8/14 Torchbearer Weekly Policy Update

Welcome back! We hope you enjoyed your weekend. Thank you for allowing us to be your trusted source for news at the local, state, and federal levels.

Local, state, and federal highlights in this week’s memo include:

DEEP DIVE: HEA 1004
Indiana Chamber Weighs in on State’s Economic Future
Indiana Legislators Discuss State’s Childcare Needs
How Indiana Plans to Spent $275M on Public and Behavioral Health
Indiana Expands Tutoring Grant Program
State GOP Party Endorses Banks for U.S. Senate
Inflation Ticks up to 3.2 Percent
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Important Dates

Let’s dive in.

DEEP DIVE: HEA 1004

An Overview: House Enrolled Act 1004, requires "truth in billing" for Indiana's largest hospital systems and prohibits them from automatically billing at the hospital rate for services performed by their office-based providers – potentially saving Hoosiers millions of dollars.

HEA 1004 also requires insurers and health plan administrators to share health-care claims data with employers who sponsor employee health coverage so employers can make more informed decisions about how to get the most affordable coverage for their employees.

Finally, the new law also requires the state government to study prices paid by commercial health plans for services at the state's largest hospital systems to more precisely gauge how Indiana's prices compare to the rest of the nation.

Dive deeper: The provisions in HEA 1004 make the following changes.

Establishes the health care cost oversight task force and sets forth duties of the task force.
Provides a credit against state tax liability to certain physicians who have an ownership interest in a physician practice and meet other eligibility criteria.
Allows a credit against the state tax liability of an employer with fewer than 50 employees if the employer has adopted a health reimbursement arrangement in lieu of a traditional employer provided health insurance plan and if the employer's contribution toward the health reimbursement arrangement meets a certain standard.
Requires the office of the secretary of family and social services to research and compile data concerning Medicaid reimbursement rates for Indiana and all other states and the national reimbursement rate average.
Requires the submission of a report to the health care cost oversight task force and the general assembly.
Establishes the payer affordability penalty fund.
Specifies additional information that a hospital must report to the Indiana department of health in the hospital's annual report and establishes a fine for a hospital that fails to timely file the report.
Provides that a bill for health care services provided by certain qualified providers in an office setting must be submitted on an individual provider form.
Prohibits an insurer, health maintenance organization, employer, or other person responsible for the payment of the cost of health care services from accepting a bill that is submitted on an institutional provider form.
Repeals language requiring a hospital to hold a public forum.
Requires the department of insurance to contract with a third party to calculate an Indiana nonprofit hospital system's prices from certain health plans for specified calendar years.
Before November 1, 2024, and before November 1 each subsequent year, requires the department's third party contractor to compare certain Indiana nonprofit hospital system facility pricing information with 285% of Medicare.
Requires the calculations to be submitted as a report for review.
Provides that a health care provider that enters into: (1) a value-based health care reimbursement agreement; and (2) an electronic medical records access agreement; with a health plan may qualify to participate in the health plan's program to reduce or eliminate prior authorization requirements.
Requires a health plan that establishes a program to reduce or eliminate prior authorization requirements to provide certain information to health care providers concerning the program.
Requires a third party administrator, insurer, or health maintenance organization that has contracted with a person to administer a self-funded insurance plan or a fully insured group plan to provide claims data to the person not later than 15 days from a request for the data.
Specifies certain claims data to be provided and establishes a fine for a failure to timely provide the claims data.
Requires the all payer claims data base advisory board to discuss specified issues concerning reimbursement rates.
Allows for the provisional credentialing of physicians who establish or join an independent primary care practice.

Indiana Chamber Weighs in on State’s Economic Future

The Indiana Chamber of Commerce wants leaders to spend the next decade tackling state shortcomings like education attainment and access to opportunities for minorities.

Driving the news: The chamber yesterday released a new vision plan for the state's economic future, titled Indiana Prosperity 2035.

Why it matters: The goals in the plan will drive the work, and statehouse lobbying efforts, of the influential chamber for the next dozen years.

State of play: The Chamber says Indiana has successfully built a competitive business climate but risks falling behind if challenges around education, opportunity, health, quality of place — the things that make people want to build not just businesses, but families and lives somewhere — aren't addressed.

Other states have gotten more competitive, too.

Details: The Chamber outlined more than 30 goals on issues like workforce, education and economic growth.

A top workforce goal is increasing the share of Hoosier adults with some kind of post-secondary education from the current rate of 54% to 70% by 2035.
The chamber's previous goal was 60% by 2025.

The bottom line: The Chamber is willing to point out the state's policy flaws and some of its most difficult challenges while advocating for solutions that won't always be popular.

"I have this old saying that around the General Assembly, the good ideas sometimes take three or more years to pass and bad ideas only take one," Brinegar said. (Axios)

Indiana Legislators Discuss State's Childcare Needs

What’s new: During an interim committee hearing at the Statehouse last week, rising concerns over a lack of affordable and accessible child care in Indiana were discussed, prompting calls for new statewide policies that would make it easier for additional care providers to open — without breaking the bank for families.

The details: A legislative panel made up mostly of Hoosier lawmakers heard more than four hours of public testimony from state officials, child care providers and business leaders who all shared a similar message: Indiana needs a more comprehensive system for child care, especially if the state wants to bolster its workforce.

State of play:

The cost of providing care in Indiana is approximately $14,000 per child, per year. From the provider standpoint the “vast majority,” or 80%, of those expenses are for labor and personnel costs.
Pay for child care workers on average ranges from $10 to $15 an hour, and in almost all cases does not include benefits. That also makes it increasingly difficult for child care providers to keep adequate staffing — which is needed for centers to remain open.
While unlicensed childcare centers can be more affordable, as of 2015, Indiana law sets higher standards for unlicensed child care programs in Indiana that accept federal vouchers.

