Indiana § 16-21-15-4 - Review of application; certification; compliance terms and conditions; attorney general investigations

§ 16-21-15-4. Review of application; certification; compliance terms and conditions; attorney general investigations

Sec. 4. (a) The state department, in consultation with the office of the secretary of family and social services, shall review an application for a certificate of public advantage and the documentation filed under section 3 of this chapter to determine whether there is clear evidence that the proposed merger agreement:

(1) would benefit the population's health outcomes, health care access, and quality of health care; and

(2) meets the standards described in this section.

(b) The state department shall consider in the review of the application and documentation the effect of the merger agreement on the following:

(1) The quality and price of hospital and health care services provided to Indiana residents, including the demonstration of population health improvement of the region serviced and the extent to which medically underserved populations have access to and are projected to use the proposed services.

(2) The preservation of sufficient health care services within the geographic area to ensure public access to acute care.

(3) The cost efficiency of services, resources, and equipment provided or used by the hospitals that are a party to the merger agreement, including avoidance of duplication of services to better meet the needs of the community.

(4) The ability of health care payors to negotiate payments and service agreements with hospitals proposed to be merged under the merger agreement.

(5) Employment.

(6) Economic impact.

(c) The state department shall grant the certification if the state department determines in the review of the application and documentation that, under the totality of the circumstances, the following apply:

(1) There is clear evidence that the proposed merger would benefit the population's health outcomes, health care access, and quality of care in the county.

(2) The likely benefits resulting from the proposed merger agreement outweigh any disadvantages attributable to a potential reduction in competition that may result from the proposed merger.

The holder of a certificate of public advantage issued by the state department under this chapter receives immunity from claims made pursuant to federal or state antitrust laws for the duration of the certificate.

(d) The state department must review and make a determination on an application filed under this chapter not later than:

(1) one hundred twenty (120) days from the filing of the application; or

(2) November 9, 2025, for an application filed under this chapter between January 1, 2025, through May 13, 2025.

(e) The state department's determination on whether to grant the application must:

(1) be in writing;

(2) specify the basis for the determination; and

(3) be provided to the applicant on the date of the determination.

(f) The state department may include terms or conditions of compliance with the issuance of a certificate of public advantage under this chapter.

(g) The state department shall maintain records of all of the applications filed under this chapter, including records of any terms or conditions of issuing a certificate of public advantage that are imposed by the state department.

(h) The office of the attorney general may, at any time after an application is filed under this chapter and before the state department makes a determination on the application, require by civil investigative demand the attendance of witnesses and the production of documents for purposes of investigating whether the merger agreement satisfies the requirements of this chapter. Any documents produced or testimony given under this subsection are subject to confidentiality if the information is deemed proprietary information. The attorney general may seek compliance with the issuance of a civil investigative demand with the appropriate district court of the county in which the merger is to occur.

As added by P.L.104-2021, SEC.2. Amended by P.L.62-2022, SEC.5; P.L.11-2023, SEC.58; P.L.100-2025, SEC.3.