2020 Legislative Session
The 2020 Session of the Indiana General Assembly began with the tradition of Organization Day on November 19, 2019. The coming session is a Short Session that will last until mid-March, a full 6 weeks shorter than the Long Session, or a Budget Session. Organization Day is typically the day that newly elected legislators are sworn in but this year being an off year for statehouse elections the day will be less ceremonial in nature. Changes in committee chairs and committee assignments will be formally announced and, perhaps, some legislation will be introduced.
The IHCA/INCAL Board of Directors, staff and members had the opportunity to meet both with Indiana House and Senate majority leadership in September and October and the message from both House and Senate leaders is that the coming session will be focused and quick. This is typically the message for every Short Session, but it may hold true in 2020 given how crazy and difficult the 2020 election year is expected to be.
House and Senate leaders are expected to focus in on a “mini-budget” that is to be focused on paying cash for significant capital projects that would otherwise be payed for via bonds and cost more over the long run. These projects include university-based buildings, state fair buildings, and other construction projects. Education and teacher salaries are sure to be debated. As for health care issues, several items will be forwarded from the interim committee on public health, and additional legislative action is likely on the issue of hospital pricing and heath care costs.
IHCA/INCAL continues to press for solutions to the Medicaid transportation/SoutheasTrans problems. Whether legislation is necessary is to be seen, but several legislators have expressed interest in legislating a solution. IHCA/INCAL will also be seeking an extension of the prohibition on managed care programming for Medicaid nursing facility residents. The current prohibition, first passed in 2016, is set to expire June 30, 2020.
2020 Legislative Session Planning
Three Preliminary Drafts have been provided to us that will be filed in 2020.
- Medicaid Managed Care – Rep. Mike Karikhoff and Sen. Vaneta Becker will file legislation to extend the prohibition on risk based managed care for 1 year, to June 30, 2021, for Medicaid recipients that are dually-eligible and qualify for Nursing Facility Level of Care.
- Advance Directives – Rep. Cindy Kirchhofer will pursue legislation to reorganize the various statutes regarding advance directives. This is the second year she has attempted the legislation, which is very complex. IHCA staff has shared the draft with legal counsel that advise members directly and with internal legal counsel and has asked for comments. It is unclear whether passage will be likely in a short session. If it does pass, significant study and re-working of consent and advance directives policies will be required.
- Health Workforce Student Loan Repayment – Rep. Ethan Manning will pursue legislation to establish a heath workforce student loan repayment program and a health workforce council. The eligible providers for loan repayment include dentists, physicians, nurses, clinical social workers, marriage and family therapists, mental health counselors, clinical addiction counselors, physician assistants, and psychologists. The program would be funded by increased licensure fees. Licensure boards of these providers and the health workforce council both have authorities to award loan repayment. IHCA would have a seat on the health workforce council.
IHCA has been in active discussion with lawmakers regarding the below, but have not seen draft legislation at this time:
- Medicaid Managed Care Safeguards – IHCA is prepared with a laundry list of safeguards to protect provider businesses and patient appeal rights if Managed Care is implemented for the sector. This will be drafted and reviewed by our legislative committee, but only used, if at all, as an amendment.
- Medicaid Transportation – several lawmakers want the SET contract cancelled, though legislation to directly cancel the contract would be unconstitutional. Lawmakers may still introduce a bill to directly cancel the contract, requiring the administration to act. IHCA continues to advocate for a carve out from the SET contract for residents in NFs and ALs.
IHCA expects to address several bills in the 2020 session, including background checks and hospital pricing.
- Background Checks – legislation has been introduced for several sessions to require either a federal fingerprint check or a multijurisdictional check for all direct care workers in nursing facilities. It was scheduled for a hearing 2019, but it was not heard as IHCA expressed several concerns with the language. The author would not compromise, and the bill died.
Many IHCA members have experienced delays this summer with the Indiana State Police (ISP) repository due to new software at ISP. The statue requires use of the ISP system and in order to do anything different, perhaps to speed things up, statutory change would be required. IHCA regulatory, workforce and government affairs committees have discussed this summer, but no recommendations have come forward from members.
- Hospital Pricing - Hospital pricing and health care costs has been a focus of the interim summer study committees and a battle is brewing between large business and Anthem against the Indiana Hospital Association. IHCA should not be impacted by this, but it greatly depends on how involved Medicaid spending is focused upon in this debate.
Changes in House Leadership
Speaker Brian Bosma (R-Indianapolis) will retire at the end of the 2020 session, to be his 34th session as a lawmaker. He has held the speakership since 2010 and has been a steady leader for the Indiana House of Representatives. The House Republican Caucus will vote on a Speaker-Elect, who will work with Bosma through this session. Bosma also announced that he will become the National Chairman for the Republican Legislative Campaign Committee and continue to work in his legal practice here in Indianapolis. Representative Todd Huston (R-Fishers) has been chosen as the Speaker-Elect and will succeed Bosma as Spealer after the 2020 session.
The Red for Ed rally at the Statehouse consumed much space and attention to support public education and teacher salaries. This issue is sure to be contentious during session, and in an election year, where House and Senate leaders are expected to focus in on a “mini-budget”. This “mini-budget” is to be focused on paying cash for significant capital projects that would otherwise be payed for via bonds and cost more over the long run, but surely the issue of education and teacher salaries will be debated.
If you any questions or need additional information, please contact Zach Cattell at email@example.com.