reglab/statecodes huggingface dataset:
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 10. Hospital Assessment Fee › 16-21-10-11. Disproportionate Share Payments; Allocations of Federal Medicaid Disproportionate Share Allotments

Sec. 11. (a) This section:
(1) does not apply to the incremental fee described in section 13.3 of this chapter;
(2) is effective upon the implementation of the fee described in section 6 of this chapter, excluding the part of the fee used for purposes of section 13.3 of this chapter; and
(3) applies to the Medicaid disproportionate share payments for the state fiscal year beginning July 1, 2013, and each state fiscal year thereafter.
(b) The state share dollars used to fund disproportionate share payments to acute care hospitals licensed under IC 16-21-2 that qualify as disproportionate share providers or municipal disproportionate share providers under IC 12-15-16-1(a) or IC 12-15-16-1(b) shall be paid with money collected through the fee and the hospital care for the indigent dollars described in section 10 of this chapter.
(c) The federal Medicaid disproportionate share allotments for the state fiscal years beginning July 1, 2013, and each state fiscal year thereafter shall be allocated in their entirety to acute care hospitals licensed under IC 16-21-2 that qualify as disproportionate share providers or municipal disproportionate share providers under IC 12-15-16-1(a) or IC 12-15-16-1(b). No part of the federal disproportionate share allotments applicable for disproportionate share payments for the state fiscal year beginning July 1, 2013, and each state fiscal year thereafter may be allocated to institutions for mental disease or other mental health facilities, as defined by applicable federal law.
As added by P.L.205-2013, SEC.214. Amended by P.L.213-2015, SEC.145; P.L.30-2016, SEC.38.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 10. Hospital Assessment Fee › 16-21-10-13. Disproportionate Share Dollars That Are Unavailable to Private Psychiatric Institutions

Sec. 13. This section does not apply to the use of the incremental fee described in section 13.3 of this chapter. Notwithstanding IC 12-15-16-6(c), the annual two million dollar ($2,000,000) pool of disproportionate share dollars under IC 12-15-16-6(c) shall not be available to eligible private psychiatric institutions. The office shall annually distribute two million dollars ($2,000,000) to eligible private psychiatric institutions that would have been eligible for payment under IC 12-15-16-6(c).
As added by P.L.205-2013, SEC.214. Amended by P.L.213-2015, SEC.147.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 10. Hospital Assessment Fee › 16-21-10-13.5. Incremental Hospital Fee Fund Established; Content; Administration; Uses; Distribution of Remaining Fund During Phase Out Period to Hospitals

Sec. 13.5. (a) The incremental hospital fee fund is established for the purpose of holding fees collected under section 13.3 of this chapter.
(b) The office shall administer the fund.
(c) Money in the fund consists of the following:
(1) Fees collected under section 13.3 of this chapter.
(2) Donations, gifts, and money received from any other source.
(3) Interest accrued under this section.
(d) Money in the fund may be used only for the following:
(1) To fund exclusively the state share of the expenses listed in section 13.3(b)(1)(A) through 13.3(b)(1)(F) of this chapter.
(2) To refund hospitals in the same manner as described in subsection (g) as soon as reasonably possible after the beginning of a phase out period of the healthy Indiana plan.
(e) Money remaining in the fund at the end of a state fiscal year does not revert to the state general fund.
(f) The treasurer of state shall invest the money in the fund not currently needed to meet the obligations of the fund in the same manner as other public funds may be invested. Interest that accrues from these investments shall be deposited in the fund.
(g) Upon the beginning of a phase out period of the healthy Indiana plan, money collected under section 13.3 of this chapter and any accrued interest remaining in the fund shall be distributed to the hospitals on a pro rata basis based upon the fees authorized by this chapter that were paid by each hospital for the state fiscal year that ended immediately before the beginning of the phase out period.
As added by P.L.213-2015, SEC.149. Amended by P.L.30-2016, SEC.41.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 10. Hospital Assessment Fee › 16-21-10-14. Permissible Uses of Hospital Assessment Fees

Sec. 14. This section does not apply to the use of the incremental fee described in section 13.3 of this chapter. The fees collected under section 8 of this chapter may be used only as described in this chapter or to pay the state's share of the cost for Medicaid services provided under the federal Medicaid program (42 U.S.C. 1396 et seq.) as follows:
(1) Twenty-eight and five-tenths percent (28.5%) may be used by the office for Medicaid expenses.
(2) Seventy-one and five-tenths percent (71.5%) to hospitals.
As added by P.L.205-2013, SEC.214. Amended by P.L.213-2015, SEC.150.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 10. Hospital Assessment Fee › 16-21-10-15. Rule of Statutory Construction; Local Fees, Taxes, or Assessments Not Permitted

