Introduced Version
SENATE BILL No. 337
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 16-21-9-4.5; IC 16-22.
Synopsis: Hospital charity care. Specifies charity care that certain
nonprofit hospitals and county hospitals must provide concerning
patients.
Effective: July 1, 2025.
Qaddoura
January 13, 2025, read first time and referred to Committee on Health and Provider
Services.
2025 IN 337—LS 6896/DI 104 Introduced
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. 337
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 16-21-9-4.5 IS ADDED TO THE INDIANA CODE
2 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
3 1, 2025]: Sec. 4.5. (a) This section applies to the following:
4 (1) A nonprofit hospital that has an annual revenue of at least
5 twenty million dollars ($20,000,000).
6 (2) A county hospital organized or established under IC 16-22.
7 (3) A patient who is not covered under the Medicaid or the
8 Medicare program.
9 (b) A nonprofit hospital and a county hospital shall provide at
10 least the following charity care:
11 (1) For patients with a household income of not more than two
12 hundred percent (200%) of the federal poverty level, health
13 care treatment and services by the nonprofit hospital at no
14 cost.
15 (2) For patients with a household income greater than two
16 hundred percent (200%) of the federal poverty level but not
17 more than three hundred percent (300%) of the federal
2025 IN 337—LS 6896/DI 104 2
1 poverty level, an adjustment to the cost of the treatment and
2 services provided using the applicable Medicare
3 reimbursement rate applicable on the date of service, to equal
4 not more than twenty-five percent (25%) of the calculated
5 billing statement using the Medicare reimbursement rate.
6 (3) For patients with a household income greater than three
7 hundred percent (300%) of the federal poverty level but not
8 more than four hundred percent (400%) of the federal
9 poverty level, the adjustment described in subdivision (2) if
10 the patient's household has incurred medical expenses in the
11 previous twelve (12) months that total at least five percent
12 (5%) of the household's annual gross income.
13 (c) A nonprofit hospital and a county hospital shall determine
14 whether a patient is eligible for the charity care required under
15 this section.
16 SECTION 2. IC 16-22-3-13 IS AMENDED TO READ AS
17 FOLLOWS [EFFECTIVE JULY 1, 2025]: Sec. 13. (a) The governing
18 board shall establish reasonable charges for patient care and other
19 hospital services for the residents of the county and may provide
20 patient care and other hospital services to nonresidents of the county
21 upon terms and conditions the board establishes by rule.
22 (b) The governing board may give appropriate discounts of charges
23 to patients, including the charity care required by IC 16-21-9-4.5.
24 (c) In establishing charges, the governing board may include a
25 reasonable charge for depreciation and obsolescence of property, plant,
26 and equipment.
27 (d) The board may periodically transfer all or part of the charges for
28 depreciation and obsolescence to a fund to be used by and at the
29 discretion of the board only for the purpose of building, remodeling,
30 repairing, replacing, or making additions to the hospital building or
31 buildings. However, in any year in which there is a tax levy for the
32 general operation and maintenance of the hospital, the board shall not
33 make a transfer to the fund. In an emergency, the board may borrow
34 from the fund for the operating fund of the hospital and shall reimburse
35 the fund within two (2) years.
36 (e) The authority granted to establish the fund does not limit the
37 power and authority of the board, the county executive, the county
38 fiscal body, or other units of government to finance hospital buildings
39 by other methods.
40 SECTION 3. IC 16-22-8-39 IS AMENDED TO READ AS
41 FOLLOWS [EFFECTIVE JULY 1, 2025]: Sec. 39. (a) A hospital
42 owned, operated, or managed by the corporation shall be for the benefit
2025 IN 337—LS 6896/DI 104 3
1 of the residents of the county and of every person who becomes sick,
2 injured, or maimed within the county. The hospital is subject to the
3 charity care requirements in IC 16-21-9-4.5.
4 (b) A patient who is able to pay shall pay to the corporation a
5 reasonable compensation for medicine or hospital services according
6 to the rules prescribed by the board. The board or the board's
7 authorized representative may exclude from the hospital a person who
8 willfully violates the rules. On terms and conditions the board
9 prescribes, the corporation may:
10 (1) extend the privileges and use of the hospital, the corporation's
11 health care programs, and health care facilities to persons residing
12 outside of the county; and
13 (2) own or operate nursing facilities located inside or outside of
14 the county.
15 (c) There may not be discrimination against practitioners of any
16 school of medicine holding unlimited licenses to practice medicine
17 recognized in Indiana. The licensed practitioners are entitled to equal
18 privileges in treating patients in the hospital.
2025 IN 337—LS 6896/DI 104