IN
Indiana Senate Bill SB0119

Indiana 2025 Regular Session

Indiana Senate Bill SB0119 Compare Versions

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1+*ES0119.1*
2+April 1, 2025
3+ENGROSSED
4+SENATE BILL No. 119
5+_____
6+DIGEST OF SB 119 (Updated April 1, 2025 10:38 am - DI 147)
7+Citations Affected: IC 4-6; IC 16-21.
8+Synopsis: Certificate of public advantage. Prohibits the submission of
9+an application for a certificate of public advantage (application) after
10+May 13, 2025. Changes the time frame in which the Indiana
11+department of health has to review and make a determination on an
12+application filed during a specified time frame.
13+Effective: Upon passage.
14+Charbonneau, Johnson T,
15+Randolph Lonnie M
16+(HOUSE SPONSORS — BARRETT, HEATON, BAIRD, PFAFF)
17+January 8, 2025, read first time and referred to Committee on Health and Provider
18+Services.
19+February 13, 2025, reported favorably — Do Pass.
20+February 19, 2025, read second time, amended, ordered engrossed.
21+February 20, 2025, engrossed. Read third time, passed. Yeas 49, nays 0.
22+HOUSE ACTION
23+March 3, 2025, read first time and referred to Committee on Public Health.
24+April 1, 2025, amended, reported — Do Pass.
25+ES 119—LS 6493/DI 104 April 1, 2025
126 First Regular Session of the 124th General Assembly (2025)
227 PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
328 Constitution) is being amended, the text of the existing provision will appear in this style type,
429 additions will appear in this style type, and deletions will appear in this style type.
530 Additions: Whenever a new statutory provision is being enacted (or a new constitutional
631 provision adopted), the text of the new provision will appear in this style type. Also, the
732 word NEW will appear in that style type in the introductory clause of each SECTION that adds
833 a new provision to the Indiana Code or the Indiana Constitution.
934 Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
1035 between statutes enacted by the 2024 Regular Session of the General Assembly.
11-SENATE ENROLLED ACT No. 119
12-AN ACT to amend the Indiana Code concerning health.
36+ENGROSSED
37+SENATE BILL No. 119
38+A BILL FOR AN ACT to amend the Indiana Code concerning
39+health.
1340 Be it enacted by the General Assembly of the State of Indiana:
14-SECTION 1. IC 4-6-3-3, AS AMENDED BY P.L.198-2021,
15-SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
16-UPON PASSAGE]: Sec. 3. (a) If the attorney general has reasonable
17-cause to believe that a person may be in possession, custody, or control
18-of documentary material, or may have knowledge of a fact that is
19-relevant to an investigation conducted to determine if a person is or has
20-been engaged in a violation of IC 4-6-9, IC 4-6-10, IC 13-14-10,
21-IC 13-14-12, IC 13-24-2, IC 13-30-4, IC 13-30-5, IC 13-30-8,
22-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,
23-IC 24-9, IC 25-1-7, IC 27-1-37-8, IC 32-34-1.5, or any other statute
24-enforced by the attorney general or is or has been engaged in a criminal
25-violation of IC 13, only the attorney general may issue in writing, and
26-cause to be served upon the person or the person's representative or
27-agent, an investigative demand that requires that the person served do
28-any combination of the following:
29-(1) Produce the documentary material for inspection and copying
30-or reproduction.
31-(2) Answer under oath and in writing written interrogatories.
32-(3) Appear and testify under oath before the attorney general or
33-the attorney general's duly authorized representative.
34-(b) The office of the attorney general may consult with the
41+1 SECTION 1. IC 4-6-3-3, AS AMENDED BY P.L.198-2021,
42+2 SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
43+3 UPON PASSAGE]: Sec. 3. (a) If the attorney general has reasonable
44+4 cause to believe that a person may be in possession, custody, or control
45+5 of documentary material, or may have knowledge of a fact that is
46+6 relevant to an investigation conducted to determine if a person is or has
47+7 been engaged in a violation of IC 4-6-9, IC 4-6-10, IC 13-14-10,
48+8 IC 13-14-12, IC 13-24-2, IC 13-30-4, IC 13-30-5, IC 13-30-8,
49+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,
50+10 IC 24-9, IC 25-1-7, IC 27-1-37-8, IC 32-34-1.5, or any other statute
51+11 enforced by the attorney general or is or has been engaged in a criminal
52+12 violation of IC 13, only the attorney general may issue in writing, and
53+13 cause to be served upon the person or the person's representative or
54+14 agent, an investigative demand that requires that the person served do
55+15 any combination of the following:
56+16 (1) Produce the documentary material for inspection and copying
57+17 or reproduction.
58+ES 119—LS 6493/DI 104 2
59+1 (2) Answer under oath and in writing written interrogatories.