Sec. 15. This chapter may not be construed to authorize any county, municipality, district, or authority to impose a fee, tax, or assessment on a hospital.
As added by P.L.205-2013, SEC.214.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 10. Hospital Assessment Fee › 16-21-10-16. Rules

Sec. 16. Subject to section 8(b) of this chapter, the office may adopt rules, including emergency rules adopted in the manner provided under IC 4-22-2-37.1, necessary to implement this chapter. Rules adopted under this section may be retroactive to the effective date of the Medicaid state plan amendments or waivers approved under this chapter.
As added by P.L.205-2013, SEC.214.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 10. Hospital Assessment Fee › 16-21-10-18. Interest on Late Payments; License Revocations for Payments at Least 120 Days Overdue

Sec. 18. (a) A hospital shall pay to the office interest on any fee that is paid eleven (11) or more days after the payment date. The interest must be applied at the same rate as the rate determined under IC 12-15-21-3(6)(A).
(b) The office shall report to the state department of health each hospital that fails to pay the fee within one hundred twenty (120) days after the payment date. The state department shall do the following concerning a hospital described in this subsection:
(1) Notify the hospital that the hospital's license under IC 16-21 will be revoked if the fee is not paid.
(2) Revoke the hospital's license under IC 16-21 if the hospital fails to pay the fee. IC 4-21.5-3-8 and IC 4-21.5-4 apply to this subdivision.
As added by P.L.205-2013, SEC.214.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 10. Hospital Assessment Fee › 16-21-10-19. Program Payments

Sec. 19. Payments for the programs described in section 8(a) of this chapter are limited to claims for dates of services provided during the fee period and that are timely filed with the office or a contractor of the office. Payments for the programs described in section 8(a) of this chapter and payments to hospitals in accordance with section 11 of this chapter may occur at any time, including after collection of the fee is stopped under section 6(b) of this chapter, to the extent the funding provided for the payments by this chapter is available under section 9(c) of this chapter. Payments for the program described in section 13 of this chapter may occur at any time, including after the collection of the fee is stopped under section 6(b) of this chapter, subject to the reconciliation and termination of the program required by section 6(b) of this chapter.
As added by P.L.205-2013, SEC.214.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 10. Hospital Assessment Fee › 16-21-10-20. Collection of Unpaid Fees; Refunds

Sec. 20. The office may collect unpaid fees owed by a hospital under this chapter and may refund fees paid by a hospital under this chapter at any time, including after the cessation of the collection of a fee under this chapter.
As added by P.L.205-2013, SEC.214.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 10. Hospital Assessment Fee › 16-21-10-21. Expiration Date

Sec. 21. This chapter expires June 30, 2025.
As added by P.L.205-2013, SEC.214. Amended by P.L.217-2017, SEC.85; P.L.108-2019, SEC.203; P.L.165-2021, SEC.146; P.L.201-2023, SEC.148.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 11. Treatment of Miscarried Remains › 16-21-11-1. "Health Care Facility"

Sec. 1. As used in this chapter, "health care facility" means any of the following:
(1) A hospital.
(2) A birthing center.
(3) Any other medical facility.
As added by P.L.127-2014, SEC.4.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 11. Treatment of Miscarried Remains › 16-21-11-2. "Miscarried Fetus"

Sec. 2. As used in this chapter, "miscarried fetus" means an unborn child, irrespective of gestational age, who has died from a spontaneous or accidental death before expulsion or extraction from the unborn child's mother, irrespective of the duration of the pregnancy.
As added by P.L.127-2014, SEC.4.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 11. Treatment of Miscarried Remains › 16-21-11-3. "Person in Charge of Interment"

Sec. 3. As used in this chapter, "person in charge of interment" means a person who places or causes to be placed the body of a miscarried fetus who has a gestational age of less than twenty (20) weeks of age or the ashes, after cremation, in a grave, vault, urn, or other receptacle, or who otherwise disposes of the body or ashes.
As added by P.L.127-2014, SEC.4.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 11. Treatment of Miscarried Remains › 16-21-11-4. Determination of Disposition

