Bill Text: IA HF2589 | 2023-2024 | 90th General Assembly | Introduced
Bill Title: A bill for an act relating to Medicaid-related programs and services including the work without worry program for employed individuals with disabilities and complex rehabilitation technology.(Formerly HF 403, HSB 198.)
Spectrum: Committee Bill
Status: (Introduced) 2024-02-19 - Introduced, referred to Appropriations. H.J. 292. [HF2589 Detail]
Download: Iowa-2023-HF2589-Introduced.html
House
File
2589
-
Introduced
HOUSE
FILE
2589
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
HSB
198)
A
BILL
FOR
An
Act
relating
to
Medicaid-related
programs
and
services
1
including
the
work
without
worry
program
for
employed
2
individuals
with
disabilities
and
complex
rehabilitation
3
technology.
4
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
5
TLSB
1820HV
(3)
90
pf/ko
H.F.
2589
Section
1.
WORK
WITHOUT
WORRY
PROGRAM
——
MEDICAID
FOR
1
EMPLOYED
INDIVIDUALS
WITH
DISABILITIES.
2
1.
The
department
of
health
and
human
services
shall
submit
3
any
waiver
request
or
state
plan
amendment,
or
combination
4
thereof,
to
the
centers
for
Medicare
and
Medicaid
services
of
5
the
United
States
department
of
health
and
human
services
as
6
necessary
to
create
a
work
without
worry
program
for
employed
7
individuals
with
disabilities
in
accordance
with
this
section.
8
2.
The
program
shall
provide
Medicaid
coverage
based
on
the
9
following
criteria:
10
a.
The
individual
has
a
qualifying
disability
as
determined
11
by
the
social
security
administration
or
the
individual
is
12
determined
by
the
department
of
health
and
human
services
13
to
have
a
physical
or
mental
impairment
or
combination
of
14
impairments
that
have
lasted
or
are
expected
to
last
for
15
at
least
twelve
months
or
result
in
death.
An
individual
16
shall
not
be
required
to
receive
federal
disability
benefits
17
to
participate
in
the
program.
An
individual
who
receives
18
supplemental
security
income
shall
be
automatically
eligible
19
for
coverage
under
the
program
and
shall
not
be
required
to
20
submit
a
separate
application
for
the
program.
21
b.
The
individual
is
sixteen
to
sixty-five
years
of
age.
22
c.
The
individual
is
employed
and
has
earned
income
23
from
employment
including
self-employment.
The
employment
24
requirement
shall
not
be
limited
by
the
number
of
hours
or
25
amount
of
income,
but
the
individual
shall
verify
employment
26
through
evidence
of
pay
stubs
or
a
self-employment
ledger.
27
The
program
shall
allow
for
continuation
of
coverage
for
a
28
participating
individual
for
six
months
following
loss
of
29
employment
if
there
is
an
intent
on
the
part
of
the
individual
30
to
return
to
employment.
31
d.
The
individual
is
not
subject
to
any
resource
or
asset
32
test
or
limit
under
the
program,
with
the
exception
of
the
33
following:
34
(1)
Any
vehicle
owned
by
the
individual
that
is
not
35
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1820HV
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2589
adapted
for
the
individual,
used
primarily
by
or
for
the
1
individual,
and
used
for
transporting
the
individual
to
medical
2
appointments.
3
(2)
The
primary
residence
owned
and
occupied
by
the
4
individual
if
the
assessed
value
of
the
residence
exceeds
four
5
hundred
thousand
dollars.
6
e.
The
individual’s
income
is
below
four
hundred
fifty
7
percent
of
the
federal
poverty
level.
Income
is
based
only
on
8
the
individual’s
net
earned
and
unearned
income
as
a
household
9
of
one
as
that
income
is
adjusted
by
the
following
deductions
10
or
disregards:
11
(1)
A
twenty
dollar
general
disregard
from
unearned
income
12
that
is
not
from
employment.
13
(2)
A
disregard
of
sixty-five
dollars
plus
one-half
of
the
14
individual’s
earned
income
from
employment.
15
(3)
A
deduction
of
impairment-related
work
expenses.
16
(4)
A
deduction
of
work
expenses
for
the
blind.
17
f.
An
individual
shall
have
access
to
all
traditional
18
Medicaid
services
under
the
Medicaid
state
plan
as
well
as
19
additional
long-term
services
and
supports
and
community-based
20
services,
including
waiver
services,
for
which
the
individual
21
meets
any
applicable
level
of
care
requirements
subject
to
any
22
waiting
list
or
availability
of
openings
for
the
service
and
23
support.
24
g.
An
individual
may
be
eligible
for
or
receive
other
health
25
care
coverage
including
through
an
employer,
through
Medicare,
26
or
through
the
medically
needy
program,
the
qualified
Medicare
27
beneficiary
program,
or
the
specified
low-income
Medicare
28
beneficiary
program.
If
the
individual
has
such
other
coverage
29
and
is
subject
to
payment
of
copayments
or
premiums
for
that
30
coverage,
notwithstanding
the
premium
requirements
under
the
31
program
to
the
contrary,
the
individual
shall
not
be
subject
to
32
payment
of
premiums
otherwise
applicable
under
the
program.
33
h.
An
individual
with
income
at
or
above
one
hundred
fifty
34
percent
of
the
federal
poverty
level
shall
be
subject
to
35
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1820HV
(3)
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5
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2589
payment
of
a
premium
not
to
exceed
the
limits
established
under
1
federal
guidelines.
2
i.
