HB 1370

                                                             Introduced Version
           HOUSE BILL No. 1370
                 _____
              DIGEST OF INTRODUCED BILL
Citations Affected: IC 27-1-37.5; IC 27-8-6-8; IC 27-13-7-27.
Synopsis: Payment of claims for emergency services. Prohibits a
utilization review entity from requiring prior authorization for
ambulance services provided: (1) to a covered individual; (2) by a
nonparticipating ambulance service provider; and (3) within 12 hours
after the ambulance services are requested. Prohibits a utilization
review entity from requiring prior authorization for emergent response
services or urgent response services that are provided: (1) to a covered
individual; (2) in good faith; and (3) within 24 hours after the emergent
response services or urgent response services are requested. Provides
that a policy of accident and sickness insurance that provides coverage
for emergency medical services must provide reimbursement for
emergency medical services that are, among other things, performed or
provided during a response initiated through the 911 system or an
equivalent telephone number, a texting system, or any other method of
summoning emergency medical services. Provides that a policy of
accident and sickness insurance that provides coverage for emergency
medical services must provide reimbursement for emergency medical
services that are, among other things, performed or provided when an
individual is determined to require emergency medical services by a
physician. Provides that an individual contract and a group contract
that provide coverage for emergency medical services must provide
reimbursement for emergency medical services that are, among other
things, performed or provided during a response initiated through the
911 system or an equivalent telephone number, a texting system, or any
other method of summoning emergency medical services. Provides that
an individual contract and a group contract that provide coverage for
                     (Continued next page)
Effective: July 1, 2026.
                          Isa, Barrett
   January 8, 2026, read first time and referred to Committee on Insurance.
2026  IN 1370—LS 6831/DI 154
Digest Continued
emergency medical services must provide reimbursement for
emergency medical services that are, among other things, performed or
provided when an individual is determined to require emergency
medical services by a physician. Repeals certain code provisions
addressing advanced life support services.
2026  IN 1370—LS 6831/DI 154
                                                                                       Introduced
            Second Regular Session of the 124th General Assembly (2026)
 PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
 Constitution) is being amended, the text of the existing provision will appear in this style type,
 additions will appear in this style type, and deletions will appear in this style type.
   Additions: Whenever a new statutory provision is being enacted (or a new constitutional
 provision adopted), the text of the new provision will appear in this style type. Also, the
 word NEW will appear in that style type in the introductory clause of each SECTION that adds
 a new provision to the Indiana Code or the Indiana Constitution.
  Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
 between statutes enacted by the 2025 Regular Session of the General Assembly.
                   HOUSE BILL No. 1370
    A BILL FOR AN ACT to amend the Indiana Code concerning
 insurance.
     Be it enacted by the General Assembly of the State of Indiana:
1     SECTION 1. IC 27-1-37.5-24, AS ADDED BY P.L.144-2025,
2 SECTION 32, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2026]: Sec. 24. (a) A utilization review entity shall allow a
4 covered individual and a covered individual's health care provider at
5 least twenty-four (24) hours (excluding weekends and state and federal
6 legal holidays) after an emergency admission or provision of
7 emergency health care services for the covered individual or health
8 care provider to notify the utilization review entity of the emergency
9 admission or provision of the emergency health care service.
10     (b) A utilization review entity shall cover emergency health care
11 services necessary to screen and stabilize a covered individual. If a
12 health care provider certifies in writing to a utilization review entity not
13 later than seventy-two (72) hours (excluding weekends and state and
14 federal legal holidays) after a covered individual's emergency
15 admission that the covered individual's condition required the
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1 emergency health care service, the certification will create a
2 presumption that the emergency health care service was medically
3 necessary. The presumption may be rebutted only if the utilization
4 review entity can establish, with clear and convincing evidence, that
5 the emergency health care service was not medically necessary.
6    (c) A utilization review entity shall not require prior
7 authorization for ambulance services provided:
8(1) to a covered individual;
9(2) by a nonparticipating (as defined in IC 27-1-2.3-6(1))
10ambulance service provider (as defined in IC 27-1-2.3-2); and
11(3) within twelve (12) hours after the ambulance services are
12requested.
13    (c) (d) The medical necessity of an emergency health care service
14 may not be based on whether the service was provided by a
15 participating or nonparticipating provider. Any restriction on the
16 coverage of an emergency health care service provided by a
17 nonparticipating provider may not be greater than the restriction that
18 applies when the service is provided by a participating provider.
19    SECTION 2. IC 27-1-37.5-29 IS ADDED TO THE INDIANA
20 CODE AS A NEW SECTION TO READ AS FOLLOWS
21 [EFFECTIVE JULY 1, 2026]: Sec. 29. (a) As used in this section,
22 "emergent response services" means any medical assessment,
23 treatment, or transportation to or from a hospital (as defined in
24 IC 16-18-2-179(a)), a health facility (as defined in IC 16-18-2-167),
25 or between hospitals (as defined in IC 16-18-2-179(a)) or health
26 facilities (as defined in IC 16-18-2-167), provided by emergency
27 medical services personnel in immediate response to a condition or
28 incident that requires immediate attention to prevent serious harm
29 to a covered individual.
