New Indiana law aims to reduce ‘surprise’ medical bills

Published: Dec. 28, 2021 at 5:41 PM EST
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INDIANA (WNDU) - Several new Indiana laws are going into effect this weekend, including one that aims to keep hospitals and healthcare providers honest about patient charges. The Indiana “balance billing” law applies to those with state-regulated health insurance.

This law allows customers to ask a provider for a good faith estimate of how much a scheduled, non-emergency service or procedure will cost. And it requires the provider to give that good faith estimate.

If a patient is getting a procedure done by an out-of-network provider at an in-network facility, the law says the provider can’t charge someone more than what’s allowed by their network plan. However, that out-of-network provider has to give a patient five days notice if they plan to charge more than what’s allowed under the network plan and give an estimate on how much the higher charge will be. The patient then will have to sign the statement in order to agree to the higher charge.

A hospital and outpatient surgery center also has to post on their websites the pricing for some of the most common services

Additionally, a federal No Surprises Act goes into effect January 1st, 2022. Indiana legislative staff told 16 News Now it covers a lot of what the state law does. The federal law protects people who have federally regulated insurance plans, which is what most people in Indiana have.

The Indiana Hospital Association released a statement to WNDU, in part, that says:

”IHA supported HEA 1004 in 2020, however, as Indiana’s law was being considered, IHA advocated for a more comprehensive solution to protect Hoosiers from receiving surprise bills in the emergency room... The No Surprises Act is a win-win because it protects patients from receiving a surprise bill and provides an independent dispute resolution process to help our independent docs be reimbursed fairly, which is important because Indiana physicians are reimbursed by government payors at one of the lowest rates in the country.”

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