Sec. 4. Subject to sections 5 and 6 of this chapter, the parent or parents of a miscarried fetus may determine the final disposition of the remains of the miscarried fetus.
As added by P.L.127-2014, SEC.4.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 11. Treatment of Miscarried Remains › 16-21-11-5. Information Required; Final Disposition Decision

Sec. 5. (a) Not more than twenty-four (24) hours after a woman has her miscarried fetus expelled or extracted in a health care facility, the health care facility shall:
(1) disclose to the parent or parents of the miscarried fetus, both orally and in writing, the parent's right to determine the final disposition of the remains of the miscarried fetus;
(2) provide the parent or parents of the miscarried fetus with written information concerning the available options for disposition of the miscarried fetus under section 6 of this chapter and IC 16-41-16-7.6; and
(3) inform the parent or parents of the miscarried fetus of counseling that may be available concerning the death of the miscarried fetus.
(b) The parent or parents of a miscarried fetus shall inform the health care facility of the parent's decision for final disposition of the miscarried fetus after receiving the information required in subsection (a) but before the parent of the miscarried fetus is discharged from the health care facility. The health care facility shall document the parent's decision in the medical record.
As added by P.L.127-2014, SEC.4. Amended by P.L.213-2016, SEC.10.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 11. Treatment of Miscarried Remains › 16-21-11-6. Disposition by Cremation or Interment; Costs; Permits; Confidential Information

Sec. 6. (a) If the parent or parents choose a location of final disposition other than the location of final disposition that is usual and customary for the health care facility, the parent or parents are responsible for the costs related to the final disposition of the fetus at the chosen location.
(b) A health care facility having possession of a miscarried fetus shall provide for the final disposition of the miscarried fetus. The burial transit permit requirements under IC 16-37-3 apply to the final disposition of the miscarried fetus, which must be cremated or interred. However:
(1) a person is not required to designate a name for the miscarried fetus on the burial transit permit and the space for a name may remain blank; and
(2) any information submitted under this section that may be used to identify the parent or parents is confidential and must be redacted from any public records maintained under IC 16-37-3.
Miscarried fetuses may be cremated by simultaneous cremation.
(c) The local health officer shall provide the person in charge of interment with a permit for the disposition of the body. A certificate of stillbirth is not required to be issued for a final disposition of a miscarried fetus having a gestational age of less than twenty (20) weeks.
(d) IC 23-14-31-26, IC 23-14-55-2, IC 25-15-9-18, and IC 29-2-19-17 concerning the authorization of disposition of human remains apply to this section.
As added by P.L.127-2014, SEC.4. Amended by P.L.213-2016, SEC.11.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-1. "After Care"

Sec. 1. As used in this chapter, "after care" means assistance provided by a lay caregiver to a patient in the patient's residence under an at home care plan following the patient's discharge from a hospital. The assistance may include any of the following:
(1) Assisting with basic activities of daily living.
(2) Assisting with instrumental activities of daily living.
(3) Assisting with medical or nursing tasks, including:
(A) managing wound care;
(B) assisting in administering medications; or
(C) operating medical equipment.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-2. "At Home Care Plan"

Sec. 2. As used in this chapter, "at home care plan" means any plan that serves to describe the after care needs of a patient upon discharge from a hospital to the patient's residence, if the at home care plan:
(1) is developed by:
(A) a registered nurse licensed under IC 25-23, social worker licensed under IC 25-23.6, or other licensed health care professional; or
(B) an individual supervised by a licensed registered nurse, licensed social worker, or other licensed health care professional;
(2) is based on an evaluation of the patient's need for after care, taking into consideration the patient's functional status and cognitive ability, including the patient's capacity for self care; and
(3) includes contact information for hospital personnel or the patient's physician if the patient or the patient's lay caregiver designated under this chapter has questions regarding the patient's after care.
The term includes a discharge plan prepared for the patient that is developed under the discharge planning requirements of the Medicare program's conditions of participation.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-3. "Discharge"

Sec. 3. As used in this chapter, "discharge" means a patient's exit or release from a hospital following an inpatient hospitalization.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-4. "Health Care Representative"

Sec. 4. As used in this chapter, "health care representative" means an individual:
(1) appointed as the patient's health care representative under IC 16-36-1-7;
(2) appointed as the patient's health care representative under IC 16-36-7; or
(3) holding the patient's health care power of attorney under IC 30-5-5-16.
However, if the patient has not appointed a health care representative under IC 16-36-1-7 or IC 16-36-7 or granted a health care power of attorney to an individual under IC 30-5-5-16, the term means an individual authorized to consent to health care for the patient under IC 16-36-7-42.
As added by P.L.137-2015, SEC.6. Amended by P.L.50-2021, SEC.33.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-5. "Lay Caregiver"

