Bill Text: IA HSB52 | 2023-2024 | 90th General Assembly | Introduced
Bill Title: A bill for an act relating to the establishment of tiered reimbursement rates for pediatric outpatient services under the Medicaid program.
Spectrum: Committee Bill
Status: (Introduced - Dead) 2023-01-17 - Subcommittee: Fry, Baeth and Kniff McCulla. H.J. 119. [HSB52 Detail]
Download: Iowa-2023-HSB52-Introduced.html
House
Study
Bill
52
-
Introduced
HOUSE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
BILL
BY
CHAIRPERSON
MEYER)
A
BILL
FOR
An
Act
relating
to
the
establishment
of
tiered
reimbursement
1
rates
for
pediatric
outpatient
services
under
the
Medicaid
2
program.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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H.F.
_____
Section
1.
MEDICAID
TIERED
REIMBURSEMENT
RATES
——
1
PEDIATRIC
OUTPATIENT
SERVICES.
The
department
of
health
and
2
human
services
shall
implement
a
tiered
rate
reimbursement
3
methodology
for
pediatric
outpatient
care
under
the
Medicaid
4
program
based
on
patient
acuity.
The
reimbursement
rates
may
5
incorporate
code
modifiers
to
reflect
the
extended
time
and
6
increased
intensity
required
of
a
pediatric
provider
to
address
7
complex
trauma,
complexity
of
a
child’s
family
environment,
and
8
other
factors
affecting
a
child
as
recommended
by
pediatric
9
providers
and
advocates.
10
EXPLANATION
11
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
12
the
explanation’s
substance
by
the
members
of
the
general
assembly.
13
This
bill
requires
the
department
of
health
and
human
14
services
to
implement
a
tiered
rate
reimbursement
methodology
15
for
pediatric
outpatient
care
under
the
Medicaid
program
based
16
on
patient
acuity.
The
reimbursement
rates
may
incorporate
17
code
modifiers
to
reflect
the
extended
time
and
increased
18
intensity
required
of
a
pediatric
provider
to
address
complex
19
trauma,
complexity
of
a
child’s
family
environment,
and
other
20
factors
affecting
a
child
as
recommended
by
pediatric
providers
21
and
advocates.
22
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