CHAPTER 6. HOSPITAL FINANCIAL DISCLOSURE LAW
IC 16-21-6
Chapter 6. Hospital Financial Disclosure Law
IC 16-21-6-0.1
Contractual allowances defined
Sec. 0.1. As used in this chapter, "contractual allowances" meansthe difference between revenue at established rates and amountsrealizable from third party payors under contractual agreements.
As added by P.L.94-1994, SEC.12.
IC 16-21-6-0.2
Education related costs defined
Sec. 0.2. As used in this chapter, "education related costs" meansthe unreimbursed cost to a hospital of providing, funding, orotherwise financially supporting educational benefits, services, andprograms, including:
(1) education of physicians, nurses, technicians, and othermedical professionals and health care providers;
(2) provision of scholarships and funding to medical schoolsand other postsecondary educational institutions for healthprofessions education;
(3) education of patients concerning diseases and home care inresponse to community needs; and
(4) community health education through informationalprograms, publications, and outreach activities in response tocommunity needs.
As added by P.L.94-1994, SEC.13. Amended by P.L.2-2007,SEC.189.
IC 16-21-6-1
Gross patient revenue defined
Sec. 1. As used in this chapter, "gross patient revenue" meansinpatient and outpatient revenue from services to patients, includingpayments received from or on behalf of individual patients.
As added by P.L.2-1993, SEC.4.
IC 16-21-6-2
Net patient revenue defined
Sec. 2. As used in this chapter, "net patient revenue" means grosspatient revenue less deductions for contractual adjustments, baddebts, and charity.
As added by P.L.2-1993, SEC.4.
IC 16-21-6-3
Fiscal reports; required documentation
Sec. 3. (a) Each hospital shall file with the state department areport for the preceding fiscal year within one hundred twenty (120)days after the end of the hospital's fiscal year. The state departmentshall grant an extension of the time to file the report if the hospitalshows good cause for the extension. The report must contain the
following:
(1) A copy of the hospital's balance sheet, including a statementdescribing the hospital's total assets and total liabilities.
(2) A copy of the hospital's income statement.
(3) A statement of changes in financial position.
(4) A statement of changes in fund balance.
(5) Accountant notes pertaining to the report.
(6) A copy of the hospital's report required to be filed annuallyunder 42 U.S.C. 1395g, and other appropriate utilization andfinancial reports required to be filed under federal statutory law.
(7) Net patient revenue.
(8) A statement including:
(A) Medicare gross revenue;
(B) Medicaid gross revenue;
(C) other revenue from state programs;
(D) revenue from local government programs;
(E) local tax support;
(F) charitable contributions;
(G) other third party payments;
(H) gross inpatient revenue;
(I) gross outpatient revenue;
(J) contractual allowance;
(K) any other deductions from revenue;
(L) charity care provided;
(M) itemization of bad debt expense; and
(N) an estimation of the unreimbursed cost of subsidizedhealth services.
(9) A statement itemizing donations.
(10) A statement describing the total cost of reimbursed andunreimbursed research.
(11) A statement describing the total cost of reimbursed andunreimbursed education separated into the following categories:
(A) Education of physicians, nurses, technicians, and othermedical professionals and health care providers.
(B) Scholarships and funding to medical schools, and otherpostsecondary educational institutions for health professionseducation.
(C) Education of patients concerning diseases and home carein response to community needs.
(D) Community health education through informationalprograms, publications, and outreach activities in responseto community needs.
(E) Other educational services resulting in education relatedcosts.
(b) The information in the report filed under subsection (a) mustbe provided from reports or audits certified by an independentcertified public accountant or by the state board of accounts.
As added by P.L.2-1993, SEC.4. Amended by P.L.94-1994, SEC.14;P.L.2-2007, SEC.190.
IC 16-21-6-4
Repealed
(Repealed by P.L.1-2010, SEC.156.)
IC 16-21-6-5
Fiscal reports; further verifying information
Sec. 5. If further fiscal information is necessary to verify theaccuracy of any information contained in the reports filed undersection 3 of this chapter, the state department may require the facilityto produce the records necessary to verify that information.
As added by P.L.2-1993, SEC.4.