Sec. 5. As used in this chapter, "lay caregiver" means an individual who:
(1) has a significant relationship with a patient;
(2) is designated as a lay caregiver by:
(A) the patient;
(B) the patient's health care representative; or
(C) if the patient has not appointed a health care representative, the patient's legal guardian;
under this chapter; and
(3) provides after care to the patient.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-6. "Residence"

Sec. 6. As used in this chapter, "residence" means a dwelling considered by a patient to be the patient's temporary or permanent home. The term does not include a hospital licensed under this article, a health facility or residential care facility licensed under IC 16-28, a state mental health institution operated under IC 12-24-1-3, a private mental health institution licensed under IC 12-25, an assisted living facility registered with the office of the secretary of family and social services as a housing with services establishment, or an institution or facility operated by the department of correction or a law enforcement agency.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-7. Opportunity to Designate Lay Caregiver; Documentation; Hospital Responsibilities Upon Designation

Sec. 7. (a) As soon as practicable following a patient's admission to a hospital as an inpatient and before the patient's discharge from the hospital to the patient's residence or transfer to another facility, the hospital shall provide each patient or the patient's health care representative with an opportunity to designate a lay caregiver. A patient or the patient's health care representative may decline to designate a lay caregiver.
(b) If a patient or the patient's health care representative declines to designate a lay caregiver, or does not provide the written consent or the information described in subsection (c), the hospital shall document that fact in the patient's medical record and the hospital is considered to have complied with the requirements of this chapter.
(c) If a patient or the patient's health care representative designates a lay caregiver, the hospital shall do the following:
(1) Request written consent by the patient or the patient's health care representative to release medical information to the patient's designated lay caregiver following the hospital's procedures for releasing personal health information in compliance with federal and state laws.
(2) Record the following information in the patient's medical record concerning the designated lay caregiver:
(A) The name, address, and telephone number of the designated lay caregiver.
(B) The relationship between the patient and the designated lay caregiver.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-8. Provision of Preferred Means to Contact Lay Caregiver; Use by Hospital; Notification to Lay Caregiver if Patient Unable

Sec. 8. (a) If a patient or the patient's health care representative designates a lay caregiver, and provides the written consent and the other information described in section 7(c) of this chapter, the hospital shall, as soon as practicable before the patient's discharge from the hospital, provide the patient or the patient's health care representative with an opportunity to advise hospital personnel of a preferred means of contacting the lay caregiver.
(b) If the patient or the patient's health care representative advises hospital personnel of a preferred means of contacting the designated lay caregiver under subsection (a), the hospital shall, when attempting to contact a patient's designated lay caregiver, attempt to use the preferred means of contact provided in subsection (a) if the preferred means of contact is permitted by the hospital and is readily available for use by hospital personnel when attempting to contact the lay caregiver.
(c) If hospital personnel, in the exercise of their professional judgment, determine that a patient lacks the physical or mental capacity to accurately and timely notify the patient's lay caregiver of the patient's pending discharge or transfer to another facility, the hospital shall, within a reasonable time before the patient's discharge or transfer, attempt to notify the patient's lay caregiver of the pending discharge or transfer.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-9. Hospital Attempt to Consult With Lay Caregiver; at Home Care Plan

Sec. 9. (a) If a patient or the patient's health care representative:
(1) designates a lay caregiver; and
(2) provides the written consent and the other information described in section 7(c) of this chapter;
the hospital shall, as soon as practicable before the patient's discharge from a hospital, attempt to consult with the designated lay caregiver to prepare the lay caregiver for the patient's after care needs and issue an at home care plan that describes the patient's after care needs upon discharge from the hospital to the patient's residence.
(b) An at home care plan may include contact information for health care, community resources, and long term services and supports necessary to successfully carry out the patient's at home care plan.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-10. Opportunity for Lay Caregiver to Ask Questions; Live or Recorded Demonstration of After Care Needs

Sec. 10. (a) As part of the consultation under section 9(a) of this chapter, the hospital shall attempt to provide the designated lay caregiver the opportunity to ask questions and receive answers about the after care needs of the patient.
(b) If the hospital personnel who consult with the lay caregiver under section 9(a) of this chapter, determine, in the exercise of their professional judgment, that a live or recorded demonstration is necessary in order to appropriately prepare the lay caregiver for the patient's after care needs, the hospital may provide to a designated lay caregiver a live or recorded demonstration of the after care described in the patient's at home care plan.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-11. No Interference or Delay of Medical Care if Unable to Contact Lay Caregiver

