Senate adopts series of amendments to health coverage bill to clarify billing, imaging and prior-authorization rules

INDIANAPOLIS — The Indiana Senate voted on a string of amendments to House Bill 1003 on April 14, approving changes intended to limit hospital-site billing practices and to clarify definitions for diagnostic imaging and laboratory services.

Supporters said the amendments restore earlier statutory language and narrow the bill so it affects billing tied to true hospital settings while preserving dispute-resolution options for prior authorization.

Senator Charbonneau opened the bill’s second reading and yielded to Senator Sarah Johnson, who presented several amendments. Johnson said one amendment "really deals with the amendment that was added in appropriations on section 43" and that sponsors had worked to revert language "back to the language that it was originally before the bill and the way law is now." She said additional changes were intended to "streamline" how places of service are defined so routine office procedures are not reclassified as hospital visits. "I'd be happy to take any questions and appreciate your support," Johnson said after outlining the revisions.

Lawmakers approved a package of Johnson's amendments by voice vote. Key changes included: - Restoring language on site-of-service codes and narrowing the bill's reach to avoid classifying office visits as hospital services. - Refining the diagnostic imaging definition and adding a requirement that carriers include, at minimum, a maximum negotiated charge in addition to discounted cash price information for certain imaging services. - Mirroring imaging changes for laboratory services and directing the state insurance department to identify a list of "shoppable" lab services. - Removing broad prior-authorization language from the underlying bill while retaining a dispute-resolution process so providers and payers can contest prior-authorization denials. - Deleting a proposed law‑enforcement investigator role and leaving fraud investigations with the Indiana State Police and Attorney General as appropriate.

Senator Brown pressed for caution about any provision that could be read as imposing price caps on providers. Brown argued that some language could have consequences for nonprofit hospitals and rural access, and urged colleagues to consider market impacts before enacting any mandatory price limits. Other senators, including sponsors, responded with data-driven examples of hospital finances and said the amendments were intended to improve transparency rather than set price ceilings.

All contested amendments described in the session were adopted by voice vote or unanimous voice consent as recorded on the floor. No formal roll-call tallies were recorded in the transcript for those amendment votes. The bill was ordered to engrossment for further processing.

The measure now reflects the sponsors’ stated goal of tightening billing definitions and increasing transparency on negotiated charges for specific imaging and lab services while preserving a path for prior-authorization dispute resolution.