IC 27-1-44.5-12: Fee schedule for data requests; exceptions; report to budget committee

Sec. 12. (a) Except as provided in subsections (b), (c), and (e), the fee schedule for each type of unrestricted data request is as follows:

Non-program Affiliated Individual

Data Set | Per Quarter | Per Year

Member Eligibility | $1,000 | $4,000

Medical Claims | $1,500 | $6,000

Pharmacy Claims | $ 500 | $2,000

Hospital Encounters | |

Inpatient | $1,500 | $6,000

Outpatient | $1,250 | $5,000

Emergency Dept. | $1,250 | $5,000

Commercial Entity (Non-redistribution)

Data Set | Per Quarter | Per Year

Member Eligibility | $1,500 | $6,000

Medical Claims | $2,250 | $9,000

Pharmacy Claims | $ 750 | $3,000

Hospital Encounters | |

Inpatient | $2,250 | $9,000

Outpatient | $1,875 | $7,500

Emergency Dept. | $1,875 | $7,500

Nonprofit/Educational Entity

Data Set | Per Quarter | Per Year

Member Eligibility | $ 250 | $1,000

Medical Claims | $ 375 | $1,500

Pharmacy Claims | $ 125 | $ 500

Hospital Encounters | |

Inpatient | $ 375 | $1,500

Outpatient | $ 312.50 | $1,250

Emergency Dept. | $ 312.50 | $1,250

Commercial Redistributor (Resellers)

Data Set | Per Quarter | Per Year

Member Eligibility | $2,500 | $10,000

Medical Claims | $3,750 | $15,000

Pharmacy Claims | $1,250 | $5,000

Hospital Encounters | |

Inpatient | $3,750 | $15,000

Outpatient | $3,125 | $12,500

Emergency Dept. | $3,125 | $12,500

(b) Data files, reports, or tables not otherwise listed in subsection (a) or custom data sets must be generated at a base rate of eighty dollars ($80) per hour with a minimum one (1) hour charge applied. An additional fee of three cents ($0.03) must be charged per individual life generated in the data, report, or table. A written estimate of the total cost must be provided to an entity that requests data or information under this subsection before the request is fulfilled.

(c) State or local agencies within the geographical boundaries of Indiana that request data for public distribution or non-redistribution purposes may not be charged a fee under this section.

(d) If it is determined by the data base that access to the analytic environment is necessary based on the quantity and type of data requested, the requesting entity will incur an additional licensing fee of one thousand dollars ($1,000) per month per user.

(e) Member eligibility data sets for the requested time period must be provided at no charge if requested along with at least one (1) other data set.

(f) A requesting entity may submit to the department a request for a waiver of any applicable fees if the entirety of the entity's research findings will be released to the public at no cost to the reader.

(g) A fee collected under this section must be deposited in the department of insurance fund created by IC 27-1-3-28.

(h) Before November 1, 2026, and before November 1 of each year thereafter, the department shall submit a report to the budget committee that contains the following information for the most recently preceding state fiscal year:

(1) The total amount of fees collected in total and for each fee type of unrestricted data.

(2) The number of individuals subject to fees in total and for each fee type of unrestricted data.

(3) Additional fee amounts charted in subsection (b) and the total amount collected.

(4) Additional licensing fee amounts charted in subsection (c) and the total amount collected.

(5) The total fund balance in the department of insurance fund under IC 27-1-3-28 as of June 30 of the most recently preceding state fiscal year.