Sec. 11. If the hospital is unable to contact the designated lay caregiver, the lack of contact may not interfere with, delay, or otherwise affect the medical care provided to the patient or an otherwise appropriate discharge or transfer to another facility.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-12. No Requirement to Designate Lay Caregiver

Sec. 12. This chapter may not be construed to require a patient or the patient's health care representative to designate a lay caregiver.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-13. No Obligation for Lay Caregiver to Perform After Care

Sec. 13. The designation of a lay caregiver does not obligate any individual to perform any after care for the patient.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-14. No Interference With, Delay, or Affect on Patient Care

Sec. 14. A hospital may not allow the process of appointing or the refusal or failure to appoint a lay caregiver for a patient to interfere with, delay, or otherwise affect the services that the hospital provides to a patient.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-15. No Interference With Health Care Representative Rights; No Private Right of Action Against Hospital

Sec. 15. (a) This chapter may not be construed to interfere with the rights of a health care representative appointed under IC 16-36-1 or a health care representative appointed under IC 16-36-7.
(b) This chapter may not be construed to create a private right of action against a hospital, a hospital employee, or an individual with whom a hospital has a contractual relationship.
(c) No cause of action of any type arises against a hospital, a hospital employee, a staff member, or an individual with whom a hospital has a contractual relationship based upon an act or omission of a lay caregiver.
As added by P.L.137-2015, SEC.6. Amended by P.L.50-2021, SEC.34.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 12. The Caregiver Advise, Record, and Enable (Care) Act › 16-21-12-16. No New Reimbursement Requirements Under Chapter

Sec. 16. This chapter may not be construed to establish a new requirement to reimburse or otherwise pay for services rendered by a lay caregiver for after care services.
As added by P.L.137-2015, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 13. Perinatal Levels of Care Designation and Perinatal Centers › 16-21-13-1. Establishment of Program; Certification

Sec. 1. (a) The state department shall establish a program to certify perinatal levels of care designations for every hospital and birthing center licensed under this article that provides birthing services.
(b) The program must include obstetrics level certification and neonatal level certification.
(c) The certification under this chapter is not part of licensure actions under this article.
As added by P.L.16-2018, SEC.2.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 13. Perinatal Levels of Care Designation and Perinatal Centers › 16-21-13-2. Department Authority

Sec. 2. The state department may do any of the following:
(1) Change the perinatal level of care designation for a hospital or birthing center if the state department determines that the hospital or birthing center failed to meet the standards necessary for the designated perinatal level of care.
(2) Investigate a complaint against a hospital or birthing center concerning a perinatal certification.
As added by P.L.16-2018, SEC.2.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 13. Perinatal Levels of Care Designation and Perinatal Centers › 16-21-13-3. Requirements to Operate as Perinatal Center; Peer Review; Review

Sec. 3. (a) A hospital or birthing center licensed under this article that offers birthing services may operate as a perinatal center if the hospital or birthing center complies with the perinatal certification requirements of the following:
(1) The American Academy of Pediatrics.
(2) The American College of Obstetricians and Gynecologists.
(b) A perinatal center may perform peer review (as described in IC 34-30-15) for:
(1) the perinatal center;
(2) other hospitals; or
(3) other birthing centers;
that offer birthing services. This subsection does not prevent a perinatal center from performing its own peer review.
(c) Peer review performed by a perinatal center under this chapter must comply with IC 34-30-15.
As added by P.L.16-2018, SEC.2.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 13. Perinatal Levels of Care Designation and Perinatal Centers › 16-21-13-4. Review Under Ic 4-21.5

Sec. 4. A decision by the state department under this chapter is subject to review under IC 4-21.5.
As added by P.L.16-2018, SEC.2.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 13. Perinatal Levels of Care Designation and Perinatal Centers › 16-21-13-5. Rules; Regulation of Interfacility Patient Transfers

Sec. 5. (a) The state department shall adopt rules under IC 4-22-2 to implement this chapter.
(b) The rules adopted under this section may include regulation of interfacility patient transfers.
As added by P.L.16-2018, SEC.2.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 14. Sepsis Guidelines › 16-21-14-1. Application of Chapter; Adoption of Guidelines

