Bill Text: IA SF168 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to an ombudsman to provide Medicaid program assistance and advocacy.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2019-02-05 - Subcommittee: Johnson, Costello, and Ragan. S.J. 247. [SF168 Detail]
Download: Iowa-2019-SF168-Introduced.html
Senate
File
168
-
Introduced
SENATE
FILE
168
BY
RAGAN
and
MATHIS
A
BILL
FOR
An
Act
relating
to
an
ombudsman
to
provide
Medicaid
program
1
assistance
and
advocacy.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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Section
1.
NEW
SECTION
.
2C.6A
Assistant
for
Medicaid
1
program.
2
1.
The
ombudsman
shall
appoint
an
assistant
who
shall
be
3
primarily
responsible
for
investigating
complaints
relating
to
4
the
Medicaid
program,
including
both
Medicaid
fee-for-service
5
and
managed
care
payment
and
delivery
systems,
and
all
Medicaid
6
populations
including
the
long-term
services
and
supports
7
population.
8
2.
The
ombudsman
shall
provide
assistance
and
advocacy
9
services
to
Medicaid
recipients
and
the
families
or
legal
10
representatives
of
Medicaid
recipients.
Such
assistance
11
and
advocacy
shall
include
but
is
not
limited
to
all
of
the
12
following:
13
a.
Assisting
recipients
in
understanding
the
services,
14
coverage,
and
access
provisions
and
their
rights
under
the
15
Medicaid
program.
16
b.
Developing
procedures
for
the
tracking
and
reporting
17
of
the
outcomes
of
individual
requests
for
assistance,
the
18
procedures
available
for
obtaining
services,
and
other
aspects
19
of
the
services
provided
to
Medicaid
recipients.
20
c.
Providing
advice
and
assistance
relating
to
the
21
preparation
and
filing
of
complaints,
grievances,
and
appeals
22
of
complaints
or
grievances,
including
through
processes
23
available
under
managed
care
plans
and
the
state
appeals
24
process
under
the
Medicaid
program.
25
3.
The
ombudsman
shall
adopt
rules
to
administer
this
26
section.
27
4.
The
ombudsman
shall
publish
special
reports
and
28
investigative
reports
as
deemed
necessary
and
shall
include
29
findings
and
recommendations
related
to
the
assistance
and
30
advocacy
provided
under
this
section
in
the
ombudsman’s
annual
31
report.
32
5.
The
ombudsman
and
the
department
of
human
services
33
shall
collaborate
to
develop
a
cost
allocation
plan
requesting
34
Medicaid
administrative
funding
to
provide
for
the
claiming
of
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168
federal
financial
participation
for
ombudsman
activities
that
1
are
performed
to
assist
with
the
administration
of
the
Medicaid
2
program.
The
cost
allocation
plan
shall
document
the
costs
3
that
directly
benefit
the
Medicaid
program
and
are
consistent
4
with
federal
requirements.
The
cost
allocation
plan
shall
be
5
developed
in
a
timely
manner
to
allow
for
such
claiming
to
6
begin
by
January
1,
2020.
7
Sec.
2.
REPEAL.
Section
231.44,
Code
2019,
is
repealed.
8
EXPLANATION
9
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
10
the
explanation’s
substance
by
the
members
of
the
general
assembly.
11
This
bill
directs
the
ombudsman
to
appoint
an
assistant
who
12
shall
be
primarily
responsible
for
investigating
complaints
13
relating
to
the
Medicaid
program,
including
both
the
Medicaid
14
managed
care
and
fee-for-service
payment
and
delivery
systems,
15
and
all
Medicaid
populations
including
the
long-term
services
16
and
supports
population.
The
bill
specifies
the
minimum
17
areas
of
assistance
and
advocacy
to
be
provided,
directs
the
18
ombudsman
to
adopt
administrative
rules
for
administration
19
of
the
bill,
and
directs
the
ombudsman
to
publish
special
20
reports
and
investigative
reports
as
deemed
necessary,
and
to
21
include
findings
and
recommendations
related
to
the
Medicaid
22
program
assistance
and
advocacy
provided
under
the
bill
in
the
23
ombudsman’s
annual
report.
24
The
bill
also
repeals
the
section
of
the
Code
that
directs
25
the
office
of
long-term
care
ombudsman
to
provide
assistance
26
and
advocacy
services
to
members
of
the
Medicaid
long-term
27
services
and
supports
population
since
under
the
bill,
the
28
ombudsman
will
provide
assistance
and
advocacy
for
both
29
Medicaid
managed
care
and
fee-for-service
payment
and
delivery
30
systems
and
for
all
populations
including
the
long-term
31
services
and
supports
population.
32
The
bill
also
requires
the
ombudsman
and
the
department
of
33
human
services
to
collaborate
to
develop
a
cost
allocation
34
plan,
consistent
with
federal
requirements,
requesting
Medicaid
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