Senate health committee advances bill to establish reimbursement deadlines for new FSSA program

A bill that would affect the rollout of the state’s changes to long-term care passed out of a Senate committee Wednesday. The proposal creates payment requirements and deadlines during the first six months of the state’s new program.

Senate Bill 132 authorizes the Family and Social Services Administration to make the shift to a managed care model for the Pathways for Aging program. And it establishes deadlines for how quickly the managed care entities must reimburse facilities.

Sen. Liz Brown (R-Fort Wayne), one of the authors of the bill, said she’s concerned about the rollout of FSSA’s program, and the goal of this legislation is to make sure assisted living facilities receive payment and are able to maintain care to patients.

“We're not trying to change anything or slow down managed care,” Brown said. “We just want to make it the best, smoothest transition as possible.”

Brown said FSSA had some concerns about the bill, but she is working with them on those concerns.
 

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The bill would also require that insurance companies honor what’s called “assignment of benefits” for dental providers. Assignment of benefits is a legal agreement between a patient and a provider. It allows the provider to receive payment on the patient’s behalf, if the patient chooses.

Shane Springer, the director of government affairs at the Indiana Dental Association, said the bill would prevent insurance companies from using the convenience of payment as a way to force dentists to join preferred provider organizations.

“It would prevent insurance companies from creating a payment hardship for the patients as leverage to get dentists to join the networks,” Springer said.

A representative for Delta Dental, who spoke against the bill, says assignment of benefits leads to fewer providers participating in networks and higher out-of-pocket costs for individuals.

Brown said without the agreements, the patient or the provider has to “front” the money if the patient goes to an out-of-network provider, which puts them at financial risk.

The bill also included sections that would make it easier for nurses from other countries to be licensed in Indiana and would change requirements for health facility administrators.

The bill passed out of the Senate Health and Provider Services Committee with a vote of nine to one. The future of the bill is unclear, as many lawmakers noted that they had issues with parts of the bill but wanted to move the legislation forward.

Abigail is our health reporter. Contact them at aruhman@wboi.org.