Sec. 1. (a) This section and section 2 of this chapter do not apply to the following:
(1) A hospital that primarily provides inpatient and outpatient services to a pediatric population.
(2) A psychiatric hospital (as defined in IC 12-7-2-151).
(b) Each hospital shall adopt, implement, and periodically update evidence based sepsis guidelines for the early recognition and treatment of patients with sepsis, severe sepsis, or septic shock that are based on generally accepted guidelines. The sepsis guidelines must include components specific to the identification, care, and treatment of adults.
As added by P.L.133-2019, SEC.1.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 14. Sepsis Guidelines › 16-21-14-2. Guidelines Provided to Department; Presumption of Meeting Guideline Requirements

Sec. 2. (a) The sepsis guidelines adopted under this chapter shall be provided to the state department upon the state department's request.
(b) A hospital that submits sepsis data as required by the Centers for Medicare and Medicaid Services Hospital Inpatient Quality Reporting program is presumed to meet the sepsis guideline requirements in section 1 of this chapter.
As added by P.L.133-2019, SEC.1.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-0.5. Findings; Applicability

Sec. 0.5. (a) The general assembly finds the following as it relates only to section 1 of this chapter:
(1) A hospital merger may benefit the public by maintaining or improving the quality, efficiency, and accessibility of health care services offered to the public.
(2) Benefits resulting from a hospital merger may outweigh any anticompetitive effects of joining together competitors, including addressing unique challenges in providing health care services in rural areas.
(3) It is in the state's best interest to supplant state and federal antitrust law with a process for regulatory approval and active supervision by the state department, as provided in this chapter.
(4) It is the intent of the general assembly that this chapter immunize, to the fullest extent possible, the following from all federal and state antitrust laws:
(A) The execution of merger agreements approved under this chapter and the transactions concerning the merger.
(B) Postmerger activities supervised under this chapter.
(b) This section applies only to merger agreements allowed under this chapter.
As added by P.L.62-2022, SEC.2.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-1. Application of Chapter

Sec. 1. This chapter applies to a merger agreement between hospitals located in a county that meets the following criteria:
(1) Has a population that is less than one hundred forty thousand (140,000) and is not contiguous to a county with a population of more than two hundred fifty thousand (250,000).
(2) Has only two (2) hospitals that are both in the statewide comprehensive trauma care system under IC 16-19-3-28 and one (1) of the hospitals is a teaching hospital with a medical residency program.
(3) Is a predominately rural county.
As added by P.L.104-2021, SEC.2.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-1.5. "Merger"; "Merger Agreement"

Sec. 1.5. (a) As used in this chapter, "merger" means any change of ownership, including:
(1) an acquisition or transfer of assets; or
(2) the purchase of stock effectuated by a merger agreement.
(b) As used in this chapter, "merger agreement" means an agreement between two (2) or more hospitals for the consolidation by merger or other acquisition or transfer of assets by which ownership or control over substantially all of the stock, assets, or activities of one (1) or more previously licensed and operating hospitals is placed under the control of another licensed hospital or other entity that controls hospitals.
As added by P.L.62-2022, SEC.3.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-2. Affect on Antitrust Immunity; Requirements for Subsequent Purchases

Sec. 2. (a) Nothing in this chapter affects antitrust immunity provided through any other provision of state or federal law.
(b) A hospital that has been issued a certificate of public advantage under this chapter may not be purchased by another hospital or system of hospitals unless the purchase has been approved by the Federal Trade Commission.
As added by P.L.104-2021, SEC.2.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-3. Merger Agreement Application; Requirements; Filing; Fees; Costs

Sec. 3. (a) Any hospital entering into a merger agreement with another hospital may submit an application to the state department for a certificate of public advantage to govern the merger agreement in the manner prescribed by the state department. However, a hospital may not submit an application under this chapter after July 1, 2026.
(b) The application for a certificate of public advantage must include the following:
(1) A written copy of the merger agreement.
(2) A written description of the nature and scope of the merger.
(c) Any documentation submitted under this section with the application that is deemed to be proprietary information shall be clearly identified as proprietary information and a copy of the application with the proprietary information redacted for public records must be submitted by the applicant.
(d) An applicant must also file a complete copy of the application for a certificate of public advantage with:
(1) the office of the secretary of family and social services in a manner prescribed by the office of the secretary; and
(2) the office of the attorney general in a manner prescribed by the office of the attorney general.
(e) The state department shall assess a filing fee for an application for a certificate of public advantage that is reasonably sufficient to fully fund the costs of the review of the application and ongoing supervision if the application is granted, including any fees for consultants and experts. The state department may not spend any money on the implementation of this chapter until the state department has received a filed application and received the filing fee.
(f) If the state department incurs costs of the review of the application and administration of the program that exceed the application fee collected, the applicant for a certificate of public advantage shall pay the reasonable charges incurred by the state department, as determined by the state department.
(g) The reasonable costs of services concerning the program:
(1) include the cost of fees for consultants and experts; and
(2) must be commensurate with the usual compensation for like services.
As added by P.L.104-2021, SEC.2. Amended by P.L.62-2022, SEC.4; P.L.143-2022, SEC.43.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-4.5. Authority for Agreement to Study Impact of Certificate of Public Advantage; Requirements

