LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
FISCAL IMPACT STATEMENT
LS 7017 NOTE PREPARED: Feb 13, 2025
BILL NUMBER: SB 317 BILL AMENDED: Feb 13, 2025
SUBJECT: Health Care Debt and Costs.
FIRST AUTHOR: Sen. Qaddoura BILL STATUS: CR Adopted - 1
st
House
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
XDEDICATED
FEDERAL
Summary of Legislation: (Amended) The bill requires hospitals to do the following:
(1) Offer the person who has received health services the opportunity to pay the charges
through a payment plan that satisfies certain requirements.
(2) Develop a written notice about a charity care program operated by the hospital, provide
the notice to patients, and post the notice.
(3) Include certain information concerning financial assistance on a billing statement.
(4) Requires a hospital that reports an annual gross patient revenue of at least $20 M to
provide written notice and information to a person who has requested an eligibility
determination concerning a payment plan or charity care.
It provides that the unpaid earnings of a consumer who meets specified income eligibility requirements may
not be attached by garnishment in satisfaction of:
(1) any amount of health care debt owed or alleged to be owed by the consumer; or
(2) any amount of the judgment that represents health care debt determined to be owed by
the consumer.
It also provides that:
(1) any amount of health care debt owed or alleged to be owed by a consumer; or
(2) in an action against a consumer in which a judgment has been entered, any amount of
the judgment that represents health care debt determined to be owed by the consumer;
does not constitute a lien against the consumer's principal residence for a consumer that meets specified
income requirements. The bill provides that in any action filed in Indiana for the recovery of health care debt
owed or alleged to be owed by a consumer, the principal residence of the consumer is not liable to judgment
or attachment or to be sold on execution against the consumer.
Effective Date: Upon passage; July 1, 2025.
Explanation of State Expenditures: (Revised) The State Health Commissioner may have additional
workload to take action against hospitals that violate the bill’s requirements concerning payment plans and
SB 317 1 charity care programs. The additional workload should be able to be implemented with no additional
appropriations, assuming near customary agency staffing and resource levels. [Administrative expenses of
the Indiana Department of Health are paid from the Tobacco Master Settlement Fund, a dedicated fund.]
Explanation of State Revenues: (Revised) In taking action against a hospital violation, the Commissioner
may impose a civil penalty of up to $10,000 per violation. Revenue from civil penalties is deposited in the
state General Fund. Any increase is expected to be minimal.
Explanation of Local Expenditures: (Revised) Locally owned hospitals with gross patient revenue greater
than $20 M will have increased workload and ongoing personnel needs to determine and notify persons
receiving emergency or medically necessary health care services of eligibility for charity care programs
operated by the hospital within 14 days. Conversely, expenditures associated with debt collection, as well
as reductions in revenue from write-offs, may be reduced to the extent that hospital costs are covered by a
charity care program.
Explanation of Local Revenues: (Revised) The bill will have an indeterminate impact on debt collections
for locally owned hospitals and ambulance services, potentially lowering overall revenue.
State Agencies Affected: Indiana Department of Health.
Local Agencies Affected: Locally-owned hospitals and ambulance services.
Information Sources: Indiana Supreme Court, Indiana Trial Court Fee Manual.
Fiscal Analyst: Karen Rossen, 317-234-2106.
SB 317 2