Bill Text: IA HF60 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to health care administrative simplification.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2019-01-31 - Subcommittee recommends passage. [HF60 Detail]
Download: Iowa-2019-HF60-Introduced.html
House
File
60
-
Introduced
HOUSE
FILE
60
BY
HINSON
A
BILL
FOR
An
Act
relating
to
health
care
administrative
simplification.
1
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
2
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Section
1.
HEALTH
CARE
ADMINISTRATIVE
SIMPLIFICATION
——
1
COMMISSIONER
OF
INSURANCE
WORKGROUP.
2
1.
During
the
fiscal
year
beginning
July
1,
2019,
the
work
3
group
convened
by
the
commissioner
of
insurance,
annually,
4
pursuant
to
section
505.8,
subsection
18,
shall
consider
ways
5
to
bring
about
greater
standardization,
streamlining
and
6
simplification
of
health
care
administrative
transactions,
7
increased
electronic
exchanges
of
administrative
data,
and
8
reduced
administrative
costs
and
burdens.
Specifically,
the
9
work
group
shall
consider
the
work
of
other
states
regarding
10
health
care
administrative
simplification
including
the
11
Minnesota
administrative
uniformity
committee
and
the
Minnesota
12
health
care
administrative
simplification
initiative
and
make
13
recommendations
regarding
all
of
the
following:
14
a.
Uniform,
HIPAA-compliant
health
care
electronic
data
15
interchange
standards
for
health
care
transactions
including
16
all
of
the
following:
17
(1)
Eligibility
verifications
submitted
by
health
care
18
providers
to
health
insurance
carriers
to
confirm
a
patient’s
19
medical
insurance
coverage
and
benefits
to
facilitate
proper
20
billing.
21
(2)
Claims
submitted
by
health
care
providers
to
health
22
insurance
carriers
for
payment
for
health
care
services
23
provided.
24
(3)
Remittance
advices
submitted
by
health
insurance
25
carriers
to
health
care
providers
to
explain
any
adjustments
to
26
claims
and
corresponding
payments.
27
(4)
Acknowledgments
indicating
that
one
party
has
received
28
an
exchange
submitted
by
another
party.
29
b.
A
HIPAA-compliant,
single,
uniform
companion
guide
for
30
the
electronic
exchange
of
patient
eligibility
verifications,
31
claims,
remittance
advices,
and
acknowledgments
by
all
health
32
care
providers
and
health
insurance
carriers.
33
c.
Unique
identification
numbers
to
be
used
by
health
care
34
providers,
health
insurance
carriers,
and
patients,
including
35
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1916YH
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3
H.F.
60
applicable
privacy
standards
to
protect
the
identity
of
the
1
individual
subject
of
the
data
exchanged.
2
d.
A
uniform
explanation
of
benefits
document.
3
e.
Best
practices
to
be
incorporated
by
health
care
4
providers
and
health
insurance
carriers
to
reduce
the
cost
of
5
providing
health
insurance
coverage
and
health
care
services
6
in
the
state.
7
2.
The
work
group
shall
report
its
findings
and
8
recommendations,
including
any
changes
in
law
or
administrative
9
rules,
in
the
annual
report
filed
with
the
general
assembly
10
pursuant
to
section
505.18.
11
3.
For
the
purposes
of
this
section:
12
a.
“Health
care
provider”
means
the
same
as
defined
in
13
section
135P.1.
14
b.
“Health
insurance
carrier”
means
“carrier”
as
defined
in
15
section
514C.13.
16
c.
“HIPAA”
means
the
federal
Health
Insurance
Portability
17
and
Accountability
Act
of
1996,
Pub.
L.
No.
104-191,
110
Stat.
18
1936
(1996).
19
EXPLANATION
20
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
21
the
explanation’s
substance
by
the
members
of
the
general
assembly.
22
This
bill
directs
the
work
group
convened
by
the
23
commissioner
of
insurance,
annually,
during
the
fiscal
year
24
beginning
July
1,
2019,
to
consider
ways
to
bring
about
25
greater
standardization,
streamlining
and
simplification
of
26
health
care
administrative
transactions,
increased
electronic
27
exchanges
of
administrative
data,
and
reduced
administrative
28
costs
and
burdens.
Specifically,
the
work
group
is
directed
29
to
consider
the
work
of
other
states
regarding
health
care
30
administrative
simplification
including
the
Minnesota
31
administrative
uniformity
committee
and
the
Minnesota
health
32
care
administrative
simplification
initiative
and
make
33
recommendations
regarding
uniform,
health
care
electronic
34
data
interchange
standards
that
comply
with
the
federal
35
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3
H.F.
60
Health
Insurance
Portability
and
Accountability
Act
of
1996
1
(HIPAA)
for
health
care
transactions
including
eligibility
2
verifications,
claims,
remittance
advices,
and
acknowledgments;
3
a
HIPAA-compliant,
single,
uniform
companion
guide
for
the
4
electronic
exchange
of
patient
eligibility
verifications,
5
claims,
remittance
advices,
and
acknowledgments;
unique
6
identification
numbers
to
be
used
by
health
care
providers,
7
health
insurance
carriers,
and
patients,
including
applicable
8
privacy
standards
to
protect
the
identity
of
the
individual
9
subject
of
the
data
exchanged;
a
uniform
explanation
of
10
benefits
document;
and
best
practices
to
be
incorporated
by
11
health
care
providers
and
health
insurance
carriers
to
reduce
12
the
cost
of
providing
health
insurance
coverage
and
health
care
13
services
in
the
state.
14
The
work
group
is
directed
to
report
its
findings
and
15
recommendations,
including
any
changes
in
law
or
administrative
16
rules,
in
the
annual
report
filed
with
the
general
assembly.
17
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3