Sec. 4.5. (a) As a part of a certificate of public advantage granted by the state department under this chapter, the state department may enter into an agreement with a nonprofit organization or a postsecondary educational institution to study the impacts of the certificate of public advantage on the community's health metrics and outcomes, including any item included in section 4(b) of this chapter. However, the state department may not enter into an agreement for more than one (1) study.
(b) If a study is entered into under subsection (a) the following requirements must be met:
(1) The hospital operating under the certificate of public advantage shall supply data it owns or maintains that is related to the certificate of public advantage and that is required by the nonprofit organization or a postsecondary educational institution to conduct the study and the data supplied must comply with the requirements under the federal Health Insurance Portability and Accountability Act (HIPAA).
(2) The preliminary report must be completed within four (4) years of the certificate of public advantage being granted.
(3) A final report must be completed within ten (10) years of the certificate of public advantage being granted.
(4) Copies of the preliminary and final report must be distributed to the following:
(A) The state department.
(B) The general assembly, including members of the interim study committee on public health, behavioral health, and human services in an electronic format under IC 5-14-6.
(c) Nothing in this section requires the state department to pay for a study.
(d) Nothing in this section requires a hospital operating under the certificate of public advantage to supply data that it does not own or maintain for purposes of a study.
As added by P.L.62-2022, SEC.6.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-5. Termination of Certificate

Sec. 5. (a) A hospital that is a party to a merger agreement for at least five (5) years that was issued a certificate of public advantage by the state department under this chapter may voluntarily terminate the certificate of public advantage by filing notice of termination with the state department in a manner prescribed by the state department at least thirty (30) days before the hospital's requested date of termination of the certificate.
(b) The state department shall grant a properly filed notice of termination request made by a hospital under this section.
As added by P.L.104-2021, SEC.2.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-6. Annual Review; Expiration; Costs

Sec. 6. (a) The state department shall annually review a certificate of public advantage issued by the state department under this chapter.
(b) The holder of a certificate of public advantage shall pay the reasonable costs incurred by the state department for the renewal of the certification of public advantage that covers the reasonable costs of the ongoing supervision of the certification, including any fees for consultants and experts.
(c) In conducting the review, the state department shall consider whether the hospital continues to meet the standards required for the issuance of a certificate under this chapter.
(d) This section expires July 1, 2026.
As added by P.L.104-2021, SEC.2. Amended by P.L.62-2022, SEC.7; P.L.143-2022, SEC.44.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-7. Monitoring of Hospital; Costs; Charges for Hospital Services; Investment of Cost Savings

Sec. 7. (a) The state department shall actively supervise and monitor a hospital operating under a certificate of public advantage issued under this chapter to ensure that the conduct of the hospital furthers the purposes of this chapter.
(b) The holder of a certificate of public advantage shall pay the reasonable costs incurred by the state department to cover the reasonable costs of the ongoing monitoring and supervision of the certification, including any fees for consultants and experts.
(c) A hospital operating under a certificate of public advantage may not increase the charge for each individual service the hospital offers by more than the increase in the preceding year's annual average of the Consumer Price Index for Medical Care as published by the federal Bureau of Labor Statistics.
(d) For the first five (5) years that a hospital is operating under a certificate of public advantage the hospital must:
(1) invest the realized cost savings from the identified efficiencies and improvements included in the certificate of public advantage application in the areas of Indiana the hospital serves for the benefit of the community; and
(2) summarize the realized cost savings and investments in the hospital's annual report submitted under section 8 of this chapter.
As added by P.L.104-2021, SEC.2. Amended by P.L.62-2022, SEC.8; P.L.143-2022, SEC.45.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-8. Annual Report