60+2 (3) Appear and testify under oath before the attorney general or
61+3 the attorney general's duly authorized representative.
62+4 (b) The office of the attorney general may consult with the
63+5 Indiana department of health in the review of an application for a
64+6 certificate of public advantage under IC 16-21-15.
65+7 SECTION 2. IC 16-21-15-3, AS AMENDED BY P.L.62-2022,
66+8 SECTION 4, AND P.L.143-2022, SECTION 43, IS AMENDED TO
67+9 READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 3. (a)
68+10 Any hospital entering into a merger agreement with another hospital
69+11 may submit an application to the state department for a certificate of
70+12 public advantage to govern the merger agreement in the manner
71+13 prescribed by the state department. However, a hospital may not submit
72+14 an application under this chapter after July 1, 2026. May 13, 2025.
73+15 (b) The application for a certificate of public advantage must
74+16 include the following:
75+17 (1) A written copy of the merger agreement.
76+18 (2) A written description of the nature and scope of the merger.
77+19 (c) Any documentation submitted under this section with the
78+20 application that is deemed to be proprietary information shall be clearly
79+21 identified as proprietary information and a copy of the application with
80+22 the proprietary information redacted for public records must be
81+23 submitted by the applicant.
82+24 (d) An applicant must also file a complete copy of the application
83+25 for a certificate of public advantage with:
84+26 (1) the office of the secretary of family and social services in a
85+27 manner prescribed by the office of the secretary; and
86+28 (2) the office of the attorney general in a manner prescribed by the
87+29 office of the attorney general.
88+30 (e) The state department shall assess a filing fee for an application
89+31 for a certificate of public advantage that is reasonably sufficient to fully
90+32 fund the costs of the review of the application and ongoing supervision
91+33 if the application is granted, including any fees for consultants and
92+34 experts. The state department may not spend any money on the
93+35 implementation of this chapter until the state department has received
94+36 a filed application and received the filing fee.
95+37 (f) If the state department incurs costs of the review of the
96+38 application and administration of the program that exceed the
97+39 application fee collected, the applicant for a certificate of public
98+40 advantage shall pay the reasonable charges incurred by the state
99+41 department, as determined by the state department.
100+42 (g) The reasonable costs of services concerning the program:
101+ES 119—LS 6493/DI 104 3
102+1 (1) include the cost of fees for consultants and experts; and
103+2 (2) must be commensurate with the usual compensation for like
104+3 services.
105+4 SECTION 3. IC 16-21-15-4, AS AMENDED BY P.L.11-2023,
106+5 SECTION 58, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
107+6 UPON PASSAGE]: Sec. 4. (a) The state department, in consultation
108+7 with the office of the secretary of family and social services, shall
109+8 review an application for a certificate of public advantage and the
110+9 documentation filed under section 3 of this chapter to determine
111+10 whether there is clear evidence that the proposed merger agreement:
112+11 (1) would benefit the population's health outcomes, health care
113+12 access, and quality of health care; and
114+13 (2) meets the standards described in this section.
115+14 (b) The state department shall consider in the review of the
116+15 application and documentation the effect of the merger agreement on
117+16 the following:
118+17 (1) The quality and price of hospital and health care services
119+18 provided to Indiana residents, including the demonstration of
120+19 population health improvement of the region serviced and the
121+20 extent to which medically underserved populations have access
122+21 to and are projected to use the proposed services.
123+22 (2) The preservation of sufficient health care services within the
124+23 geographic area to ensure public access to acute care.
125+24 (3) The cost efficiency of services, resources, and equipment
126+25 provided or used by the hospitals that are a party to the merger
127+26 agreement, including avoidance of duplication of services to
128+27 better meet the needs of the community.
129+28 (4) The ability of health care payors to negotiate payments and
130+29 service agreements with hospitals proposed to be merged under
131+30 the merger agreement.
132+31 (5) Employment.
133+32 (6) Economic impact.
134+33 (c) The state department shall grant the certification if the state
135+34 department determines in the review of the application and
136+35 documentation that, under the totality of the circumstances, the
137+36 following apply:
138+37 (1) There is clear evidence that the proposed merger would
139+38 benefit the population's health outcomes, health care access, and
140+39 quality of care in the county.
141+40 (2) The likely benefits resulting from the proposed merger
142+41 agreement outweigh any disadvantages attributable to a potential
143+42 reduction in competition that may result from the proposed
144+ES 119—LS 6493/DI 104 4
145+1 merger.
146+2 The holder of a certificate of public advantage issued by the state
147+3 department under this chapter receives immunity from claims made
148+4 pursuant to federal or state antitrust laws for the duration of the
149+5 certificate.
150+6 (d) The state department has must review and make a
151+7 determination on an application filed under this chapter not later
152+8 than:
153+9 (1) one hundred twenty (120) days from the filing of the
154+10 application; or
155+11 (2) November 9, 2025, for an application filed under this
156+12 chapter between January 1, 2025, through May 13, 2025.
