Senate Health committee advances six health and human services bills, sends several to appropriations

The Senate Health and Provider Services Committee on March 1 considered a package of health and human services proposals, advancing each bill to the next step in the process and sending multiple measures to appropriations for fiscal review.

Committee members spent most of the morning on House Bill 1003, a broad health-care package that was amended in committee and recommitted to the Appropriations Committee after unanimous approval. The bill’s provisions — as presented in committee by Senator Johnson — address site-of-service “site-neutrality” coding and reporting, a uniform discounted-cash price requirement for labs and diagnostic imaging, expanded price-transparency and good‑faith estimate rules, and continued treatment of prior authorization and “right-to-try” provisions. Committee members removed 340B-related language from the measure, and Senator Johnson said the bill keeps some contracting, data‑ownership and audit-rights language while deferring additional changes on anti‑competitive contracting to later work.

Senator Johnson said the amended bill defines a discounted cash price and narrows the outpatient services required to publish uniform prices to an explicit top‑100 list of ambulatory surgery/diagnostic codes; it also drops the Secretary of Health and Human Services from some governance roles tied to the All‑Payers Claims Database pending further work on interoperability and feasibility. The committee took two omnibus amendments (amendments 15 and 17) by consent and then approved recommitment to appropriations by a 12‑0 vote.

Votes at a glance - House Bill 1003 (health care price transparency, site of service, surprise billing, prior authorization): Committee vote 12‑0; recommitted to Appropriations. Motion: move as amended (omnibus amendments 15 and 17 taken by consent). Presenter: Senator Johnson. Notes: 340B language removed; top‑100 CPT approach for ambulatory surgery center price lists; good‑faith estimates allowed 1–2 business days rather than immediate or at‑discharge; prior authorization language retained pending separate Senate bill (SB480).

The committee also advanced House Bill 1595, a rewrite of Indiana’s Long‑Term Care Partnership program that seeks to adopt options consistent with the federal Deficit Reduction Act (DRA) partnership rules. Representative Carball (author) and supporters said the proposal aims to make partnership policies more affordable by changing design rules such as inflation‑protection requirements that have sharply raised premiums for partnership contracts. Supporters — including industry representative Chris Barthouse of the National Association of Insurance and Financial Advisors, Indiana chapter — said changing the compounding inflation requirement and other design elements would lower premiums and encourage more companies to participate. The committee passed the bill 12‑0, and sponsors said the change is intended to preserve promises made to current policyholders while creating more affordable options for future buyers.

- House Bill 1595 (Long‑Term Care Partnership modernization): Committee vote 12‑0; passed from committee. Motion: do pass. Presenter: Representative Carball. Notes: Aims to allow DRA partnership options, reduce inflation‑protection compounding, preserve existing contract promises for current policyholders; stakeholders pledged assistance in outreach to carriers and the Department of Insurance.

House Bill 1555, the measure to create a limited in‑state license pathway for qualified internationally trained physicians to practice in underserved and rural Indiana under supervision, passed as amended and was reported out with a do‑pass recommendation. The bill sets eligibility conditions for internationally trained applicants (medical degree from an international program, in‑good‑standing foreign license, completion of a residency judged by the state medical board to be substantially similar or five years’ practice experience, successful USMLE Step 3, English proficiency). The limited license is valid up to six years; conversion to a full license may be permitted after five years at the board’s discretion. Sponsors added several amendments in committee: removing osteopathic (DO) graduates from this version pending follow‑up, setting a $100 application fee to avoid recommitment for an undefined fee, clarifying supervision and scope‑of‑practice limits, and limiting the program’s sunset to Dec. 3, 2030 to allow future review. The bill passed as amended (do‑pass as amended) with roll call support.

- House Bill 1555 (limited license for internationally trained physicians): Committee vote — do‑pass as amended (recorded as pass by the committee, 11‑0 in the roll call reported in committee); outcome: advanced as amended. Motion: do pass as amended; amendments included removal of DOs from the pathway, supervision and scope‑of‑practice safeguards, and a $100 fee. Presenter: Representative Baird. Notes: Board discretion to convert provisional license to full license; sponsor and witnesses emphasized need to safeguard quality and to pair the pathway with verification such as ECFMG certification and Step exams.

The committee then took lengthy testimony on House Bill 1453, which would create a pediatric cancer research and treatment grant program administered by the Indiana Department of Health. The bill creates a dedicated fund for pediatric cancer research, allows grants to Indiana‑based academic centers, hospitals and nonprofits, and requires annual reporting to the governor and Legislative Council. Parents and advocacy groups provided extensive testimony describing gaps in pediatric‑specific therapies and long-term toxicities of adult chemotherapy regimens used for children. Witnesses cited other states’ programs (Florida, Kentucky, Texas) and presented buy‑in from Indiana nonprofits and research institutions; several private foundations pledged seed funding to a state fund if established. The committee approved recommitment to appropriations 12‑0.

