By Luke McNamee, JD
ISMA Director of Policy and Government Affairs

During the 2024 legislative session, Indiana lawmakers passed House Enrolled Act (HEA) 1426, requiring a hospital that operates a maternity unit to ensure that a Medicaid-enrolled/-eligible patient who is giving birth in the hospital is provided the option—if not medically contraindicated—to have a long-acting reversible subdermal contraceptive implanted after delivery and before discharge.

HEA 1426 was authored by Rep. Rita Fleming, MD, a retired OB-GYN. The introduced version of the legislation would have required a hospital to ensure eligible patients were provided the option to receive a “long-acting reversible contraceptive” (LARC) after delivery and before discharge. The final version amended that language to replace “long-acting reversible contraceptive” with “long-acting reversible subdermal contraceptive.” While this amounts to a new requirement for hospitals, it does not restrict patients’ current access to all forms of LARCs or Medicaid reimbursement for LARCs.

Since 2015, Indiana Health Coverage Programs (IHCP), also known as Medicaid, has allowed separate reimbursement for LARC devices implanted during an inpatient hospital or birthing center stay for delivery. Per IHCP Bulletin 201517, LARC devices are defined as “implantable devices that remain effective for several years to prevent pregnancies. Devices include intrauterine devices (IUDs) and birth control implants.” This bulletin remains in effect as of this writing. HEA 1426 does not change this longstanding Medicaid policy. Nor does HEA 1426 prohibit or otherwise limit the ability of physicians to discuss or provide contraception options with their patients.

ISMA encourages physicians caring for these patients immediately post-partum to consult with their hospital about the implementation of this legislation before the law's effective date, July 1, 2024. This law does have a sunset clause. The provisions of HEA 1426 expire on June 30, 2025, unless next year’s General Assembly acts to extend them.

If you have any additional questions, please contact the ISMA Government Relations team at policy@ismanet.org.