospitals proposed to be merged under
the merger agreement.
(5) Employment.
(6) Economic impact.
(c) The state department shall grant the certification if the state
department determines in the review of the application and
documentation that, under the totality of the circumstances, the
following apply:
(1) There is clear evidence that the proposed merger would
benefit the population's health outcomes, health care access, and
quality of care in the county.
(2) The likely benefits resulting from the proposed merger
agreement outweigh any disadvantages attributable to a potential
reduction in competition that may result from the proposed
merger.
The holder of a certificate of public advantage issued by the state
department under this chapter receives immunity from claims made
pursuant to federal or state antitrust laws for the duration of the
certificate.
(d) The state department has must review and make a
determination on an application filed under this chapter not later
than:
(1) one hundred twenty (120) days from the filing of the
application; or
(2) for an application filed under this chapter between
January 1, 2025, through February 15, 2025, August 13, 2025.
to review and make a determination on the application.
(e) The state department's determination on whether to grant the
application must:
(1) be in writing;
(2) specify the basis for the determination; and
(3) be provided to the applicant on the date of the determination.
(e) (f) The state department may include terms or conditions of
compliance with the issuance of a certificate of public advantage under
this chapter.
(f) (g) The state department shall maintain records of all of the
SB 119—LS 6493/DI 104 8
applications filed under this chapter, including records of any terms or
conditions of issuing a certificate of public advantage that are imposed
by the state department.
(g) (h) The office of the attorney general may, at any time after an
application is filed under this chapter and before the state department
makes a determination on the application, require by civil investigative
demand the attendance of witnesses and the production of documents
for purposes of investigating whether the merger agreement satisfies
the requirements of this chapter. Any documents produced or testimony
given under this subsection are subject to confidentiality if the
information is deemed proprietary information. The attorney general
may seek compliance with the issuance of a civil investigative demand
with the appropriate district court of the county in which the merger is
to occur.
SECTION 4. An emergency is declared for this act.".
Renumber all SECTIONS consecutively.
(Reference is to SB 119 as printed February 14, 2025.)
CHARBONNEAU
SB 119—LS 6493/DI 104