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Transparent Pricing Mandated by Law in Indiana House Bill 1004

On June of 2019, the White House published the "Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First." Since then, lawmakers and forward-thinking care facilities have been implementing policies to create a more transparent healthcare experience.

The most recent bill, Indiana House Bill 1004, requires "health care providers, beginning July 1, 2021, to provide a good faith estimate to individuals" for nonemergency services.

Out of Network Practitioners

Along with the new guidelines concerning estimates, the bill also states that out-of-network practitioners cannot charge more for healthcare services than the patient's plan permits. That is, unless the patient receives a transparent pricing estimate at least 5 days prior to the service that includes the following:

  • Notices informing patients that the facility or practitioner intends to charge more than is allowed under the patient's network plan
  • Clear estimates of all charges 

The bill, passed on March 30, 2020, also requires that patients sign the estimate statement to show consent.

Along with many other legislative efforts across the country, this bill targets surprise billing and other deceptive practices that limit patient access to data for more informed decision making.

This bill comes on the heels of the rise of high deductible health plans that have forced patients to assume greater responsibility for their healthcare. With the nationwide mandated push towards greater price transparency, healthcare facilities that quickly adapt and offer clear cost estimates will get ahead of coming legislation and win over consumer-minded patients.