On Jan. 5, the Indiana General Assembly will convene for a short session, which by law must end March 14. During those weeks, each House member may introduce no more than five bills. Senate members will be limited to 10 proposals each.

While the main issue of debate this year is whether or not the state should amend the constitution to include a cap on property taxes, several health care bills are expected to be introduced.

Assignment of benefits
“On the issues, we will pick up where we left off from last year,” noted Mike Rinebold, ISMA director of Government Relations. “For example, assignment of benefits is something that will definitely come back.”

Last summer, the legislature directed the Health Finance Committee to study whether an insurer should be required to reimburse an out-of-network health care provider. Committee members also studied the effect of open access clauses in insurance contracts, as well as a provider’s ability to control patient panel mix.

Current law requires an insurer who makes a payment to a covered individual for a health care service rendered by a noncontracted provider to include with the payment a notice in large bold type. It must instruct insureds that:

• Payment is due to the out-of-network physician if it has not already been paid in full.
• They (the insureds) are responsible for paying the physician.
• Failure to make the payment violates the law and may result in collection proceedings.

“Insurance companies can still block checks to doctors,” noted Rinebold. “The ISMA is pushing hard for out-of-network doctors to receive checks directly.”

Immunity for charity care
Also this year, the ISMA is working with legislators on a bill that would amend state law to provide liability immunity for physicians who volunteer in free-care clinics. The effort is based on policy adopted by the ISMA House of Delegates in 2008.

“We are working to extend immunity already established in the free clinic to follow a patient into the physician’s office,” explained Rinebold. “It’s part of an effort to encourage more physician participation in providing care to the uninsured.”

Improving complaint form
Frustration with the revised Indiana Department of Insurance (IDOI) complaint form has caused the ISMA to seek legislation. Currently, the IDOI will accept only those complaints involving claims of more than $250.

By direction of our House of Delegates, the ISMA also is seeking a bill to require the IDOI to include all Employee Retirement Income Security Act (ERISA) complaints in each health insurance company’s annual complaint index.

“Physicians have no other recourse to recoup this money, except to go to court. We are simply asking the IDOI to consider all complaints,” said Rinebold.

Medicine Day
You can get involved during this legislative session by attending the ISMA’s Medicine Day on Jan. 20. The event provides an excellent opportunity for you to personally meet with your legislators.

Here’s how to maximize Medicine Day:

• Contact your legislators to let them know you’ll be attending Medicine Day.
• Pre-schedule private meeting times with them on Jan. 20.
• Come to the legislative briefing at breakfast that day and listen for key talking points on hot topics.
• Participate, as appropriate, in committee hearings. (You are urged to wear your white lab coat while at the Statehouse.)
• Attend the noon luncheon with your legislators.

Also, be sure to sign up as a Key Contact. The program alerts you via e-mail to important health care issues that arise during the General Assembly. The alerts provide talking points or standardized messages you can use when talking to your legislators.

For information about these programs or to register, contact the ISMA’s Sally Pierson at (800) 257-4762 or (317) 261-2060, e-mail her.