Ind. Code § 27-1-44.5-0.2 "Administrator"
Sec. 0.2. As used in this chapter, "administrator" means the entity that contracts with the department to create, operate, and maintain the data base.
As added by P.L.195-2021, SEC.1.
Ind. Code ch. 27-1-44.5
Ind. Code ch. 27-1-44.5
in effectInd. Code § 27-1-44.5-0.4 "Advisory board"
Sec. 0.4. As used in this chapter, "advisory board" means the all payer claims data base advisory board established under IC 27-1-44.6-5.
As added by P.L.195-2021, SEC.2.
Ind. Code § 27-1-44.5-1 "Data base"
Sec. 1. As used in this chapter, "data base" refers to the all payer claims data base created under this chapter.
As added by P.L.50-2020, SEC.6.
Ind. Code § 27-1-44.5-1.2 "Executive director"
Sec. 1.2. As used in this chapter, "executive director" means the individual who is responsible for overseeing the operations of the data base as an employee of the department.
As added by P.L.195-2021, SEC.3.
Ind. Code § 27-1-44.5-2 "Health payer"
Sec. 2. As used in this chapter, "health payer" includes the following:
(1) Medicare.
(2) Medicaid or a managed care organization (as defined in IC 12-7-2.1-218) that has contracted with Medicaid to provide services to a Medicaid recipient.
(3) An insurer that issues a policy of accident and sickness insurance (as defined in IC 27-8-5-1), except for the following types of coverage:
(A) Accident only, credit, dental, vision, long term care, or disability income insurance.
(B) Coverage issued as a supplement to liability insurance.
(C) Automobile medical payment insurance.
(D) A specified disease policy.
(E) A policy that provides indemnity benefits not based on any expense incurred requirements, including a plan that provides coverage for:
(i) hospital confinement, critical illness, or intensive care; or
(ii) gaps for deductibles or copayments.
(F) Worker's compensation or similar insurance.
(G) A student health plan.
(H) A supplemental plan that always pays in addition to other coverage.
(4) A health maintenance organization (as defined in IC 27-13-1-19).
(5) A pharmacy benefit manager (as defined in IC 27-1-24.5-12).
(6) An administrator (as defined in IC 27-1-25-1).
(7) A multiple employer welfare arrangement (as defined in IC 27-1-34-1).
(8) An employee benefit plan that is subject to the federal Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et seq.), including a third party administrator of an employee benefit plan.
(9) A state employee health plan (as defined in IC 5-10-8-6.7(a)).
(10) An insurance producer, for purposes of the required reporting under IC 27-1-15.6-13.6.
(11) Any other person identified by the commissioner for participation in the data base described in this chapter.
As added by P.L.50-2020, SEC.6. Amended by P.L.32-2021, SEC.84; P.L.195-2021, SEC.4; P.L.165-2022, SEC.6; P.L.190-2023, SEC.19; P.L.216-2025, SEC.45; P.L.145-2026, SEC.144.
Ind. Code § 27-1-44.5-3 Issue of request for information by department; requirements; deadline
Sec. 3. (a) Before July 1, 2020, the department shall issue a request for information in compliance with IC 5-23-4.5 concerning the creation, operation, and maintenance of a data base.
(b) The request for information must include the following questions:
(1) How the person would collect all relevant claims data for the data base from a health payer in a manner that would minimize technical barriers for a health payer to submit a claim.
(2) How the person would promote and encourage self-funded plans to voluntarily submit claims data for inclusion in the data base.
(3) What funding sources the person would seek to offset costs to implement and maintain the data base.
(4) How the person would make data from the data base available, including what sufficient fee would need to be assessed, to researchers, companies, and other interested parties in analyzing the data.
(5) How the person would ensure the following:
(A) That data is submitted and released in a machine readable format.
(B) That the data from the data base is used in an ethical manner.
(C) That the data is not personally identifiable and is properly secured and maintained, and that the person complies with federal and state health care privacy laws.
