The 2026 short session of the Indiana General Assembly has concluded, marking a successful outcome for ISMA and our members. ISMA secured legislative wins on all its priority bills while successfully stopping legislation that conflicted with established ISMA policy. Through consistent engagement with lawmakers, striking testimony from ISMA leaders, and close partnerships with coalitions and physician advocates, ISMA helped shape policy outcomes that support the practice of medicine and protect patient care across Indiana. Though all the wins that advance medicine in Indiana are worth celebrating, look at the major wins that have shaped medicine while ISMA lobbied on behalf of physicians. Download a PDF list and share with your colleagues. Here are ISMA wins that have had a lasting impact:

Scope of Practice 
Each year, ISMA's efforts help kill multiple bills that would have expanded the scope of practice for non-physician practitioners. In 2026, three legislative bills regarding pharmacists and advanced practice registered nurses failed to advance to the second half of the session and never resurfaced in any other bills.

Prior Authorization
In 2025, legislation was passed on denials of prior authorization not made on a peer-to-peer basis. Physicians’ requests can only be denied by a physician with expertise in the relevant field; requests from nonphysician practitioners can be denied by a practitioner with equivalent credentials and relevant expertise. This speeds up the process of approving or denying prior authorization requests. This was the first law to apply to all payors.

Medical Malpractice
Speaking with the voice of thousands of members, ISMA has defended the law against numerous legal and legislative challenges since 1975. Those efforts – made possible by your annual dues – continue to yield results: In the latest national report (showing three specialties), Indiana’s malpractice insurance rates remain 40% to 70% lower than those of nearby states in 2026.

Noncompete Clauses 
In 2023, ISMA led the fight to ban noncompete clauses for primary care physicians. In 2025, the fight continued to expand to include hospital-employed physicians in all specialties, extending protection to about 70% of physicians. 

Reimbursement and Insurance Issues 
In 2026, ISMA worked with industry partners to protect patient access to timely, medically necessary care by prohibiting insurance companies from imposing a 10% penalty on hospitals and facilities when a patient’s care involves an out-of-network provider. Indiana has become the first state in the nation to enact such legislation.

Downcoding
In 2026, Indiana physicians secured a win against insurer downcoding. The law bars insurers from using AI or automated tools alone without human medical record review, mandates transparency in AI use, and prohibits downcoding based solely on diagnosis codes. It also requires clear explanations of reductions, guarantees at least 180 days for appeals, and protects providers who treat complex or chronically ill patients. The law does not apply to Medicaid. 

HIP Medicaid Equalized to Medicare
ISMA helped usher in the Healthy Indiana Plan (HIP), the Medicaid expansion program, through policy advocacy, regulatory input, and reimbursement-structure negotiations. In 2023, ISMA won a major policy fight by maintaining 100% Medicare-level payments for HIP and increasing payments for other Medicaid programs. There was an estimated $200.7 million increase in provider reimbursements by 2025. 

GME for Workforce Expansion
In 2021, ISMA helped secure a major win when the Indiana General Assembly appropriated $9 million in funding to the Graduate Medical Education Board over the 2021-2023 fiscal biennium. This funding was increased to $14 million over the 2023-2025 fiscal biennium. Most recently, in the face of major funding cuts to state programs in 2025, ISMA worked with legislators and state fiscal leaders to prevent a cut to GME funding and to secure $14 million for the GME Board over the 2025-2027 fiscal biennium. 

Cigarette Tax Increase for Public Health
In 2025, ISMA successfully lobbied for a $2 increase in the cigarette tax, marking the first legislation in over 17 years. In 2026, ISMA supported legislation that would impose a stiffer penalty for those selling or receiving tobacco, vape, or e-liquid products to individuals under 18 years of age.