The
program
shall
also
provide
that
any
individual
3
participating
in
the
Medicaid
for
employed
persons
with
4
disabilities
program
when
the
work
without
worry
program
is
5
implemented
shall
be
transferred
to
and
enrolled
in
the
work
6
without
worry
program.
7
3.
The
department
of
health
and
human
services
shall
8
implement
a
work
without
worry
public
awareness
campaign
to
9
ensure
that
consumer
information
and
educational
resources
are
10
accessible
to
individuals
with
disabilities
and
the
public.
11
The
department
shall
also
provide
technical
assistance
to
12
individuals
with
disabilities
in
determining
if
the
work
13
without
worry
program
is
the
best
option
for
coverage
under
14
that
individual’s
particular
circumstances
and
in
applying
for
15
and
maintaining
participation
in
the
program.
16
Sec.
2.
MEDICAID
——
REIMBURSEMENT
FOR
THE
REPAIR
OF
COMPLEX
17
REHABILITATION
TECHNOLOGY.
Under
both
Medicaid
managed
care
18
and
fee-for-service
administration
of
the
Medicaid
program,
the
19
department
of
health
and
human
services
shall
not
require
a
20
prescription
for
reimbursement
of
a
provider
for
the
repair
of
21
complex
rehabilitation
equipment,
if
the
complex
rehabilitation
22
technology
was
previously
prescribed
and
reimbursed
under
23
the
Medicaid
program.
For
the
purposes
of
this
section,
24
“complex
rehabilitation
technology”
means
items
classified
25
under
the
Medicare
program
as
durable
medical
equipment
that
26
is
individually
configured
for
individuals
to
meet
their
27
specific
and
unique
medical,
physical,
and
functional
needs
28
and
capacities
for
basic
activities
of
daily
living
and
29
instrumental
activities
of
daily
living
identified
as
medically
30
necessary.
31
EXPLANATION
32
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
33
the
explanation’s
substance
by
the
members
of
the
general
assembly.
34
This
bill
relates
to
programs
and
services
under
the
35
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1820HV
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2589
Medicaid
program.
The
bill
creates
the
work
without
worry
1
program
for
employed
individuals
with
disabilities
16
to
65
2
years
of
age
under
the
Medicaid
program.
The
bill
directs
the
3
department
of
health
and
human
services
(HHS)
to
submit
any
4
waiver
request
or
state
plan
amendment,
or
combination
thereof,
5
to
the
centers
for
Medicare
and
Medicaid
services
of
the
United
6
States
department
of
health
and
human
services
as
necessary
to
7
create
a
work
without
worry
program
for
employed
individuals
8
with
disabilities
in
accordance
with
the
bill.
Criteria
for
9
coverage
under
the
program
include
that
the
individual
has
10
a
qualifying
disability
and
although
an
individual
is
not
11
required
to
receive
federal
disability
benefits
to
participate
12
in
the
program,
an
individual
who
receives
supplemental
13
security
income
shall
be
automatically
eligible
for
coverage
14
under
the
program;
the
individual
is
16
to
65
years
of
age;
the
15
individual
is
employed
and
has
earned
income
from
employment
16
including
self-employment;
the
individual
is
not
subject
to
17
any
resource
or
asset
test
or
limit
under
the
program
with
the
18
exception
of
nonadapted
vehicles
and
a
primary
residence
for
19
which
the
assessed
value
exceeds
$400,000;
the
individual’s
20
income
is
below
450
percent
of
the
federal
poverty
level
as
21
adjusted
by
specified
deductions
or
disregards;
the
individual
22
has
access
to
all
traditional
Medicaid
services
as
well
as
23
additional
long-term
services
and
supports
and
community-based
24
services
subject
to
waiting
lists
and
availability
of
openings;
25
the
individual
may
be
eligible
for
or
receive
other
coverage
26
including
through
an
employer,
through
Medicare,
through
the
27
medically
needy
program,
the
qualified
Medicare
beneficiary
28
program,
or
the
specified
low-income
Medicare
beneficiary
29
program,
and
is
not
subject
to
otherwise
applicable
premiums
30
if
the
individual
is
subject
to
copayments
or
premiums
for
31
the
other
coverage;
the
individual
with
income
at
or
above
32
150
percent
of
the
federal
poverty
level
shall
be
subject
to
33
payment
of
a
premium
not
to
exceed
the
limits
established
34
under
federal
guidelines;
and
the
program
shall
provide
that
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any
individual
participating
in
the
Medicaid
for
employed
1
persons
with
disabilities
program
at
the
time
the
work
without
2
worry
program
is
implemented
shall
be
transferred
to
and
3
enrolled
in
the
work
without
worry
program.
The
bill
also
4
requires
HHS
to
implement
a
work
without
worry
public
awareness
5
campaign
to
ensure
that
consumer
information
and
educational
6
resources
are
accessible
to
individuals
with
disabilities
and
7
the
public,
and
to
provide
technical
assistance
to
individuals
8
with
disabilities
in
determining
if
the
work
without
worry
9
program
is
the
best
option
for
coverage
under
the
individual’s
10
particular
circumstances
and
in
applying
for
and
maintaining
11
participation
in
the
program.
12
The
bill
also
provides
that
under
both
Medicaid
managed
care
13
and
fee-for-service
administration
of
the
Medicaid
program,
14
HHS
shall
not
require
a
prescription
for
reimbursement
of
a
15
provider
for
the
repair
of
complex
rehabilitation
technology,
16
if
the
complex
rehabilitation
technology
was
previously
17
prescribed
and
reimbursed
under
the
Medicaid
program.
The
bill
18
defines
complex
rehabilitation
technology.
19
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