Iowa HF 2518: A bill for an act relating to the department of health and human services and reporting requirements for shelter care, residential treatment, and Medicaid provider reimbursement rates, and establishing provider reimbursement rates for Medicaid home and community-based waiver services.

Bill Text

House File 2518
H-8036
Amend House File 2518 as follows:1
1. Page 1, by striking lines 16 through 28 and inserting:2
<NEW SUBSECTION. 15. a. Conduct an annual review of3
provider reimbursement rates for medical and health services4
provided under this chapter that are reimbursed by a statewide5
fee schedule and that are not periodically updated or rebased6
pursuant to federal or state law or rule. The department shall7
compare each provider reimbursement rate in the following8
manner:9
(1) For all medical and health services other than dental10
services, to reimbursement rates under the federal Medicare11
program.12
(2) For dental services, to reimbursement rates for13
Medicaid programs in states contiguous to Iowa.14
b. On or before January 15 of each calendar year, the15
department shall submit to the general assembly a report16
summarizing the department’s review under paragraph “a”.>17
2. By striking page 1, line 35, through page 2, line 21, and18
inserting:19
<2. On or before July 1 of each fiscal year, providers20
shall submit actual cost of service and supply data to the21
department. Upon request by the department, a provider shall22
submit to reasonable review of the actual cost of service and23
supply data submitted.24
3. a. Upon the required submission of annual cost reports25
by providers and implementation by the department of a waiver26
fee schedule, the department, with input from the public,27
consumers, providers, and other stakeholders, shall develop a28
proposed cost-based reimbursement system and related changes to29
department policies and procedures for all services rendered30
under a waiver during the period of review specified by31
the department. The cost-based reimbursement system shall32
be developed using information provided to the department33
including but not limited to all of the following:34
(1) Provider cost data.35
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(2) Provider claims data.1
(3) Consumer needs assessment data.2
(4) Other relevant regional and national data.3
b. The department shall, with input from providers and4
other relevant stakeholders, develop a uniform and streamlined5
provider cost reporting mechanism for home and community-based6
services.7
4. At least once every four years, the department shall8
establish a new base period to be used in calculating proposed9
rate models and related changes to department policies and10
procedures. On or before October 1 of each year that a new base11
period is established, the department shall submit a report12
to the general assembly that includes proposed rate models,13
the projected fiscal impact of implementing the proposed rate14
models, including documentation supporting the actuarial15
soundness of the proposed rate models, and the proposed changes16
to department policies and procedures.>17
3. Title page, by striking lines 1 through 4 and inserting18
<An Act relating to the department of health and human services19
and reporting requirements for shelter care, residential20
treatment, and Medicaid provider reimbursement rates, and21
establishing provider reimbursement rates for Medicaid home and22
community-based waiver services.>23
4. By renumbering as necessary.24
______________________________
A. MEYER of Webster
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