Finding solutions:

John Niederman with the Fortitude Fund, which provides grants to entrepreneurs in Northeast Indiana, said “it’s critical” for Indiana to adopt more flexible policies that make childcare a more “attractive” and “viable business opportunity.”
Sam Snideman, the vice president of government relations at United Way of Central Indiana, said the state should earmark additional appropriations to further expand eligibility for subsidized child care. Lawmakers could also duplicate programs in other states that match what employers provide workers for child care costs, he said.
Courtney Hott’s, director of the Indiana Early Learning Advisory Committee, recommendations included increased reimbursement rates to child care providers and tax credits for businesses that offer help to employees.
Courtney Penn, with FSSA, said the state’s child care licensing process could also be more efficient if the multiple state agencies involved work together more collaboratively.

What’s next: While additional funding will not be an option for the 2024 legislative session due to it not being a budget year, we are likely to see other solutions offered that will begin to chip away at the childcare infrastructure issues the sate is seeing. (Indiana Capital Chronicle)

How Indiana Plans to Spend $275M on Public and Behavioral Health

What’s new: Indiana made national headlines in the spring when lawmakers authorized $275 million in public and behavioral health funding — a massive increase — but now, the state’s health systems must execute.

The details:

Senate Enrolled Act 1 aims to fortify the year-old 988 crisis response center and hotline with funding for mental health emergencies. Lawmakers hoped to deliver on three elements: someone to call for help, someone to respond and somewhere to go.
The two-year budget allots $50 million annually to the effort — more than the previous $35 million but far short of the $150 million that a fall 2022 state report requested.
And Senate Enrolled Act 4 will give counties additional funds in exchange for providing enhanced public health services and complying with reporting and metrics requirements. It’s an opt-in system. Counties have until September 1st to opt-in.

State of play: Indiana has long recorded poor health metrics — and it ranks 48th in the nation for public health funding, spending $55 per capita versus the nationwide average of $91 per capita.

What they’re saying:

“We have been reactive in our approach to health care and this is a momentous time where I think we were proactive,” said Rep. Brad Barrett, a retired surgeon now representing Richmond as a Republican.
“My only reservation is that things are going to take some time to get long-term results,” Barrett said. “And some of these things aren’t fixable, aren’t measurable (short-term). I think it’s a real challenge for our counties to come up with some metrics and performance indicators that are short-term that we can say, “Hey, two or three years, we made a difference.”
What’s next: Rep. Barrett is likely accurate in his comments on long-term results. There may be legislation introduced in the 2024 legislative session that could attempt to further assist rollout efforts. (Inside INdiana Business)

Indiana Expands Tutoring Grant Program

What’s new: Indiana is expanding its grant program for tutoring that it launched last fall to cover middle school students, as well as more elementary schoolers, the state education department announced Thursday.

The details: In addition, the maximum grant award for Indiana Learns, which provides grants to students to use for tutoring and academic programs that meet “learning partner” requirements, is increasing to $1,000. The new maximum award of $1,000 is available to students who are new to the program and those who signed up earlier.

Some background: The state first rolled out Indiana Learns last fall in response to learning loss in the wake of the pandemic. Originally geared towards students in fourth and fifth grades, the program is now open to any student in third through eighth grade who qualifies for free or reduced-price lunch, and whose scores on state math or English language arts tests were below proficiency.

Dive deeper: The expansion comes as 2023 state ILEARN scores demonstrated a small improvement in math but a slight dip in English. In 2022, 41.2% of Indiana students scored at or above proficiency in English, compared to 40.7% of students this year. Meanwhile, math proficiency rose from 39.4% in 2022 to 40.9% this year.

What they’re saying: “We know from our 2023 ILEARN proficiency results, and the ongoing academic impact/recovery analysis, that our middle school students in particular need strategic learning support and interventions,” Secretary of Education Katie Jenner said in a press release. (Chalkbeat)

State GOP Party Endorses Banks for U.S. Senate

What’s new: The Indiana Republican Party on Thursday endorsed U.S. Rep. Jim Banks in his 2024 bid for Senate, marking the first time in at least recent history that the state party has made an endorsement before primary elections for an open seat.

What they’re saying:

“You can start calling him the presumptive nominee and the next United States Senator from Indiana,” party Chair Kyle Hupfer said at the organization’s annual dinner Thursday night.

“I’m proud to have your endorsement,” Banks responded. “When I go to Washington D.C. as your United States senator I won’t back down on fighting the fight every day for our conservative values. I’ll make you proud.”

State of play: The move means national cash. The RNC can’t contribute money or in-kind resources to anyone before a primary except if the candidate is unopposed — unless all of a state’s RNC members approve it in writing, according to the organization’s rules.

What’s next: Currently, Bank faces no serious GOP challengers so far. The primary election is scheduled for May 7, 2024. The general election will follow on Nov. 5, 2024. (Indiana Capital Chronicle)

Inflation Ticks up to 3.2 Percent

What’s new: Inflation ticked up to 3.2 percent year-over-year in July and 0.2 percent from June alone, according to new consumer price data released Thursday by the Labor Department.

Wy it matters: This marks the first increase after 13 months of falling inflation. But that doesn’t necessarily mean inflation is about to come roaring back.

Details: Shelter, auto insurance and education were among the categories that saw prices increase in July, while prices for airline fares, used cars and trucks were among those that declined outright.

Where it stands: The Federal Reserve continued its rate-hiking campaign last month to tackle inflation after pausing in June.

Officials say any further rate increases later this year will depend on what a slate of economic data, including Thursday's CPI report, suggests about inflation's path. (Axios)