The 2023 Indiana General Assembly has wrapped up its Legislative session, and we will have new laws that impact Indiana’s fully insured health insurance.
HEA 1004- Healthcare Matters
This bill addresses Indiana skyrocketing healthcare costs. The original version required non-profit hospitals to report healthcare charges and would fine any costs exceeding 260% of what Medicare would charge. The final version removed penalties for charging over 285% of Medicare, but a Hospital can be fined for not reporting what they charge. This is a good step in bringing transparency to what hospitals are charging.
The bill includes tax credits for physician-owned practices and employers providing health reimbursement accounts (HRA) options to their employees. With all of the mega-hospital mergers, Indiana should assist physicians who operate their own practice.
HRA tax credits benefit small Indiana employers who do not offer a traditional group health plan but do want to offer some resources to purchase an Individual policy.
It also mandated a state study on Medicaid reimbursement rates for hospitals. That study could confirm that hospitals need a higher reimbursement rate to treat Indiana’s Medicaid population, thus starting to relieve some of the burdens Indiana hospitals have placed on employers and private insurance.
The bill also adds language to reduce the prior authorization burden healthcare providers have been faced with to certify benefits. If you have ever had to wait or delay treatment because the healthcare provider steps to get prior authorization, you know how frustrating this can be.
SEA8-Perscription Drug Rebates
This bill will require individual health policies to provide 85% of the pharmacy rebate to the member at the point of sale when they fill the script. If you have ever used GoodRx in lou of your health insurance plan, you may have encountered the cost of the drug was cheaper using the pharmacy assistance program instead of your insurance. This is due to manufacturers’ rebates.
For employers who offer fully insured group health plans, the rebates will go back to the employer.
The administration and set of these new bills will create challenges and additional costs for all stakeholders in the Indiana healthcare system. Our state officials tackled complex healthcare issues and compromised on multiple topics for all stakeholders to try to improve Indiana’s healthcare system.
Anthony Nefouse