(6) How the person would establish a public web portal for individuals to quickly and easily compare prices for the full spectrum of medical billing codes as well as check quality ratings of providers.
(7) What threshold should be set for health payers to submit data for the data base.
(8) How the person would work with other states and relevant stakeholders to either:
(A) use a data language that is already available; or
(B) facilitate the establishment of a common data language to be used by states for the data.
(9) Whether any changes to state law would increase the functionality and effectiveness of the data base and recommendations of the statutes and necessary changes.
(10) Any other questions the department determines are relevant to the implementation of a robust and transparent data base.
(c) The department shall set the deadline for submissions of the request for information under this section that may be not later than November 30, 2020.
As added by P.L.50-2020, SEC.6.
Ind. Code § 27-1-44.5-3.5 Request for information; comparison shopping
Sec. 3.5. (a) Not later than September 1, 2025, the department shall issue a request for information in compliance with IC 5-23-4.5 concerning ways to better enable medical consumers to compare and shop for medical and health care services using real time price and health quality information from respected sources approved by the advisory board, including claims data maintained by the data base.
(b) The request for information must consider:
(1) the convenience of medical consumers, including whether and how to develop, procure, or license one (1) or more services into a single application that is available on both desktop and mobile; and
(2) whether and how to benchmark price and health quality comparison shopping by medical consumers in Indiana.
(c) The department shall set the deadline for submissions of the request for information under this section that may not be later than December 1, 2025.
As added by P.L.215-2025, SEC.54.
Ind. Code § 27-1-44.5-4 Request to create, operate, and maintain data base; requirements; publication of decision; contract; ensure compliance of privacy laws
Sec. 4. (a) After December 31, 2021, the department shall issue a request for an entity that is not a state agency or political subdivision to create, operate, and maintain the data base under this chapter. In addition to the requirements of IC 5-22-9, the request for proposals must include the considerations contained in the request for information under section 3 of this chapter.
(b) The request for proposals must state that the data base's purpose is to facilitate the following:
(1) Identifying health care needs and informing health care policy.
(2) Comparing costs between various treatment settings and approaches.
(3) Providing information to consumers and purchasers of health care.
(4) Improving the quality and affordability of patient health care and health care coverage.
(c) The department shall publish the department's decision concerning the submissions not later than April 1, 2022, on the department's Internet web site.
(d) If the department accepts a submission for the request for proposals, the department shall enter into a contract with the person to act as administrator of the data base and develop the data base.
(e) The administrator shall ensure that the data base is secure and compliant with the federal Health Insurance Portability and Accountability Act (HIPAA).
As added by P.L.50-2020, SEC.6. Amended by P.L.195-2021, SEC.5.
Ind. Code § 27-1-44.5-5 Submission of required data by health payers
Sec. 5. A health payer shall begin submitting the required data in a format specified by the administrator of the data base not later than three (3) months from the first day the department declares the data base to be fully operational.
As added by P.L.50-2020, SEC.6. Amended by P.L.195-2021, SEC.6; P.L.190-2023, SEC.20.
Ind. Code § 27-1-44.5-7 Duties of administrator
Sec. 7. The administrator, with input from the executive director and the advisory board:
(1) shall ensure the security of the data;
(2) shall protect the privacy of the data in compliance with state and federal law;
(3) shall incorporate and utilize publicly available data other than administrative claims data if necessary to measure and analyze a significant health care quality, safety, or cost issue that cannot be adequately measured with administrative claims data alone;
(4) shall ensure uniform data collection and determine the data elements to be collected, the reporting formats for data submitted, and the use and reporting of any data submitted, which shall align with national, regional, and other uniform all payer claims data bases' standards where possible;
(5) may audit the accuracy of all data submitted;
(6) shall collect, aggregate, distribute, and publicly report performance data on cost, utilization, and pricing in a manner accessible for consumers, public and private purchasers, providers, and policymakers;
(7) may share data nationally or help develop a multistate effort if recommended by the advisory board; and
(8) may share data for research and publication purposes if approved by the advisory board.
