2022 Legislative Agenda

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Patient Safety in Specialty Drug Administration (HB 1158)

  • In 2021, the legislature passed HEA 1405, which directed the Indiana Department of Health (IDOH) to report on the practice of “white bagging" and detail best practices regarding specialty drug administration.
  • White bagging became a hot topic during the 2021 session following a change in insurance company policies requiring hospitals to acquire specialty drugs from insurance company-owned pharmacies.
  • The policy change continues to cause delays in patient care due to delivery issues and incorrect drug dosages, among other concerns.
  • Further, patients with advanced and complex illnesses have not been able to receive treatment timely due to these delays.
  • IDOH released the statutorily required report in July, which concludes that, while white bagging is acceptable in certain contexts, oversight and application of best practices are necessary to ensure patient safety. Additionally, the report concludes that there are circumstances in which white bagging should not be used because it jeopardizes patient health.
  • The members of the Hoosiers for Safe Meds Coalition, including IHA, have since translated the report's conclusions into a bill draft that prioritizes patient safety.
  • The proposed legislation requires the Indiana Board of Pharmacy to promulgate rules defining the appropriate use of white bagging in specialty drug administration and sets guardrails to protect patient safety and pharmacist integrity.
  • Hospitals urge the adoption of this legislation to ensure patients receive the care they need when they need it, without unnecessary, life-threatening delays.

Support for Indiana's Health Care Workforce (HB 1003, SB 5, SB 251​)

  • For the past 22 months, Indiana's health care workforce has faced unprecedented challenges caring for Hoosiers during the COVID-19 pandemic.
  • The pandemic has taken its toll on Indiana's workforce, and especially on nurses, which has led to burnout and an ongoing exodus of workers from the health care industry.
  • The Governor's public health emergency (PHE) provided some needed flexibility for nurses and other health care professionals to care for patients more effectively, but, without action, those flexibilities will end when the PHE ends.
  • Although the immediate nursing shortage is a pressing concern, of equal concern is the lack of future nurses in the workforce pipeline due to a shortage of educators and educational opportunities.
  • To address these concerns, IHA proposes a multi-pronged approach to Nurse Indiana Back to Health:
    • Provide student loan repayment for nurses who continue to practice in Indiana, via a program funded through nurse licensure fees.
    • Increase the pathways for foreign-educated nurses to become licensed in Indiana. 
    • Expand the nursing student pipeline by increasing available nursing preceptors through streamlined preceptor qualification requirements.
    • Improve adjunct to full-time faculty ratios to increase the number of instructors available to teach future nurses.
    • Increase the number of clinical hours that may be conducted via simulation to provide greater flexibility to nursing programs.
    • Implement license reciprocity and licensure compacts for health care professions to allow more nurses and other providers to practice in Indiana.

Parity in Health Care Transparency (HB 1046, SB 249​)

  • Over the past several legislative sessions, hospitals have engaged in numerous transparency measures to ensure that patients have as much information about the cost of their health care as hospitals can provide.
  • These measures include the forthcoming All-Payer Claims Database, posting price information on hospital websites (all available on mycareINsight.org), good faith estimates, and public forums by not-for-profit hospitals.
  • Despite the transparency measures hospitals have undertaken, Hoosiers still lack clarity about the cost of their health care due to insufficient information sharing from other members of the health care industry, including insurance providers and pharmacy benefit managers.
  • To continue improving Indiana's health care costs through full transparency, health insurance providers should also provide additional cost information to the public.
  • For example, requiring health insurance companies to provide the reasoning behind premium increases over 5% will help individual Hoosiers and employers better understand the drivers of cost year over year.
  • While this information alone will not provide the full picture of health care costs, it is one step toward insurance companies achieving transparency parity with hospitals to allow transparency initiatives to drive market forces and help lower the cost of healthcare in Indiana.​