Indiana Code 16-21-17-1. Internet posting of pricing and information
(1) For as many of the seventy (70) shoppable services specified in the final rule of the Centers for Medicare and Medicaid Services published in 84 FR 65524 that are provided by the ambulatory outpatient surgical center.
Terms Used In Indiana Code 16-21-17-1
- item or service: means any item or service, including service packages, that could be provided by an ambulatory outpatient surgical center to a patient for which the ambulatory outpatient surgical center has established a standard charge. See Indiana Code 16-21-17-0.3
- standard charge: means the regular rate established by the ambulatory outpatient surgical center for an item or service provided to a specific group of paying patients. See Indiana Code 16-21-17-0.3
(A) the thirty (30) most common services that are provided by the ambulatory outpatient surgical center not included in subdivision (1); or
(B) if the ambulatory outpatient surgical center offers less than thirty (30) services not included under subdivision (1), all of the services provided by the ambulatory outpatient surgical center.
(b) The following information, to the extent applicable, must be included on the Internet web site by an ambulatory outpatient surgical center for the shoppable and common services described in subsection (a):
(1) A description of the shoppable and common service.
(2) The standard charge per item or service for each of the following categories:
(A) Any nongovernment sponsored health benefit plan or insurance plan provided by a health carrier in which the provider is in the network.
(B) Medicare, including fee for service and Medicare Advantage.
(C) Self-pay without charitable assistance from the ambulatory outpatient surgical center.
(D) Self-pay with charitable assistance from the ambulatory outpatient surgical center.
(E) Medicaid, including fee for service and risk based managed care.
(c) If:
(1) the federal Hospital Price Transparency Rule is repealed; or
(2) federal enforcement of the federal Hospital Price Transparency Rule is stopped;
the state health commissioner shall notify the legislative council of the occurrence referred to in subdivision (1) or (2) in an electronic format under IC 5-14-6.
(d) This subsection takes effect when the legislative council receives a notification from the state health commissioner under subsection (c). A hospital shall post pricing information in compliance with the federal Hospital Price Transparency Rule of the federal Centers for Medicare and Medicaid Services as published at 84 FR 65524 and in effect on January 1, 2021.
As added by P.L.50-2020, SEC.2. Amended by P.L.93-2020, SEC.4; P.L.151-2021, SEC.11; P.L.198-2021, SEC.14.