Hospitals would limit bills for drugs given to patients

If enacted, a licensed hospital would not be allowed to bill more than the lower of 120% of Medicare’s rate or its June 30, 2026 charge for a drug. The rule would cover hospitals licensed under Indiana law and drugs given to a person by injection, infusion, ingestion, or another means. The rule would not apply to critical access hospitals or the Medicaid program. If Medicare’s rate rises, the hospital could raise its June 30 charge limit by no more than that same percentage, but its bill still could not exceed 120% of Medicare’s rate. If enacted, the billing limit would take effect July 1, 2026, and use the hospital’s charge on June 30, 2026 as its baseline.

Covered hospitals would update the Medicare rate used for each drug they give to a patient. This would apply to drugs given to a person by injection, infusion, ingestion, or another means. The Medicare rate here is what federal Medicare pays for a drug or biological product under Part B. Updates would be due each January 1 and July 1.