- House Bill 1453 (Pediatric Cancer Research and Treatment Grant Program): Committee vote 12‑0; recommitted to Appropriations. Motion: do pass and recommit for appropriation. Presenter: Representative O’Brien. Notes: Creates a Department of Health‑administered grant program; fund will accept public and private gifts and not revert to the general fund; supporters cited examples of state seed money producing federal and philanthropic leverage and clinical trials for children.

Later in the hearing the committee considered House Bill 1689, a bill focused on attendant care, oversight, and supports for medically complex children and adults. The measure clarifies ombudsman access for waiver participants, requires improved Medicaid reporting on Home and Community‑Based Services (HCBS) waivers, and directs stakeholder engagement to develop definitions and plans for individuals with extraordinary care needs. Testimony from families and advocacy groups — including Arc of Indiana and Indiana Families United for Care — emphasized workforce shortages for home nursing, the burden on unpaid family caregivers, and potential pilot models such as a state‑authorized complex care assistant (CCA) role that would allow delegation of specific nursing tasks under RN oversight. The committee amended the bill with an FSSA‑requested technical change and passed it 12‑0; sponsors said the measure is intended as a compromise and the start of continued multi‑stakeholder work.

- House Bill 1689 (attendant care, ombudsman access, Medicaid HCBS reporting and extraordinary‑care planning): Committee vote 12‑0; amended and passed out of committee pending recommitment. Motion: do pass as amended; amendment added conforming language requested by FSSA. Presenter: Representative Clear. Notes: Requires BDS ombudsman access for all applicable waivers; establishes improved data reporting to inform policy; directs FSSA to work with DDRS advisory council on extraordinary‑care definitions and plans.

Finally the committee considered House Bill 1391, a package of Choice program modernization measures and a pilot to test “Choice” funding as a Medicaid‑diversion tool. Sponsors described decoupling certain Choice services (for example, home modifications, pest control, handyman work) from Medicaid provider enrollment rules to allow more local procurement and lower unit costs; the bill leaves skilled medical services tied to Medicaid provider rules. The legislation also authorizes a pilot (Thrive West Central and Richmond area participation) that will partner with an independent evaluator (the LEO Lab at Notre Dame) to study whether targeted, lower‑cost in‑home interventions and chronic disease telehealth reduce progression onto Medicaid waivers and acute care use. The committee approved the amended bill and recommitted it to appropriations 12‑0.

- House Bill 1391 (Choice modernization and Medicaid‑diversion pilot): Committee vote 12‑0; recommitted to Appropriations. Motion: do pass as amended; amendment clarified services that remain tied to Medicaid and refined pilot language. Presenter: Representative Clear. Notes: Pilot will include clinical chronic‑care telehealth and home modification interventions; sponsors described potential cost savings if diversion succeeds.

What this means next Several of the bills approved by the committee were recommitted to the Appropriations Committee for fiscal analysis before final floor action. Committee sponsors repeatedly emphasized that some measures are intentionally staged — removing contested provisions to allow parallel bills to advance or to refine agency roles — while flagging follow‑up work (for example, contracting and anti‑steering language in HB1003; detailed agency rules and board processes for HB1555; further stakeholder work on extraordinary care linked to HB1689).

Speakers and testimony Key presenters and witnesses included Senator Johnson (HB1003), Representative Carball/Carballa (HB1595), Representative Baird (HB1555), Representative O’Brien (HB1453), parents and nonprofit advocates (HB1453), Representative Clear (HB1689 and HB1391), Tom Krishan (Arc of Indiana), Jennifer DeWitt and other parents (attendant care), and Ryan Keller (Choice pilot). Several associations — Indiana State Medical Association, Indiana Academy of Family Physicians, Americans for Prosperity, Cicero Institute/Americans for Prosperity affiliate, Leukemia & Lymphoma Society, American Cancer Society Cancer Action Network, Indiana Biosciences Research Institute, AARP Indiana — registered support or provided comment during the hearing.

Context and next steps Committee sponsors said many items will be refined as bills move through appropriations and as related measures in the House and Senate are reconciled. Multiple witnesses urged additional funding and programmatic attention: pediatric cancer advocates asked the legislature to invest seed funds to unlock federal and private grants; families caring for medically complex children requested pilot authorities for delegated caregiver roles and better Medicaid access; provider and insurer stakeholders asked for further work on contracting and insurer incentives tied to site‑of‑service reforms. The committee adjourned after unanimous action on each item and several recommitments to appropriations for fiscal review.