§ 16-21-6-3 — Fiscal reports; required documentation; failure to file report

Note: This version of section effective until 7-1-2025. See also
following version of this section, effective 7-1-2025.
Sec. 3. (a) Each hospital shall file with the state
department a report for the preceding fiscal year within one hundred
twenty (120) days after the end of the hospital's fiscal year. For the
filing of a report, the state department may grant an extension of the
time to file the report if the hospital shows good cause for the
extension. The report must contain the following:
(1) A copy of the hospital's balance sheet, including a statement
describing the hospital's total assets and total liabilities.
(2) A copy of the hospital's income statement.
(3) A statement of changes in financial position.
(4) A statement of changes in fund balance.
(5) Accountant notes pertaining to the report.
(6) A copy of the hospital's report required to be filed annually
under 42 U.S.C. 1395g, and other appropriate utilization and
financial reports required to be filed under federal statutory law.
(7) Net patient revenue and total number of paid claims, including
providing the information as follows:
(A) The net patient revenue and total number of paid claims for
inpatient services for:
(i) Medicare;
(ii) Medicaid;
(iii) commercial insurance, including inpatient services
provided to patients participating in a fully-funded health
insurance plan or a self-funded health insurance plan;
(iv) self-pay; and
(v) any other category of payer.
(B) The net patient revenue and total number of paid claims for
outpatient services for:
(i) Medicare;
(ii) Medicaid;
(iii) commercial insurance, including outpatient services
provided to patients participating in a fully-funded health
insurance plan or a self-funded health insurance plan;
(iv) self-pay; and
(v) any other category of payer.
(C) The total net patient revenue and total number of paid
claims for:
(i) Medicare;
(ii) Medicaid;
(iii) commercial insurance, including the total net patient
revenue for services provided to patients participating in a
fully-funded health insurance plan or a self-funded health
insurance plan;
(iv) self-pay; and
(v) any other category of payer.
(8) Net patient revenue and total number of paid claims from
facility fees, including providing the information as follows:
(A) The net patient revenue and total number of paid claims for
inpatient services from facility fees for:
(i) Medicare;
(ii) Medicaid;
(iii) commercial insurance, including inpatient services from
facility fees provided to patients participating in a
fully-funded health insurance plan or a self-funded health
insurance plan;
(iv) self-pay; and
(v) any other category of payer.
(B) The net patient revenue and total number of paid claims for
outpatient services from facility fees for:
(i) Medicare;
(ii) Medicaid;
(iii) commercial insurance, including outpatient services from
facility fees provided to patients participating in a
fully-funded health insurance plan or a self-funded health
insurance plan;
(iv) self-pay; and
(v) any other category of payer.
(C) The total net patient revenue and total number of paid
claims from facility fees for:
(i) Medicare;
(ii) Medicaid;
(iii) commercial insurance, including the total net patient
revenue from facility fees provided to patients participating
in a fully-funded health insurance plan or a self-funded health
insurance plan;
(iv) self-pay; and
(v) any other category of payer.
(9) Net patient revenue and total number of paid claims from
professional fees, including providing the information as follows:
(A) The net patient revenue and total number of paid claims for
inpatient services from professional fees for:
(i) Medicare;
(ii) Medicaid;
(iii) commercial insurance, including inpatient services from
professional fees provided to patients participating in a
fully-funded health insurance plan or a self-funded health
insurance plan;
(iv) self-pay; and
(v) any other category of payer.
(B) The net patient revenue and total number of paid claims for
outpatient services from professional fees for:
(i) Medicare;
(ii) Medicaid;
(iii) commercial insurance, including outpatient services from
professional fees provided to patients participating in a
fully-funded health insurance plan or a self-funded health
insurance plan;
(iv) self-pay; and
(v) any other category of payer.
(C) The total net patient revenue and total number of paid
claims from professional fees for:
(i) Medicare;
(ii) Medicaid;
(iii) commercial insurance, including the total net patient
revenue from professional fees provided to patients
participating in a fully-funded health insurance plan or a
self-funded health insurance plan;
(iv) self-pay; and
(v) any other category of payer.
(10) A statement including:
(A) Medicare gross revenue;
(B) Medicaid gross revenue;
(C) other revenue from state programs;
(D) revenue from local government programs;
(E) local tax support;
(F) charitable contributions;
(G) other third party payments;
(H) gross inpatient revenue;
(I) gross outpatient revenue;
(J) contractual allowance;
(K) any other deductions from revenue;
(L) charity care provided;
(M) itemization of bad debt expense; and
(N) an estimation of the unreimbursed cost of subsidized health
services.
(11) A statement itemizing donations.
(12) A statement describing the total cost of reimbursed and
unreimbursed research.
(13) A statement describing the total cost of reimbursed and
unreimbursed education separated into the following categories:
(A) Education of physicians, nurses, technicians, and other
medical professionals and health care providers.
(B) Scholarships and funding to medical schools, and other
postsecondary educational institutions for health professions
education.
(C) Education of patients concerning diseases and home care in
response to community needs.
(D) Community health education through informational
programs, publications, and outreach activities in response to
community needs.
(E) Other educational services resulting in education related
costs.
(b) The information in the report filed under subsection (a) must be
provided from reports or audits certified by an independent certified
public accountant or by the state board of accounts.
(c) A hospital that fails to file the report required under subsection
(a) by the date required shall pay to the state department a fine of ten
thousand dollars ($10,000) per day for which the report is past due. A
fine under this subsection shall be deposited into the payer affordability
penalty fund established by IC 12-15-1-18.5.
[Pre-1993 Recodification Citation: 16-10-5-2(a),
(d).]

Legislative History

As added by P.L.2-1993, SEC.4. Amended by P.L.94-1994, SEC.14; P.L.2-2007, SEC.190; P.L.203-2023, SEC.16; P.L.9-2024, SEC.372; P.L.17-2024, SEC.4; P.L.152-2024, SEC.5; P.L.216-2025, SEC.16.