First Regular Session of the 124th General Assembly (2025)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
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provision adopted), the text of the new provision will appear in this style type. Also, the
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a new provision to the Indiana Code or the Indiana Constitution.
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between statutes enacted by the 2024 Regular Session of the General Assembly.
SENATE ENROLLED ACT No. 119
AN ACT to amend the Indiana Code concerning health.
Be it enacted by the General Assembly of the State of Indiana:
SECTION 1. IC 4-6-3-3, AS AMENDED BY P.L.198-2021,
SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]: Sec. 3. (a) If the attorney general has reasonable
cause to believe that a person may be in possession, custody, or control
of documentary material, or may have knowledge of a fact that is
relevant to an investigation conducted to determine if a person is or has
been engaged in a violation of IC 4-6-9, IC 4-6-10, IC 13-14-10,
IC 13-14-12, IC 13-24-2, IC 13-30-4, IC 13-30-5, IC 13-30-8,
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,
IC 24-9, IC 25-1-7, IC 27-1-37-8, IC 32-34-1.5, or any other statute
enforced by the attorney general or is or has been engaged in a criminal
violation of IC 13, only the attorney general may issue in writing, and
cause to be served upon the person or the person's representative or
agent, an investigative demand that requires that the person served do
any combination of the following:
(1) Produce the documentary material for inspection and copying
or reproduction.
(2) Answer under oath and in writing written interrogatories.
(3) Appear and testify under oath before the attorney general or
the attorney general's duly authorized representative.
(b) The office of the attorney general may consult with the
Indiana department of health in the review of an application for a
SEA 119 — Concur 2
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. May 13, 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
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
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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
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.
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(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) November 9, 2025, for an application filed under this
chapter between January 1, 2025, through May 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
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.
SEA 119 — Concur President of the Senate
President Pro Tempore
Speaker of the House of Representatives
Governor of the State of Indiana
Date: Time:
SEA 119 — Concur