Gov. Mike Braun signed a suite of 10 health care reform bills into law, marking Indiana’s effort to address rising health care costs and systemic inefficiencies. The laws, which Braun called “transformative,” aim to increase transparency, end anti-competitive practices and reduce costs for Hoosier patients.
“I promised Hoosiers I would take on the big health care industry and get solutions to the problems making health care unaffordable,” Braun said. “My partners in the General Assembly and I have enacted landmark health care solutions to bring transparency, accountability and competition to our health care system. Indiana is now the national leader in health care reform and lowering prices for patients.”
The laws cover a wide range of reforms targeting hospitals, insurers, pharmacy benefit managers (PBMs) and Medicaid policies. Each bill is designed to address specific issues contributing to high costs and a lack of accountability in the health care system.
HEA 1003: Patient-centric health care solutions
This comprehensive bill requires nonprofit hospitals with high revenues to implement Site of Service payments for outpatient care, ensuring lower fees for Medicaid and privately insured patients. It expands Indiana’s right-to-try statute to include experimental treatments for rare diseases, prohibits insurers from denying coverage for care referred by out-of-network providers and mandates hospitals and insurers provide upfront cost estimates within 48 hours.
HEA 1004: Reducing hospital prices
This legislation requires nonprofit hospitals to submit audited financial statements or face penalties of $10,000 per day. By 2029, hospitals must lower inpatient and outpatient prices to match Indiana’s statewide average. Additionally, the bill introduces a Medicaid state-directed payment program to encourage cost reduction while revising disproportionate share hospital (DSH) payments to prevent overlap with other state-directed payments.
SEA 2: Medicaid sustainability
This bill reforms Medicaid eligibility and reporting requirements, introducing work requirements and limits on presumptive eligibility for beneficiaries. The goal is to ensure Medicaid remains financially sustainable while reducing potential abuse of the system.
SEA 3: Fiduciary duty in health plan administration
Under this law, PBMs and third-party administrators (TPAs) must act in the best interest of the health plan sponsors they represent. The legislation mandates transparency in fees and contractual arrangements, prohibits self-dealing and requires full disclosure of costs.
SEA 140: Regulating pharmacy benefit managers
This law prohibits PBMs from engaging in anti-competitive practices, such as penalizing pharmacies for offering lower-cost alternatives or reimbursing affiliated pharmacies at higher rates. It aims to promote fair competition and ensure equitable pricing for patients.
SEA 118: Transparency in 340B drug programs
Entities participating in the 340B Discount Drug Program must now report financial transactions to the Indiana Department of Health. Failure to comply will result in daily fines of $1,000.
SEA 475: Banning physician non-compete agreements
This legislation prohibits hospitals from requiring non-compete agreements for physicians, a move aimed at fostering greater competition in the market and allowing patients more provider choices.
HEA 1604: Credit for out-of-pocket costs
This bill mandates that insurers credit patients’ out-of-pocket payments for lower-cost services toward their deductibles, regardless of whether the provider is in-network. The law also ensures cost-sharing limits are applied to prescription drugs without generic alternatives.
HEA 1666: Ownership transparency
Health care entities must disclose ownership structures, and the Indiana Attorney General can investigate market concentration to ensure competitive practices.
SEA 480: Reforming prior authorization
This law streamlines the prior authorization process to protect provider-patient treatment plans and ensure access to timely care.
Supporters of the legislation argue the reforms are essential for addressing the opaque and anti-competitive practices driving up health care costs. However, critics warn of potential unintended consequences, particularly for rural hospitals that may struggle under new compliance and transparency requirements.
To view the bills for the 2025 Indiana legislative session, visit iga.in.gov/legislative/2025/bills.
This reporting is made possible by a grant from the Indianapolis African-American Quality of Life Initiative, empowering our community with essential health insights. https://iaaqli.org/
To read more health stories, click here.
Contact Health & Environmental Reporter Hanna Rauworth at 317-762-7854 or follow her on Instagram at @hanna.rauworth.
Hanna Rauworth is the Health & Environmental Reporter for the Indianapolis Recorder Newspaper, where she covers topics at the intersection of public health, environmental issues, and community impact. With a commitment to storytelling that informs and empowers, she strives to highlight the challenges and solutions shaping the well-being of Indianapolis residents.
