Indiana Statehouse

Indiana Statehouse

State lawmakers will continue evaluating whether Indiana needs to increase the Medicaid rates it pays on behalf of young Hoosier children, particularly those from Northwest Indiana, who receive treatment for serious illnesses at out-of-state hospitals.

The General Assembly's Legislative Council last month assigned its Interim Study Committee on Fiscal Policy to review the issue of children's hospital Medicaid reimbursement rates and to decide whether to craft recommended changes for lawmakers to consider adopting during the 2020 legislative session.

Earlier this year, the Indiana House and Senate approved separate versions of House Bill 1238 with a goal of ensuring that Hoosier children covered by Medicaid are not at risk of being denied treatment at out-of-state hospitals, due to Indiana paying significantly reduced rates for care at those compared to what it pays for services at Indianapolis' Riley Hospital for Children.

The House version would have established a pilot program to pay the University of Chicago Comer Children's Hospital the same Medicaid reimbursement rates that Riley receives for the approximately 495 Hoosier children ages 6 and under, mostly living in the Region, who annually are treated at Comer.

However, the Senate rewrote the proposal to instead require the Indiana Family and Social Services Administration to merely compile data on the number of Hoosiers receiving Medicaid-covered treatment at out-of-state medical facilities, and to consult with Medicaid directors in neighboring states about appropriate hospital reimbursement rates.

State Sen. Ed Charbonneau, R-Valparaiso, said many states with population centers near their borders are looking at similar issues, and it didn't make sense for Indiana to ink a payment deal with one Chicago hospital when several regions of the state are similarly affected.

Lawmakers from each chamber ultimately were unable to agree on a compromise measure that could again pass the House and Senate before the April 24 adjournment of Indiana's annual legislative session — leaving the issue unresolved.

State Rep. Mara Candelaria Reardon, D-Munster, is optimistic the study committee, composed of both representatives and senators with experience in state finance matters, will see the wisdom of the House proposal and help enact it next year.

"For parents of sick premature babies in Northwest Indiana, Comer is the closest place to obtain Level IV neonatal care," Candelaria Reardon said. "However, Comer has advised the state of Indiana that it may not be able to accept Hoosier children covered by Medicaid as patients if their reimbursement rates are not increased to match the rates that hospitals in Indiana presently receive."

"Without access to Comer, the only other option available to families is the Riley Hospital for Children in Indianapolis. That is a three-hour drive from Northwest Indiana for treatment that often lasts longer than six months. Having to go to Riley for treatment only adds to burdens facing the child and the family that already are immense."

The study committee has not yet scheduled a hearing on the issue, or any of the other topics on its docket, among them education funding, cannabidiol taxes, affordable housing incentives, and evaluations of Indiana's workforce development programs and state tax credit effectiveness.

The panel typically holds its first meeting in August or September, and its second and third meetings in September and October. It is required to issue a final report by Nov. 1.

"The most important thing here is that we do everything in our power to make sure that children get the life-saving treatment they deserve," Candelaria Reardon said. "I will keep a very close watch on this committee's work in the months to come to make sure that worthy goal is achieved."

Other notable topics assigned this year to legislative study committees include the use of speed enforcement cameras in road construction zones, prescription drug pricing, funding options for lead water line replacement, Lake Michigan beach erosion issues, misclassification of company employees as independent contractors and career counseling for elementary and high school students.

Not making the cut was a proposal by state Rep. Earl Harris Jr., D-East Chicago, to study the prevalence of housing and food insecurity at state colleges and universities.

"While this is a slight setback, it does not end our fight," Harris said. "We know that it is important to make sure that people that want to continue their education and training post-high school have those tools in place to help them get to that point."

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