As added by P.L.195-2021, SEC.7.
Ind. Code § 27-1-44.5-8 Data base requirements
Sec. 8. The data base must do the following:
(1) Provide an online, public web portal that is free to use and allows the public to view the average negotiated charges by each health carrier for specific health care services provided by an individual health care provider, as well as the quality metrics for facilities and providers for specific health care services. Facilities and providers include hospitals, physician groups, ambulatory outpatient surgical centers, physical therapy offices, imaging centers, laboratories, infusion clinics, pharmacies, and any other location providing health care services.
(2) Be available to the public as a resource to insurers, consumers, employers, providers, purchasers of health care, and state agencies to allow for continuous review of health care utilization, expenditures, and quality and safety performance in the state.
(3) Be available to state agencies and private entities in the state that are engaged in efforts to improve health care, subject to rules adopted by the department.
(4) Be presented to allow for comparisons of geographic, demographic, and economic factors and institutional size.
(5) Present data in a consumer friendly manner.
As added by P.L.195-2021, SEC.8.
Ind. Code § 27-1-44.5-9 Duties of executive director
Sec. 9. (a) The executive director shall do the following:
(1) Report to the governor and, in an electronic format under IC 5-14-6, to the general assembly not later than September 1 of each year on the following:
(A) The status of the operations of the data base.
(B) The financial stability of the data base.
(C) The status of efforts to obtain funding for the data base.
(2) Seek to establish agreements or requests with the federal Centers for Medicare and Medicaid Services to obtain their health claims data.
(3) Maximize private and federal funding opportunities, including private and federal grants, and the use of fees for the costs of implementing and operating the data base.
(4) Establish a fee formula for data licensing and claims data collection and release.
(5) Ensure privacy and security of the data collected.
(6) Provide leadership and coordination of public and private health care quality and performance measurements to ensure efficiency, cost effectiveness, transparency, and informed choice by consumers and public and private purchasers.
(7) Seek to establish agreements for voluntary reporting of health care claims data from health payers that are not subject to mandatory reporting requirements in order to ensure availability of the most comprehensive and systemwide data on health care costs and quality.
(8) Determine the data to be collected from health payers and the method of collection, including mandatory and voluntary reporting of health care and health quality data.
(9) Determine the measures necessary to implement the reporting requirements in a manner that is cost effective and reasonable for data sources and timely, relevant, and reliable for consumers, public and private purchasers, providers, and policymakers.
(10) Determine the reports and data to be made available to the public, with recommendations from the advisory board, in order to accomplish the purposes of this chapter, including conducting studies and reporting the results of the studies.
(b) The executive director may contract with third parties to collect and process the health care data collected under this chapter.
As added by P.L.195-2021, SEC.9.
Ind. Code § 27-1-44.5-10 Health care data privacy
Sec. 10. The collection, storage, and release of health care data and other information under this chapter is subject to the federal Health Insurance Portability and Accountability Act (42 U.S.C. 201 et seq.), as amended.
As added by P.L.195-2021, SEC.10.
Ind. Code § 27-1-44.5-11 Adoption of rules
Sec. 11. (a) Except as provided in subsection (c), the department shall adopt rules under IC 4-22-2 to implement this chapter. The rules must include a requirement that health payer data sources submit necessary information to the administrator. Rules enacted under this subsection must cover all health payer data sources as follows:
(1) The department shall adopt rules that apply to health payers regulated under IC 27.
(2) The office of the secretary of family and social services shall adopt rules that apply to health payers regulated under IC 12.
(b) The department shall adopt provisional rules under IC 4-22-2-37.1 establishing a fee formula for data licensing and the collection and release of claims data.
(c) The department may adopt rules under IC 4-22-2 concerning the:
(1) requirement that health payers submit required data under section 5 of this chapter; and
(2) establishment of a fee formula for data licensing, collection, and release of claims described in section 9 of this chapter.
