SB 119: Certificate of public advantage. - Indiana

Enrolled Senate Bill (S) → Senate Bill (S) · 6 edits

MODERATE

This bill repeals the certificate of public advantage program for hospital mergers in Indiana, effectively ending the state's ability to grant immunity from antitrust claims for such mergers. The changes remove the administrative process that previously allowed hospitals to apply for approval to merge without facing antitrust lawsuits.

Scope change

The bill significantly narrows the scope by eliminating the entire certificate of public advantage program for hospital mergers that was previously established under IC 16-21-15.

ELIGIBILITY

Removed the ability for hospitals to submit applications for certificates of public advantage to govern hospital merger agreements.

REQUIREMENT

Eliminated the requirement for hospitals to file merger agreements with the state department, secretary of family and social services, and attorney general.

ENFORCEMENT

Removed the state department's authority to review merger applications and grant immunity from federal or state antitrust laws for approved mergers.

TIMELINE

Changed the effective date from 'upon passage' to July 1, 2025, for the repeals of the certificate of public advantage program.

DEFINITION

Added a repealed section (IC 16-18-2-226.2) that previously defined 'merger' and 'merger agreement' for purposes of the certificate program.

FISCAL

Eliminated the state department's authority to assess filing fees for certificate applications and the program's funding structure.

Engrossed Senate Bill (H) → Enrolled Senate Bill (S) · 5 edits · Apr 22, 2025

MODERATE

This bill transitions from a draft Senate Bill to an enrolled Senate Act, finalizing its status for implementation. The substantive policy changes include setting a hard deadline of July 1, 2026, for hospitals to submit merger applications for public advantage certification, requiring applications to be filed with both the Department of Health and the Attorney General, and establishing a fee structure to fund the review process. These changes ensure regulatory oversight of hospital mergers while providing a clear timeline and funding mechanism for the state's review authority.

Scope change

The bill's scope remains focused on hospital mergers requiring state certification, but the timeline for applications was extended from February 15, 2025, to July 1, 2026, and additional filing requirements were added.

TIMELINE

The deadline for submitting hospital merger applications was changed from February 15, 2025, to July 1, 2026, providing a longer window for hospitals to seek certification.

REQUIREMENT

New requirement that merger applications must be filed with both the Department of Health and the Attorney General's office in addition to the state department.

FISCAL

Established a filing fee system to fund the review of merger applications and ongoing supervision, with provisions for applicants to pay additional costs if review expenses exceed fees collected.

ENFORCEMENT

Clarified that only the Attorney General may issue investigative demands related to violations of the relevant statutes, with the Attorney General's office consulting with the Department of Health on applications.

TECHNICAL

Changed document status from 'Engrossed Senate Bill' to 'Enrolled Senate Act,' indicating the bill has passed both houses and is ready for governor's signature.

Introduced Senate Bill (S) → Engrossed Senate Bill (H) · 4 edits · Feb 20, 2025

MODERATE

This bill amends the certificate of public advantage process for hospital mergers in Indiana, primarily by establishing a hard deadline for submitting merger applications and clarifying the review timeline for the Department of Health. The changes shift the effective date from July 1, 2025 to upon passage, and add a prohibition on submitting applications after July 1, 2026.

Scope change

The bill's scope now includes a specific cutoff date for merger applications and expands the attorney general's role to include consultation with the Department of Health during reviews.

TIMELINE

Changed the effective date of the bill from July 1, 2025 to upon passage, and added a new deadline prohibiting hospital merger applications after July 1, 2026.

REQUIREMENT

Added a requirement that the attorney general's office consult with the Indiana Department of Health when reviewing applications for certificates of public advantage.

ENFORCEMENT

Removed the repeal of the certificate of public advantage concerning hospital mergers that was set to take effect on July 1, 2025, replacing it with a modified framework that keeps the program active but with new application deadlines.

DEFINITION

Amended IC 16-21-15-3 to include new requirements for application content, filing procedures with the secretary of family and social services, and fee assessment rules.

Certificate of public advantage.

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