157+13 to review and make a determination on the application.
158+14 (e) The state department's determination on whether to grant the
159+15 application must:
160+16 (1) be in writing;
161+17 (2) specify the basis for the determination; and
162+18 (3) be provided to the applicant on the date of the determination.
163+19 (e) (f) The state department may include terms or conditions of
164+20 compliance with the issuance of a certificate of public advantage under
165+21 this chapter.
166+22 (f) (g) The state department shall maintain records of all of the
167+23 applications filed under this chapter, including records of any terms or
168+24 conditions of issuing a certificate of public advantage that are imposed
169+25 by the state department.
170+26 (g) (h) The office of the attorney general may, at any time after an
171+27 application is filed under this chapter and before the state department
172+28 makes a determination on the application, require by civil investigative
173+29 demand the attendance of witnesses and the production of documents
174+30 for purposes of investigating whether the merger agreement satisfies
175+31 the requirements of this chapter. Any documents produced or testimony
176+32 given under this subsection are subject to confidentiality if the
177+33 information is deemed proprietary information. The attorney general
178+34 may seek compliance with the issuance of a civil investigative demand
179+35 with the appropriate district court of the county in which the merger is
180+36 to occur.
181+37 SECTION 4. An emergency is declared for this act.
182+ES 119—LS 6493/DI 104 5
183+COMMITTEE REPORT
184+Mr. President: The Senate Committee on Health and Provider
185+Services, to which was referred Senate Bill No. 119, has had the same
186+under consideration and begs leave to report the same back to the
187+Senate with the recommendation that said bill DO PASS.
188+ (Reference is to SB 119 as introduced.)
189+
190+CHARBONNEAU, Chairperson
191+Committee Vote: Yeas 7, Nays 4
192+_____
193+SENATE MOTION
194+Mr. President: I move that Senate Bill 119 be amended to read as
195+follows:
196+Replace the effective date in SECTION 1 with "[EFFECTIVE
197+UPON PASSAGE]".
198+Page 1, line 3, after "3." insert "(a)".
199+Page 1, line 9, reset in roman "IC 16-21-15,".
200+Page 2, delete lines 4 through 13, begin a new paragraph and insert:
201+"(b) The office of the attorney general may consult with the
35202 Indiana department of health in the review of an application for a
36-SEA 119 — Concur 2
37203 certificate of public advantage under IC 16-21-15.
38204 SECTION 2. IC 16-21-15-3, AS AMENDED BY P.L.62-2022,
39205 SECTION 4, AND P.L.143-2022, SECTION 43, IS AMENDED TO
40206 READ AS FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 3. (a)
41207 Any hospital entering into a merger agreement with another hospital
42208 may submit an application to the state department for a certificate of
43209 public advantage to govern the merger agreement in the manner
44210 prescribed by the state department. However, a hospital may not submit
45-an application under this chapter after July 1, 2026. May 13, 2025.
211+an application under this chapter after July 1, 2026. February 15,
212+2025.
46213 (b) The application for a certificate of public advantage must
47214 include the following:
48215 (1) A written copy of the merger agreement.
49216 (2) A written description of the nature and scope of the merger.
50217 (c) Any documentation submitted under this section with the
51218 application that is deemed to be proprietary information shall be clearly
52219 identified as proprietary information and a copy of the application with
53220 the proprietary information redacted for public records must be
221+ES 119—LS 6493/DI 104 6
54222 submitted by the applicant.
55223 (d) An applicant must also file a complete copy of the application
56224 for a certificate of public advantage with:
57225 (1) the office of the secretary of family and social services in a
58226 manner prescribed by the office of the secretary; and
59227 (2) the office of the attorney general in a manner prescribed by the
60228 office of the attorney general.
61229 (e) The state department shall assess a filing fee for an application
62230 for a certificate of public advantage that is reasonably sufficient to fully
63231 fund the costs of the review of the application and ongoing supervision
64232 if the application is granted, including any fees for consultants and
65233 experts. The state department may not spend any money on the
66234 implementation of this chapter until the state department has received
67235 a filed application and received the filing fee.
68236 (f) If the state department incurs costs of the review of the
69237 application and administration of the program that exceed the
70238 application fee collected, the applicant for a certificate of public
71239 advantage shall pay the reasonable charges incurred by the state
72240 department, as determined by the state department.
73241 (g) The reasonable costs of services concerning the program:
74242 (1) include the cost of fees for consultants and experts; and
75243 (2) must be commensurate with the usual compensation for like
76244 services.