(d) The department may impose a civil penalty on a health payer that is required to submit information under this chapter and fails to comply. A civil penalty collected under this section must be deposited in the department of insurance fund created by IC 27-1-3-28.
As added by P.L.195-2021, SEC.11. Amended by P.L.190-2023, SEC.21; P.L.225-2023, SEC.2; P.L.249-2023, SEC.81.
Ind. Code § 27-1-44.5-12 Fee schedule for data requests; exceptions; report to budget committee
Sec. 12. (a) Except as provided in subsections (b), (c), and (e), the fee schedule for each type of unrestricted data request is as follows:
Non-program Affiliated Individual
Data Set
Per Quarter
Per Year
Member Eligibility
$1,000
$4,000
Medical Claims
$1,500
$6,000
Pharmacy Claims
$ 500
$2,000
Hospital Encounters
Inpatient
$1,500
$6,000
Outpatient
$1,250
$5,000
Emergency Dept.
$1,250
$5,000
Commercial Entity (Non-redistribution)
Data Set
Per Quarter
Per Year
Member Eligibility
$1,500
$6,000
Medical Claims
$2,250
$9,000
Pharmacy Claims
$ 750
$3,000
Hospital Encounters
Inpatient
$2,250
$9,000
Outpatient
$1,875
$7,500
Emergency Dept.
$1,875
$7,500
Nonprofit/Educational Entity
Data Set
Per Quarter
Per Year
Member Eligibility
$ 250
$1,000
Medical Claims
$ 375
$1,500
Pharmacy Claims
$ 125
$ 500
Hospital Encounters
Inpatient
$ 375
$1,500
Outpatient
$ 312.50
$1,250
Emergency Dept.
$ 312.50
$1,250
Commercial Redistributor (Resellers)
Data Set
Per Quarter
Per Year
Member Eligibility
$2,500
$10,000
Medical Claims
$3,750
$15,000
Pharmacy Claims
$1,250
$5,000
Hospital Encounters
Inpatient
$3,750
$15,000
Outpatient
$3,125
$12,500
Emergency Dept.
$3,125
$12,500
(b) Data files, reports, or tables not otherwise listed in subsection (a) or custom data sets must be generated at a base rate of eighty dollars ($80) per hour with a minimum one (1) hour charge applied. An additional fee of three cents ($0.03) must be charged per individual life generated in the data, report, or table. A written estimate of the total cost must be provided to an entity that requests data or information under this subsection before the request is fulfilled.
(c) State or local agencies within the geographical boundaries of Indiana that request data for public distribution or non-redistribution purposes may not be charged a fee under this section.
(d) If it is determined by the data base that access to the analytic environment is necessary based on the quantity and type of data requested, the requesting entity will incur an additional licensing fee of one thousand dollars ($1,000) per month per user.
(e) Member eligibility data sets for the requested time period must be provided at no charge if requested along with at least one (1) other data set.
(f) A requesting entity may submit to the department a request for a waiver of any applicable fees if the entirety of the entity's research findings will be released to the public at no cost to the reader.
(g) A fee collected under this section must be deposited in the department of insurance fund created by IC 27-1-3-28.
(h) Before November 1, 2026, and before November 1 of each year thereafter, the department shall submit a report to the budget committee that contains the following information for the most recently preceding state fiscal year:
(1) The total amount of fees collected in total and for each fee type of unrestricted data.
(2) The number of individuals subject to fees in total and for each fee type of unrestricted data.
(3) Additional fee amounts charted in subsection (b) and the total amount collected.
(4) Additional licensing fee amounts charted in subsection (c) and the total amount collected.
(5) The total fund balance in the department of insurance fund under IC 27-1-3-28 as of June 30 of the most recently preceding state fiscal year.
As added by P.L.86-2026, SEC.3.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://iga.in.gov/laws/2026/ic/titles/27Fetched: 10/17/2026