HB1502: A BILL FOR AN ACT to amend the Indiana Code concerning insurance.

Page last updated: Sunday, April 20, 2025 at 7:36 PM (America/Indianapolis).

General Information

• Stage: House Bill (H)
• Current Chamber: house
• Origin Chamber: house
• Description: State employee health plan payment limits.

Legislators

Actions (4 total)

• Feb 11, 2025, 9:54 AM: Committee report: do pass, adopted
• Jan 21, 2025, 8:38 AM: First reading: referred to Committee on Insurance
• Jan 21, 2025, 8:38 AM: Authored by Representative McGuire
• Jan 21, 2025, 8:38 AM: Coauthored by Representative Carbaugh

Digest

Limits the amount that a state employee health plan may pay for a medical facility service provided to a covered individual to: (1) the lesser of the amount of compensation established by the network plan or 200% of the amount paid by the Medicare program for that type of medical facility service or for a medical facility service of a similar type, if the medical facility service is provided by an in network provider; and (2) 185% of the amount paid by the Medicare program for that type of medical facility service or for a medical facility service of a similar type, if the medical facility service is provided by an out of network provider. Prohibits a provider from charging a covered individual an additional amount for a medical facility service, other than cost sharing amounts authorized by the terms of the state employee health plan. Requires a medical facility that provides drugs to a covered individual, in billing a state employee health plan for the cost of the drugs, to include in the billing the same "TB" or "JG" modifier that the medical facility would include in the billing if the medical facility were billing the Medicare program for the drugs.