77245 SECTION 3. IC 16-21-15-4, AS AMENDED BY P.L.11-2023,
78246 SECTION 58, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
79-SEA 119 — Concur 3
80247 UPON PASSAGE]: Sec. 4. (a) The state department, in consultation
81248 with the office of the secretary of family and social services, shall
82249 review an application for a certificate of public advantage and the
83250 documentation filed under section 3 of this chapter to determine
84251 whether there is clear evidence that the proposed merger agreement:
85252 (1) would benefit the population's health outcomes, health care
86253 access, and quality of health care; and
87254 (2) meets the standards described in this section.
88255 (b) The state department shall consider in the review of the
89256 application and documentation the effect of the merger agreement on
90257 the following:
91258 (1) The quality and price of hospital and health care services
92259 provided to Indiana residents, including the demonstration of
93260 population health improvement of the region serviced and the
94261 extent to which medically underserved populations have access
95262 to and are projected to use the proposed services.
96263 (2) The preservation of sufficient health care services within the
264+ES 119—LS 6493/DI 104 7
97265 geographic area to ensure public access to acute care.
98266 (3) The cost efficiency of services, resources, and equipment
99267 provided or used by the hospitals that are a party to the merger
100268 agreement, including avoidance of duplication of services to
101269 better meet the needs of the community.
102270 (4) The ability of health care payors to negotiate payments and
103271 service agreements with hospitals proposed to be merged under
104272 the merger agreement.
105273 (5) Employment.
106274 (6) Economic impact.
107275 (c) The state department shall grant the certification if the state
108276 department determines in the review of the application and
109277 documentation that, under the totality of the circumstances, the
110278 following apply:
111279 (1) There is clear evidence that the proposed merger would
112280 benefit the population's health outcomes, health care access, and
113281 quality of care in the county.
114282 (2) The likely benefits resulting from the proposed merger
115283 agreement outweigh any disadvantages attributable to a potential
116284 reduction in competition that may result from the proposed
117285 merger.
118286 The holder of a certificate of public advantage issued by the state
119287 department under this chapter receives immunity from claims made
120288 pursuant to federal or state antitrust laws for the duration of the
121289 certificate.
122-SEA 119 — Concur 4
123290 (d) The state department has must review and make a
124291 determination on an application filed under this chapter not later
125292 than:
126293 (1) one hundred twenty (120) days from the filing of the
127294 application; or
128-(2) November 9, 2025, for an application filed under this
129-chapter between January 1, 2025, through May 13, 2025.
295+(2) for an application filed under this chapter between
296+January 1, 2025, through February 15, 2025, August 13, 2025.
130297 to review and make a determination on the application.
131298 (e) The state department's determination on whether to grant the
132299 application must:
133300 (1) be in writing;
134301 (2) specify the basis for the determination; and
135302 (3) be provided to the applicant on the date of the determination.
136303 (e) (f) The state department may include terms or conditions of
137304 compliance with the issuance of a certificate of public advantage under
138305 this chapter.
139306 (f) (g) The state department shall maintain records of all of the
307+ES 119—LS 6493/DI 104 8
140308 applications filed under this chapter, including records of any terms or
141309 conditions of issuing a certificate of public advantage that are imposed
142310 by the state department.
143311 (g) (h) The office of the attorney general may, at any time after an
144312 application is filed under this chapter and before the state department
145313 makes a determination on the application, require by civil investigative
146314 demand the attendance of witnesses and the production of documents
147315 for purposes of investigating whether the merger agreement satisfies
148316 the requirements of this chapter. Any documents produced or testimony
149317 given under this subsection are subject to confidentiality if the
150318 information is deemed proprietary information. The attorney general
151319 may seek compliance with the issuance of a civil investigative demand
152320 with the appropriate district court of the county in which the merger is
153321 to occur.
154-SECTION 4. An emergency is declared for this act.
155-SEA 119 — Concur President of the Senate
156-President Pro Tempore
157-Speaker of the House of Representatives
158-Governor of the State of Indiana
159-Date: Time:
160-SEA 119 — Concur
322+SECTION 4. An emergency is declared for this act.".
323+Renumber all SECTIONS consecutively.
324+(Reference is to SB 119 as printed February 14, 2025.)
325+CHARBONNEAU
326+_____
327+COMMITTEE REPORT
328+Mr. Speaker: Your Committee on Public Health, to which was
329+referred Senate Bill 119, has had the same under consideration and
330+begs leave to report the same back to the House with the
331+recommendation that said bill be amended as follows:
332+Page 2, line 14, delete "February 15," and insert "May 13,".
333+Page 4, line 12, after "(2)" insert "November 9, 2025,".
334+Page 4, line 13, delete "February 15, 2025, August 13, 2025." and
335+insert "May 13, 2025.".
336+and when so amended that said bill do pass.
337+(Reference is to SB 119 as reprinted February 20, 2025.)
338+BARRETT
339+Committee Vote: yeas 10, nays 1.
340+ES 119—LS 6493/DI 104