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Committee sends insurance omnibus bill forward to allow insurer reimbursement for mobile integrated health and add small-group FTE option
Summary
The committee advanced an insurance omnibus bill that would allow private-insurer reimbursement for mobile integrated health services, add an FTE option for small-group counting and make technical changes to emergency payment rules, data transparency and minor settlements; the measure passed 9-2.
Representative Carbaugh presented House Bill 15-87, an omnibus insurance measure that the sponsor and supporters said bundles several technical changes sought by insurers, providers and local governments. Major provisions added or clarified in committee amendments include:
- Mobile integrated health (MIH): permits MIH providers to bill private insurers directly for non-911 preventive and follow-up care, which advocates said expands programs that keep patients in their homes and reduce inappropriate emergency-department use. Supporters said the change aims to make MIH programs financially sustainable without relying solely on municipal budgets. "This allows mobile integrated health services to build private insurers for reimbursement," an AIM witness said.
- Small-group definition: creates an insurer option to count full-time equivalents (FTEs) by aggregating part-time hours, instead of the current average-total-employee method that counts part-time staff as full-time; insurers must apply the chosen method consistently.
- Emergency services payment flexibility: restores the ability for providers and managed-care organizations to negotiate case rates for emergency-department claims separate from provider agreements, instead of the statutory 100%-of-Medicare default; the American College of Emergency Physicians representative emphasized the change applies only to emergency-department claims.
- Data-transparency and policing: exempts the National Insurance Crime Bureau (NICB) from certain public-notification requirements in the state's data-transparency law so investigators need not notify subjects under investigation.
- Minor settlements: adopts a model approach to allow small personal-injury settlements for minors to be settled by affidavit (up to a cap), with funds placed in protected accounts for the minor until court release.
Supporters included the Insurance Institute of Indiana, UnitedHealth Group, local governments and public-safety and EMS associations. Testifiers described MIH programs in Crawfordsville, Monticello and Muncie that reduce hospital readmissions and nonemergency 911 calls; municipal and provider witnesses said private reimbursement would help long-term sustainability. Lou Belch of the American College of Emergency Physicians said the emergency payment provision "only applies to emergency department claims" and should be a separate negotiation from overall provider agreements.
Some committee members said they supported MIH but wanted more time to review other provisions; Representative Campbell said she had concerns about non-MIH items and voted no on final passage. The committee ultimately approved the amended bill by a 9-2 vote and advanced it to the next stage.
