# Indiana SB 242: Payment for Medicaid physician services.

Indiana SB 242, Payment for Medicaid physician services., is a First Regular Session 124th General Assembly (2025) Senate bill sponsored by Tyler Johnson (Republican); status failed, last action 2025-02-06 (Committee report: amend do pass adopted; reassigned to Committee on Appropriations) (as of 2026-10-17).

- Canonical: https://policyrisk.com/state-bill/IN-SB242-2025
- As of: 2026-10-17
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: Indiana SB 242
- State: Indiana
- Session: First Regular Session 124th General Assembly (2025)
- Title: Payment for Medicaid physician services.
- Status: failed
- Chamber: Senate
- Introduced: 2025-01-13
- Last action: 2025-02-06, Committee report: amend do pass adopted; reassigned to Committee on Appropriations
- Sponsor: Tyler Johnson (Republican)
- Cosponsors: 1
- Subjects: health and provider services, appropriations
- Touches household money: no
- Economic provisions PRIA read: 0

## Summary

Requires the office of Medicaid policy and planning (office) or a managed care organization to promptly cover physician services rendered in a hospital emergency department by a physician who has entered into a provider agreement with the office or managed care organization, without limiting what constitutes an emergency medical condition. Specifies considerations that must be made in determining whether the prudent layperson standard has been met. Prohibits any delay in or denial of compensation to the physician unless the cause of the delay or denial is specifically provided for in: (1) the Medicaid managed care law; (2) an administrative rule adopted under the Medicaid managed care law; (3) the federal administrative rules on Medicaid managed care; or (4) the provider agreement. Prohibits a managed care organization from denying an emergency services claim solely because the claim code is not listed on the autopay list.

## Bill overview

No economic impacts identified for this bill.

## Sponsors and cosponsors

- Sponsor: Tyler Johnson (Republican), Senate
- Cosponsor: Justin Busch (Republican), Senate

## Actions (4)

- 2025-02-06: Committee report: amend do pass adopted; reassigned to Committee on Appropriations (Senate)
- 2025-02-06: Senator Busch added as second author (Senate)
- 2025-01-13: First reading: referred to Committee on Health and Provider Services (Senate)
- 2025-01-13: Authored by Senator Johnson T (Senate)

## Bill text

- Introduced Senate Bill (S): [PDF](https://api.iga.in.gov/2025/bills/SB0242/versions/SB0242.01.INTR?format=pdf)
- Senate Bill (S): [PDF](https://api.iga.in.gov/2025/bills/SB0242/versions/SB0242.02.COMS?format=pdf)

## Related bills

- SB 324: Criminal procedures. (signed)
- SB 231: Various corrections matters. (signed)
- SB 80: Code publication. (signed)
- SB 453: Various tax matters. (signed)
- SB 464: Financial institutions and consumer credit. (signed)
- SB 371: Workforce matters. (signed)

## Sources
- [Introduced Senate Bill (S) (PDF)](https://api.iga.in.gov/2025/bills/SB0242/versions/SB0242.01.INTR?format=pdf)
- [Senate Bill (S) (PDF)](https://api.iga.in.gov/2025/bills/SB0242/versions/SB0242.02.COMS?format=pdf)

## Related
- [SB 324: Criminal procedures.](https://policyrisk.com/state-bill/IN-SB324-2025)
- [SB 231: Various corrections matters.](https://policyrisk.com/state-bill/IN-SB231-2025)
- [SB 80: Code publication.](https://policyrisk.com/state-bill/IN-SB80-2025)
- [SB 453: Various tax matters.](https://policyrisk.com/state-bill/IN-SB453-2025)
- [SB 464: Financial institutions and consumer credit.](https://policyrisk.com/state-bill/IN-SB464-2025)
- [SB 371: Workforce matters.](https://policyrisk.com/state-bill/IN-SB371-2025)
- [Indiana bills](https://policyrisk.com/states/indiana/bills)
- [Indiana state hub](https://policyrisk.com/states/indiana)
- [All state legislation](https://policyrisk.com/state-bills)

Source: PRIA, https://policyrisk.com/state-bill/IN-SB242-2025 (as of 2026-10-17).