Fabio
113 lines
10 KiB
Markdown
113 lines
10 KiB
Markdown
---
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type: "Bill"
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title: "Health matters."
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description: "States that the office of the secretary of family and social services and a managed care organization may not prohibit a provider from participating in another insurance network. Defines \"weighted average negotiated charge\" and requires the weighted average negotiated charge per service per provider type for Medicaid to be reported by hospitals and ambulatory outpatient surgical centers. Requires certain health care providers, beginning July 1, 2021, to provide a good faith estimate to individuals of the price for nonemergency health care services to be provided to the individual by the health care provider and sets forth requirements. Allows an individual to request a good faith estimate from a health care provider for the total price for nonemergency services that have been ordered, scheduled, or referred. and requires the health care provider to provide the good faith estimate. Sets forth requirements for the good faith estimate. Provides that an out of network practitioner who provides health care services to a covered individual in an in network facility may not charge more for the health care services provided to a covered individual than allowed according to the rate or amount of compensation established by the covered individual's network plan unless: (1) at least five days before the health care services are scheduled to be provided, the covered individual is provided a statement that: (A) informs the covered individual that the facility or practitioner intends to charge more than allowed under the network plan; and (B) sets forth an estimate of the charge; and (2) the covered individual signs the statement, signifying the covered individual's consent to the charge. Sets forth notice requirements. Sets forth provisions that a physician noncompete agreement must include in order to be enforceable. Provides for information and notification that an employer must give to a physician who leaves the employment of the provider. Allows an individual to request from a health carrier a good faith estimate of the amount of the cost of nonemergency health care services that the health carrier will pay for or reimburse and the applicable benefit limitations of the nonemergency health care service. Sets forth requirements of a good faith estimate by a health carrier and sets penalties for violations."
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jurisdiction: "us/states/in"
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legislature: "Indiana General Assembly"
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session: "2020"
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identifier: "HB 1004"
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citation: "Indiana HB 1004 (2020)"
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classification: ["bill"]
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subjects: ["HEALTH", "Health Care Costs; Health Insurance", "INSURANCE generally", "FAMILY AND SOCIAL SERVICES ADMINISTRATION"]
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status: "enacted"
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primary_sponsors: ["Ben Smaltz", "Ed Charbonneau", "Eric Bassler"]
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version_count: 5
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action_count: 43
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vote_count: 2
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first_action: "2020-01-06"
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last_action: "2020-03-30"
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source: "openstates"
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source_identifier: "ocd-bill/c496dad9-be10-4874-992c-af93e566d084"
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source_url: "http://iga.in.gov/legislative/2020/bills/house/1004"
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source_hash: "b3bedd55c906bfe2916f64dfc6038d6b542fb97cb4ed3d361006365669703d27"
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vintage: "2026-07-01"
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source_snapshot: "https://data.openstates.org/daily/2026-07-01/public.pgdump"
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retrieved_at: "2026-07-06"
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confidence: "reported"
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tags: ["legislation", "bill", "us-in"]
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---
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# Indiana HB 1004 (2020) — Health matters.
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States that the office of the secretary of family and social services and a managed care organization may not prohibit a provider from participating in another insurance network. Defines "weighted average negotiated charge" and requires the weighted average negotiated charge per service per provider type for Medicaid to be reported by hospitals and ambulatory outpatient surgical centers. Requires certain health care providers, beginning July 1, 2021, to provide a good faith estimate to individuals of the price for nonemergency health care services to be provided to the individual by the health care provider and sets forth requirements. Allows an individual to request a good faith estimate from a health care provider for the total price for nonemergency services that have been ordered, scheduled, or referred. and requires the health care provider to provide the good faith estimate. Sets forth requirements for the good faith estimate. Provides that an out of network practitioner who provides health care services to a covered individual in an in network facility may not charge more for the health care services provided to a covered individual than allowed according to the rate or amount of compensation established by the covered individual's network plan unless: (1) at least five days before the health care services are scheduled to be provided, the covered individual is provided a statement that: (A) informs the covered individual that the facility or practitioner intends to charge more than allowed under the network plan; and (B) sets forth an estimate of the charge; and (2) the covered individual signs the statement, signifying the covered individual's consent to the charge. Sets forth notice requirements. Sets forth provisions that a physician noncompete agreement must include in order to be enforceable. Provides for information and notification that an employer must give to a physician who leaves the employment of the provider. Allows an individual to request from a health carrier a good faith estimate of the amount of the cost of nonemergency health care services that the health carrier will pay for or reimburse and the applicable benefit limitations of the nonemergency health care service. Sets forth requirements of a good faith estimate by a health carrier and sets penalties for violations.
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## Version chain
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The bill's text revisions, in order — the diff chain from filing to enrollment.
