Lawmakers, providers and insurers spar over broad health omnibus bill at Senate hearing

Rep. Brad Barrett, the bill's author, told the Senate Health Committee that House Bill 1003 is a wide-ranging, patient-focused package intended to lower costs, increase transparency and expand access.

"It's a pretty thorough bill. I think 56 pages, 102 sections, 8 different titles," Barrett said as he opened testimony, adding the measure aims to "lower cost, fight waste, fraud, and abuse, ... enhance transparency, expand access ... promote wellness, and increase competition." Barrett told the panel he expected further amendment work after the hearing and said the committee would hold the bill for a week.

Why it matters: HB1003 would touch multiple pieces of Indiana health policy at once — surprise billing, site-of-service payment differences, prior authorization rules, pharmacy benefit manager oversight, 340B drug program limits, the state's all-payer claims database (APCD) access and Medicaid fraud enforcement. Stakeholders from hospitals, employers, insurers, patient advocates and state officials said many provisions matter to patient access, provider finances and the state budget.

Key provisions and debate

Surprise billing and network adequacy — Barrett and others said the root problem is out-of-network providers working at in-network facilities. Barrett said the bill seeks to strengthen network adequacy and reduce situations where a patient goes to an in‑network facility and later receives an out‑of‑network bill. Several hospital and provider witnesses warned that payment limits or a blunt site-neutral approach could force service reductions or closures at smaller hospitals.

Site of service and payment — The bill includes site-of-service…