LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
200 W. Washington St., Suite 301
Indianapolis, IN 46204
(317) 233-0696
iga.in.gov
FISCAL IMPACT STATEMENT
LS 7169 NOTE PREPARED: Dec 31, 2020
BILL NUMBER: HB 1347 BILL AMENDED:
SUBJECT: Telemedicine.
FIRST AUTHOR: Rep. Lindauer BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED: X GENERAL IMPACT: State & Local
X DEDICATED
X FEDERAL
Summary of Legislation: Home Health Agencies: The bill expands the list of medical professionals from
which home health agencies may accept written orders.
Telemedicine: The bill also changes the requirements for the issuance of a prescription via telemedicine.
Advance Practice Registered Nurse (APRN): It provides that advanced practice registered nurses may operate
in multiple locations in collaboration with a physician.
Pharmacy Technicians: The bill increases the number of pharmacy technicians that a single licensed
pharmacist may supervise. It also provides that pharmacy technicians may perform certain work remotely
without the direct supervision of a licensed pharmacist.
Effective Date: July 1, 2021.
Explanation of State Expenditures: To the extent that more practitioners may order services, practice at
more locations, or fill more prescriptions in certain circumstances, reimbursement of these services may
increase for the state health plans. Additionally, the Professional Licensing Agency (PLA) may experience
an increase in workload to notify license holders of the changes made by the bill. These actions are within
PLA’s routine administrative functions and should be able to be implemented with no additional
appropriations, assuming near customary agency staffing and resource levels. The bill is not expected to
direct impact expenditures within the state Medicaid program or Children’s Health Insurance Program
(CHIP).
HB 1347 1
Additional Information -State Employee Health Plans: Costs for the state health plans are shared between
the state and state employees covered by the plan as determined in the plans’ designs, including premiums,
coinsurance, copayments, and deductibles. An increase in premiums cost may be mitigated with adjustments
to other benefits or to employee compensation packages, or through the division of premium costs between
the state and state employees.
Medicaid and CHIP: Medicaid and CHIP services are governed by the Medicaid state plan and federally
granted waivers. Changes in state practice would have to be incorporated into the plans or waivers through
the amendment process. However, price and availability of services for Medicaid and CHIP may be effected
by the changes in the bill.
Explanation of State Revenues: Increases in private insurance payments of health care and prescription
services may create upward pressure on premiums collected in the state, leading to increased premiums. State
General Fund revenue from either insurance premium tax or Adjusted Gross Income (AGI) tax collections
may result. However, any impact to revenue as a result of this bill would likely be small.
Explanation of Local Expenditures: Locally owned health care facilities may have increased workload as
the result of the bill’s changes, which may be offset with increased revenue.
The bill potentially impacts local units of government that offer health insurance coverage for employees.
Added local health coverage costs may be mitigated with adjustments to other benefits or to the total
employee compensation packages, or through the division of costs between the local unit and employees.
Explanation of Local Revenues: If the bill results in more services being provided, locally owned health
services agencies, such as community mental health centers or county hospitals, may have increased revenue
from reimbursements.
State Agencies Affected: State Personnel Department; Professional Licensing Agency.
Local Agencies Affected: Locally owned health care facilities; local government units offering employee
health plans.
Information Sources: IC 25-1-9-9; Legislative Services Agency, Indiana Handbook of Taxes, Revenues,
and Appropriations, FY 2020.
Fiscal Analyst: Karen Rossen, 317-234-2106.
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Statutes affected: 1. Introduced House Bill (H): 25-1-9.5-8, 25-23-1-19.4, 25-26-13-18.5, 25-26-13-25