IC 16-21-6-6
Patient information reports
Sec. 6. In addition to the report filed under section 3 of thischapter, each hospital shall, not more than one hundred twenty (120)days after the end of each calendar quarter, file with the statedepartment, or the state department's designated contractor, inpatientand outpatient discharge information at the patient level, in a formatprescribed by the state health commissioner, including the following:
(1) The patient's:
(A) length of stay;
(B) diagnoses and surgical procedures performed during thepatient's stay;
(C) date of:
(i) admission;
(ii) discharge; and
(iii) birth;
(D) type of admission;
(E) admission source;
(F) gender;
(G) race;
(H) discharge disposition; and
(I) payor, including:
(i) Medicare;
(ii) Medicaid;
(iii) a local government program;
(iv) commercial insurance;
(v) self-pay; and
(vi) charity care.
(2) The total charge for the patient's stay.
(3) The ZIP code of the patient's residence.
As added by P.L.2-1993, SEC.4. Amended by P.L.94-1994, SEC.15;P.L.44-2002, SEC.3.
IC 16-21-6-7
Fiscal and patient information reports; personal identification ofpatients; public inspection; copies
Sec. 7. (a) The reports filed under section 3 of this chapter:
(1) may not contain information that personally identifies a
patient or a consumer of health services; and
(2) must be open to public inspection.
(b) The state department shall provide copies of the reports filedunder section 3 of this chapter to the public upon request, at the statedepartment's actual cost.
(c) The following apply to information that is filed under section6 of this chapter:
(1) Information filed with the state department's designatedcontractor:
(A) is confidential; and
(B) must be transferred by the contractor to the statedepartment in a format determined by the state department.
(2) Information filed with the state department or transferred tothe state department by the state department's designatedcontractor is not confidential, except that information that:
(A) personally identifies; or
(B) may be used to personally identify;
a patient or consumer may not be disclosed to a third party otherthan to a hospital that has filed inpatient and outpatientdischarge information.
(d) An analysis completed by the state department of informationthat is filed under section 6 of this chapter:
(1) may not contain information that personally identifies ormay be used to personally identify a patient or consumer ofhealth services, unless the information is determined by thestate department to be necessary for a public health activity;
(2) must be open to public inspection; and
(3) must be provided to the public by the state department uponrequest at the state department's actual cost.
As added by P.L.2-1993, SEC.4. Amended by P.L.44-2002, SEC.4;P.L.78-2004, SEC.22.
IC 16-21-6-8
Compliance; injunctive relief
Sec. 8. The state department may, through the attorney general,seek to compel compliance with this chapter through injunctiverelief.
As added by P.L.2-1993, SEC.4.
IC 16-21-6-9
Rules; uniform reporting system
Sec. 9. (a) The state department shall adopt rules under IC 4-22-2necessary to carry out this chapter.
(b) The rules adopted under this section must include rules thatestablish a uniform system for completing the reports required undersections 3 and 6 of this chapter.
(c) The rules adopted under this section must provide that, to thegreatest extent possible, copies of reports required to be filed withfederal, state, and local agencies may be used by facilities incompleting the reports required by this chapter.As added by P.L.2-1993, SEC.4.
IC 16-21-6-10
State health commissioner; findings and recommendations; report
Sec. 10. Each year the state health commissioner or thecommissioner's designee shall make a compilation of the dataobtained from the reports required under sections 3 and 6 of thischapter and report in an electronic format under IC 5-14-6 thefindings and recommendations to the general assembly not later thanDecember 1 of the year the reports are filed. However, thecommissioner is not required to incorporate a report that is requiredto be filed by a hospital with the state department less than onehundred twenty (120) days before December 1, but shall incorporatethe report data in the report to be made the following year.
As added by P.L.2-1993, SEC.4. Amended by P.L.28-2004, SEC.136.
IC 16-21-6-11
Consumer guide to Indiana hospitals
Sec. 11. (a) The state department shall annually publish aconsumer guide to Indiana hospitals. The state department shallcompile the data for the consumer guide from the relevant datarequired to be filed under sections 3 and 6 of this chapter and publishthe data in an understandable format that assists the consumingpublic in making both financial and utilization comparisons betweenhospitals.
(b) The state department shall, upon request, provide to thepublic, at the state department's actual cost, copies of the consumerguide to Indiana hospitals published under subsection (a).
As added by P.L.2-1993, SEC.4.
IC 16-21-6-12
Violations
Sec. 12. Any person who is a custodian of confidential data at thestate department and who knowingly or intentionally:
(1) discloses, distributes, or sells confidential data obtainedunder this chapter; or
(2) identifies a specific patient in violation of section 7 of thischapter;
commits a Class B misdemeanor.
As added by P.L.94-1994, SEC.16.