House Bill 1003, introduced in the Indiana House on April 16, 2025, aims to enhance transparency and accountability in the administration of health care plans by third-party administrators (TPAs), managed care organizations (MCOs), and prepaid health care delivery plans. The bill seeks to address concerns regarding the fees and conditions imposed on plan sponsors and state agencies related to claims processing and audits.

Key provisions of House Bill 1003 include prohibiting TPAs and MCOs from charging fees for audit requests or imposing restrictions on the audit process. This includes limitations on the time period of audits, the number of claims analyzed, and the selection of auditors. The bill mandates that any auditor selected must meet specific criteria, including having no conflicts of interest and maintaining adequate liability insurance. Additionally, the bill requires that TPAs confirm receipt of audit requests within ten business days, ensuring timely communication with plan sponsors and relevant state departments.

The introduction of this bill has sparked notable debates among legislators and stakeholders. Proponents argue that it will protect consumers and ensure fair practices in health care administration, while opponents express concerns about the potential burden it may place on TPAs and MCOs, which could lead to increased operational costs.

Economically, the bill could have significant implications for the health care industry in Indiana. By increasing transparency, it may lead to more competitive pricing and better service delivery, ultimately benefiting consumers. However, if operational costs rise for TPAs and MCOs, these costs may be passed on to consumers in the form of higher premiums.

As House Bill 1003 moves through the legislative process, its potential impact on health care administration practices in Indiana remains a focal point of discussion. Stakeholders are closely monitoring the bill's progress, as its passage could reshape the landscape of health care plan management in the state.