HB 1024 amends Indiana Medicaid law to adjust how the state reimburses children’s hospitals located in bordering states when they provide inpatient or outpatient services to Indiana Medicaid recipients under age 19. The bill directs the Office of Medicaid Policy and Planning to pay these hospitals using a formula tied either to the comparable federal Medicare reimbursement rate for the service or, if no Medicare rate exists, 130% of the Medicaid reimbursement rate. It also requires the reimbursement methodology to account for high-cost “outlier” cases so the final payment reflects unusually expensive stays.
The bill preserves the existing focus on out-of-state children’s hospitals serving Indiana children and expressly excludes non-emergency medical transportation from its scope. It also authorizes the office to seek any necessary federal approval, including state plan amendments or Medicaid waivers, and to adopt implementing rules. The act includes an emergency clause, making it effective upon passage, and it extends the section’s expiration date from July 1, 2025 to July 1, 2027.
Impact
HB 1024 changes Indiana Code section IC 12-15-15-1.2, which governs Medicaid reimbursement for children’s hospitals in neighboring states. The practical effect is to continue and refine a reimbursement framework for covered pediatric services, including a specific method for handling cost outlier cases and the possibility of retroactive reimbursement tied to the initial Medicaid waiver application. The bill affects the state Medicaid agency, out-of-state children’s hospitals that treat Indiana Medicaid children, and Indiana Medicaid recipients under age 19.
Sentiment
The bill appears to have broad bipartisan support and little visible opposition. It passed the House 92-0, the Senate 43-0, and the House concurred with Senate amendments 86-0. The unanimous votes suggest the measure was viewed as a routine or technical Medicaid reimbursement update rather than a controversial policy change.
Contention
No committee testimony or recorded debate was provided, and the voting record shows no opposition. The only potentially notable policy issue is the reimbursement methodology itself—specifically, tying payment to Medicare rates or a percentage of Medicaid rates and requiring adjustments for cost outlier cases—which could affect state spending and hospital payment levels. The extension of the section’s sunset date and the retroactive reimbursement authority may also be relevant to fiscal or administrative concerns, but no direct disagreement is reflected in the available materials.
An Act Concerning A Five-year Medicaid Rate Review, Dental Representation On A Medical Assistance Oversight Council, Biomarker Testing And Opioid Prescription Coverage Requirements And A Study Concerning Payment Of Spouses For State-subsidized Home Care.