30    (b) As used in this section, "urgent response services" means
31 any medical assessment, treatment, or transportation to or from a
32 hospital (as defined in IC 16-18-2-179(a)), a health facility (as
33 defined in IC 16-18-2-167), or between hospitals (as defined in
34 IC 16-18-2-179(a)) or health facilities (as defined in
35 IC 16-18-2-167), provided by emergency medical services
36 personnel that is necessary to protect the covered individual's
37 health, ensure timely access to care, or prevent treatment delays,
38 including transports from hospitals, nursing homes, assisted living
39 facilities, or between health care facilities.
40    (c) A utilization review entity shall not require prior
41 authorization for emergent response services or urgent response
42 services that are provided:
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1(1) to a covered individual;
2(2) in good faith; and
3(3) within twenty-four (24) hours after the emergent response
4services or urgent response services are requested.
5    SECTION 3. IC 27-8-6-8, AS AMENDED BY P.L.236-2025,
6 SECTION 11, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
7 JULY 1, 2026]: Sec. 8. (a) As used in this section, "emergency medical
8 services" has the meaning set forth in IC 16-18-2-110.
9    (b) As used in this section, "emergency medical services provider
10 organization" means a provider of emergency medical services that is
11 certified by the Indiana emergency medical services commission as an
12 advanced life support provider organization under rules adopted under
13 IC 16-31-3.
14    (c) As used in this section, "policy of accident and sickness
15 insurance" has the meaning set forth in IC 27-8-5-1. However, for
16 purposes of this section, the term does not include the following:
17(1) Accident only, credit, dental, vision, Medicare supplement,
18long term care, or disability income insurance.
19(2) Coverage issued as a supplement to liability insurance.
20(3) Automobile medical payment insurance.
21(4) A specified disease policy.
22(5) A policy that provides a stipulated daily, weekly, or monthly
23payment to an insured without regard to the actual expense of the
24confinement.
25(6) A short term insurance plan (as defined in IC 27-8-5.9-3).
26    (d) A policy of accident and sickness insurance that provides
27 coverage for emergency medical services must provide reimbursement
28 for emergency medical services that are:
29(1) rendered by an emergency medical services provider
30organization;
31(2) within the emergency medical services provider organization's
32scope of practice; and
33(3) performed or provided as advanced life support services; and
34(4) (3) performed or provided:
35(A) during a response initiated through the 911 system or an
36equivalent telephone number, a texting system, or any
37other method of summoning emergency medical services;
38or
39(B) as part of a mobile integrated healthcare program
40described in IC 16-31-12; or
41(C) when an individual is determined to require emergency
42medical services by a physician licensed under IC 25-22.5;
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1regardless of whether the patient is transported.
2     (e) Reimbursement for basic and advanced life support services
3 through a policy to which this section applies must be provided on an
4 equal basis regardless of whether the services involve transportation of
5 the patient by ambulance.
6     (f) If multiple emergency medical services provider organizations
7 qualify and submit a claim for reimbursement under this section for an
8 encounter, the insurer:
9(1) may reimburse under this section only for one (1) claim per
10patient encounter; and
11(2) shall reimburse the claim submitted by the emergency medical
12services provider organization that performed or provided the
13majority of advanced life support services for the patient.
14     (g) The department may adopt rules under IC 4-22-2 to implement
15 this section.
16     (h) This section does not require a policy of accident and sickness
17 insurance to provide coverage for emergency medical services.
18     SECTION 4. IC 27-13-7-27, AS AMENDED BY P.L.236-2025,
19 SECTION 13, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
20 JULY 1, 2026]: Sec. 27. (a) This section applies to each of the
21 following:
22(1) An individual contract.
23(2) A group contract.
24     (b) As used in this section, "emergency medical services" has the
25 meaning set forth in IC 16-18-2-110.
26     (c) As used in this section, "emergency medical services provider
27 organization" means a provider of emergency medical services that is
28 certified by the Indiana emergency medical services commission as an
29 advanced life support provider organization under rules adopted under
30 IC 16-31-3.
31     (d) An individual contract and a group contract that provide
32 coverage for emergency medical services must provide reimbursement
33 for emergency medical services that are:
34(1) rendered by an emergency medical services provider
35organization;
36(2) within the emergency medical services provider organization's
37scope of practice;
38(3) performed or provided as advanced life support services; and
39(4) (3) performed or provided:
40(A) during a response initiated through the 911 system or an
41equivalent telephone number, a texting system, or any
42other method of summoning emergency medical services;
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1or
2(B) as part of a mobile integrated healthcare program
3described in IC 16-31-12; or
4(C) when an individual is determined to require emergency
5medical services by a physician licensed under IC 25-22.5;
6regardless of whether the patient is transported.
7    (e) Reimbursement for basic and advanced life support services
8 through a contract to which this section applies must be provided on an
9 equal basis regardless of whether the services involve transportation of
10 the patient by ambulance.
11    (f) If multiple emergency medical services provider organizations
12 qualify and submit a claim for reimbursement under this section, the
13 health maintenance organization:
14(1) may reimburse under this section only for one (1) claim per
15patient encounter; and
16(2) shall reimburse the claim submitted by the emergency medical
17services provider organization that performed or provided the
18majority of advanced life support services.
19    (g) The department may adopt rules under IC 4-22-2 to implement
20 this section.
21    (h) This section does not require an individual contract or a group
22 contract to provide coverage for emergency medical services.
 2026  IN 1370—LS 6831/DI 154