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1. **Engrossed House Bill (H)** (committee substitute) — [source](http://in-proxy.openstates.org/2020/bills/HB1004/versions/HB1004.04.ENGS)
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2. **Enrolled House Bill (H)** (committee substitute) — [source](http://in-proxy.openstates.org/2020/bills/HB1004/versions/HB1004.05.ENRS)
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3. **House Bill (S)** (committee substitute) — [source](http://in-proxy.openstates.org/2020/bills/HB1004/versions/HB1004.02.COMH)
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4. **House Bill (S)** (committee substitute) — [source](http://in-proxy.openstates.org/2020/bills/HB1004/versions/HB1004.03.COMS)
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5. **Introduced House Bill (H)** (committee substitute) — [source](http://in-proxy.openstates.org/2020/bills/HB1004/versions/HB1004.01.INTR)
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## Votes
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- HB 1004 - Smaltz - 3rd Reading — **99–0** (pass) · lower
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- HB 1004 - Charbonneau - 3rd Reading — **49–1** (pass) · upper
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## Sponsors
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- Ben Smaltz — primary (person)
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- Ed Charbonneau — primary (person)
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- Eric Bassler — primary (person)
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- Brad Barrett — coauthor (person)
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- Jean Breaux — cosponsor (person)
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- Lonnie Randolph — cosponsor (person)
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- Martin Carbaugh — coauthor (person)
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- Matt Lehman — coauthor (person)
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- Victoria Spartz — cosponsor (person)
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## Timeline
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The legislative action history — every referral, reading, and vote.
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- **2020-01-06** Authored by Representative Smaltz
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- **2020-01-06** First reading: referred to Committee on Insurance `reading-1, referral-committee`
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- **2020-01-23** Committee report: amend do pass, adopted `committee-passage`
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- **2020-01-27** Amendment #1 (Shackleford) failed; Roll Call 67: yeas 31, nays 62 `amendment-failure`
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- **2020-01-27** Amendment #3 (Austin) motion withdrawn `amendment-failure, amendment-withdrawal`
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- **2020-01-27** Second reading: ordered engrossed `reading-2`
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- **2020-01-28** Senate sponsors: Senators Charbonneau and Bassler
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- **2020-01-28** Third reading: passed; Roll Call 75: yeas 99, nays 0 `reading-3, passage`
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- **2020-01-28** Representative Barrett added as coauthor
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- **2020-01-28** Representatives Lehman and Carbaugh added as coauthors
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- **2020-01-29** Referred to the Senate
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- **2020-02-05** First reading: referred to Committee on Health and Provider Services `reading-1, referral-committee`
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- **2020-02-27** Committee report: amend do pass, adopted `committee-passage`
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- **2020-02-27** Senator Breaux added as cosponsor
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- **2020-03-02** Amendment #4 (Charbonneau) prevailed; voice vote `amendment-passage, amendment-failure`
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- **2020-03-02** Amendment #5 (Charbonneau) prevailed; voice vote `amendment-passage, amendment-failure`
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- **2020-03-02** Second reading: amended, ordered engrossed `reading-2`
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- **2020-03-02** Senator Randolph added as cosponsor
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- **2020-03-03** Third reading: passed; Roll Call 271: yeas 49, nays 1 `reading-3, passage`
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- **2020-03-03** Senator Spartz added as cosponsor
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- **2020-03-04** Returned to the House with amendments `amendment-failure`
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- **2020-03-04** Motion to dissent filed
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- **2020-03-04** House dissented from Senate amendments `amendment-failure`
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- **2020-03-04** House conferees appointed: Smaltz and Fleming
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- **2020-03-04** House advisors appointed: Carbaugh, Schaibley, Lehman, Judy, Shackleford, Bauer and Campbell
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- **2020-03-05** Representative Fleming removed as conferee
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- **2020-03-05** Representative Austin added as conferee
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- **2020-03-05** Representative Fleming added as advisor
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- **2020-03-05** Senate conferees appointed: Charbonneau and Breaux
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- **2020-03-05** Senate advisors appointed: Brown L and Melton
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- **2020-03-05** Senator Ford Jon added as advisor
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- **2020-03-11** Representative Schaibley removed as advisor
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- **2020-03-11** Representative Austin removed as conferee
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- **2020-03-11** Representative Schaibley added as conferee
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- **2020-03-11** CCR # 1 filed in the House
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- **2020-03-11** CCR # 1 filed in the Senate
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- **2020-03-11** Rules Suspended. Conference Committee Report 1: adopted by the Senate; Roll Call 401: yeas 46, nays 2
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- **2020-03-11** Rules Suspended. Conference Committee Report 1: adopted by the House; Roll Call 397: yeas 59, nays 32
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- **2020-03-12** Signed by the President Pro Tempore
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- **2020-03-16** Signed by the Speaker
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- **2020-03-18** Signed by the Governor `executive-signature`
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- **2020-03-18** Signed by the President of the Senate
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- **2020-03-30** Public Law 93
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## Source
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OpenStates / OpenCivicData bulk snapshot [2026-07-01](https://data.openstates.org/daily/2026-07-01/public.pgdump); origin `ocd-bill/c496dad9-be10-4874-992c-af93e566d084`. Confidence: reported (aggregated from official Indiana legislature records).
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