House Bill 1003, introduced in the Indiana House on April 16, 2025, aims to streamline billing practices for healthcare services provided by qualified providers in office settings. The bill seeks to address issues related to billing discrepancies and the submission of claims, particularly focusing on the distinction between institutional and individual provider forms.

Key provisions of House Bill 1003 stipulate that claims for services rendered by qualified providers in office settings must be submitted using individual provider forms, explicitly prohibiting the use of institutional provider forms. This measure is designed to prevent confusion and ensure that payors—such as insurers and health maintenance organizations—do not accept bills submitted incorrectly. Additionally, the bill mandates that qualified providers cannot include facility fees or charges on individual provider forms, nor can they bill for services using specific place of service codes associated with institutional settings.

The legislation also outlines the payment process for in-network qualified providers, requiring that claims be paid based on a physician's fee schedule. If a payor identifies a billing violation after payment has been made, they are permitted to pursue remedies as defined in their contractual agreements with the provider. Furthermore, the bill establishes a dispute resolution process for providers who contest a payor's determination regarding billing violations.

House Bill 1003 has sparked discussions among healthcare professionals and insurers, with some expressing concerns about the potential administrative burden it may impose on providers. Supporters argue that the bill will enhance transparency and efficiency in healthcare billing, ultimately benefiting patients by reducing errors and disputes.

The implications of this legislation are significant, as it could reshape billing practices across Indiana's healthcare system. By clarifying the requirements for billing submissions, House Bill 1003 aims to reduce confusion and improve the overall efficiency of healthcare transactions. As the bill moves through the legislative process, stakeholders will be closely monitoring its progress and potential impact on the state's healthcare landscape.