Indiana Federation of Ambulatory Surgical Centers


Legislative Update – Summer 2023

posted: August 3, 2023

The 2023 Indiana legislative Session is in the books. Business concluded in the very late hours of April 26, 2023, with the legislature having passed a $44 billion biennial budget plan. The seas were stormy for some health care providers and, in particular, for nonprofit hospitals operating in our State. Last year many candidates made campaign trail promises to support efforts to reduce health care costs. This was obvious by the number of bills filed attempting to lower costs for patients and employers who provide health care coverage.

While there were no bills passed that negatively targeted ambulatory surgery centers directly, HEA1004 impacts “an individual or entity owned in whole or in part by an Indiana nonprofit hospital system that is duly licensed or legally authorized to provide health care services,” if the hospital system has an annual patient service revenue of at least $2 billion, based on the hospital system’s 2021 audited financial statement.

Thus, HEA1004 applies to ambulatory surgery centers who are wholly or partially owned by an Indiana nonprofit hospital system with the financial parameters noted above. The new law contains site of service language -- the impacted hospitals are not able to assess a facility fee for office settings 250 feet away from the hospital’s main building. Further, the new law prescribes that charges in such facilities for health examinations, diagnosis or non-invasive treatment of illness or injury on an ambulatory basis must be billed on an individual provider form. In summary, if your ambulatory surgery center is owned partially or fully by an Indiana nonprofit hospital system, that meets the specified criteria, discussions with your revenue leadership is recommended. The new law becomes effective January 1, 2025.

IFASC’s Board works with its lobbyist, Cindy Kirchhofer, each year to identify potentially helpful or harmful legislation. For example, 2023’s HB1272 (which was not given a hearing), created a civil penalty against an ambulatory outpatient surgical center that fails to post required pricing information on its website of up to $1,000 for each day the information is not posted. Please take the opportunity to evaluate the requirements for posting prices and make certain that your facility is compliant.

Finally, Cindy will be traveling across the state meeting with IFASC members to learn about what your facility does well and what barriers and challenges your ASC faces in providing quality services to your patients. If you would like a visit or phone call from Cindy, please contact her at (317) 435-9305 or