House adopts site‑of‑service clarification after debate over physician fee schedules

The Indiana House approved a conference committee report on House Bill 1003 that primarily clarifies implementation of site‑of‑service policy passed in earlier sessions and adjusts its effective date.

Supporters told the House the conference committee reconciled confusing language from the Senate and restored contract language for completeness. The chair of the committee said the report contains three main components: language aligning with prior authorization in Senate Bill 480, contract language returned to the House version, and clarifying implementation steps for previously passed site‑of‑service/site‑neutral policy.

Representative Campbell urged colleagues to reject the report, arguing the measure effectively locks physician reimbursement to a physician fee schedule and could set a statewide standard without having first evaluated the 2023 changes. "By locking hospitals into current physician fee schedules, the general assembly is essentially negotiating these contracts for insurers moving forward," Campbell said on the floor.

Representative Bauer also urged rejection, noting that the bill does not guarantee that any provider or insurer savings will be passed to patients and warning the changes could prompt hospitals to contract out services, including obstetrics in some communities. "If our goal is to reduce cost of health care or expand services, I don't believe this is the proper route," Bauer said.

The conference report moved back the implementation date to January 2026 and preserved the underlying 2023 policy while clarifying the statutory language needed to implement it. The report also included provisions that would prohibit contract terms requiring all facilities be included in a health plan contract and would allow providers to opt out of a new select or tiered network introduced by a carrier with at least 60 days' notice prior to submission to the Department of Insurance.

Outcome: The House adopted the conference committee report by a roll call of 65 ayes to 25 noes.

Context: The session spent significant time reconciling site‑of‑service language and the conference report reflects an attempt to balance competing interests among hospitals, insurers and patient‑access advocates. The bill’s opponents principally objected to what they characterized as premature statutory constraints on price-setting before the results of related studies are available.