Sec. 8. (a) A hospital that is issued a certificate of public advantage under this chapter shall submit a written report not later than July 1 of each year to:
(1) the state department in the manner and time determined by the state department;
(2) the office of the attorney general in a manner prescribed
by the office of the attorney general; and
(3) the general assembly in an electronic format under IC 5-14-6.
(b) The report must include the following:
(1) Information about the extent of the benefits attributed to the issuance of a certificate of public advantage.
(2) Information, if applicable, about the hospital's action:
(A) in furtherance of any commitments made by the parties to the merger; or
(B) in complying with terms imposed by the state department as a condition for approval of the certificate of public advantage.
(3) A description of the activities conducted by the hospital under the merger agreement.
(4) Information relating to the price, cost, health improvements, quality of, and access to health care for the community served by the hospital.
(5) Any other health information required by the state department to ensure compliance with this chapter, including compliance with any terms or conditions for the issuance of the certificate of public advantage.
As added by P.L.104-2021, SEC.2.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-9. Authority Over Hospitals Granted a Certificate; Deficiency Notice; Investigations

Sec. 9. (a) The state department may do any of the following concerning a hospital that is issued a certificate of public advantage under this chapter:
(1) Investigate the hospital's activities.
(2) Require the hospital to either take action or prohibit an action in order to retain the hospital's certificate, including revocation of a hospital's certificate of public advantage, if the state department determines any of the following:
(A) The hospital is not complying with this chapter or with a term or condition issued with the hospital's certificate.
(B) The state department's issuance of a hospital's certificate was based on a material misrepresentation in the application.
(C) The hospital has failed to pay a fee authorized under this chapter.
(D) The benefits determined in the issuance of the certificate no longer outweigh the disadvantages attributable to the reduction in competition resulting from the merger.
(b) If the state department determines that a hospital holding a certificate of public advantage has a deficiency in violation of the certificate, the state department shall issue a deficiency notice and require the hospital to adopt a plan of correction concerning the deficiency notice in order to maintain the certificate. A hospital issued a deficiency notice by the state department shall adopt and implement a plan of correction for each indicated deficiency.
(c) The office of the attorney general may issue a civil investigative demand concerning the state department's review or revocation of an issued certificate of public advantage and demand the attendance of witnesses and the production of documents to investigate whether a hospital that holds the certificate continues to meet the requirements of the certificate set forth in this chapter. The office of the attorney general may file an action with the district court of the county in which the hospital is located for the revocation of a certificate issued under this chapter. The attorney general has the burden of establishing by clear and convincing evidence that a change in circumstances has resulted in the public disadvantage in the reduction in competition from the merger outweighs the benefits resulting from the merger.
(d) If the attorney general brings an action under this section and proves by clear and convincing evidence that a certificate of public advantage was obtained through a material misrepresentation to the state department, the parties to the merger agreement bear the burden of establishing by clear and convincing evidence that benefits of the merger are not outweighed by the disadvantages attributable by a reduction in competition as a result of the merger.
As added by P.L.104-2021, SEC.2.
2023 Indiana Code › Title 16. Health › Article 21. Hospitals › Chapter 15. Certificate of Public Advantage of Hospital Mergers › 16-21-15-10. Appeals

Sec. 10. (a) A person aggrieved by a decision of the state department to:
(1) grant or deny issuing a certificate under this chapter; or
(2) revoke a certificate issued under this chapter;
may appeal the order by filing a petition for judicial review in a district court of the county in which the hospital is located.
(b) The filing of a petition for judicial review under subsection (a) stays the decision by the state department that is the subject of the review.
(c) The state department shall submit the documentation and all of the records the state department has concerning the subject of the review to the court not later than forty-five (45) days after the filing of the petition under subsection (a).
(d) The district court may require or permit later corrections or additions to the record or extend the time frame prescribed by subsection (c).
(e) The district court shall consider the petition under this section without a jury.
(f) The district court may reverse a decision made by the state department that is the subject of the petition if the court finds any of the following:
(1) The decision is in violation of the Constitution of the State of Indiana or the Constitution of the United States.
(2) The state department exceeded the state department's authority under this chapter.
(3) The state department violated procedures specified under this chapter.
(4) The decision by the state department was arbitrary or capricious, or characterized an abuse or unwarranted exercise of discretion.
(5) The state department's decision was unsupported by substantial and material evidence based on the entire record.
(g) The district court shall issue a decision on the petition in writing setting forth the court's findings of fact and conclusions of law.
As added by P.L.104-2021, SEC.2.