Senate File 2027 - Introduced SENATE FILE 2027 BY DANIELSON A BILL FOR An Act relating to directives to the department of human 1 services regarding changes in the IowaCare and Medicaid 2 programs. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 5350XS (4) 84 pf/nh

S.F. 2027 Section 1. IOWACARE AND MEDICAID PROGRAM —— DIRECTIVES TO 1 DEPARTMENT OF HUMAN SERVICES. The department of human services 2 shall submit any waiver or state plan amendments under the 3 medical assistance program to the centers for Medicare and 4 Medicaid services of the United States department of health 5 and human services as necessary to implement the following 6 directives: 7 1. Amend the specifications for utilization of funds 8 appropriated from the IowaCare account created in section 9 249J.24 to the department of human services for a laboratory 10 test and radiology pool to allow federally qualified health 11 centers, designated by the department as part of the IowaCare 12 regional provider network that do not have the capability 13 to provide such services on site, to utilize laboratory and 14 radiology providers selected by the individual federally 15 qualified health center and approved by the department in 16 addition to any laboratory and radiology providers designated 17 for that federally qualified health center by the department. 18 Notwithstanding any provision to the contrary, the department 19 shall amend specifications for utilization of the funds 20 to restrict expenditures to payment for routine screening 21 and basic diagnostic testing and to allow adjustment of 22 reimbursement for covered services to provide reimbursement in 23 an amount that is no greater than the Medicaid reimbursement 24 rate. 25 2. Allow federally qualified health centers that are not 26 participating regional provider network providers to refer 27 patients directly to the university of Iowa hospitals and 28 clinics or to the publicly owned acute care teaching hospital 29 located in a county with a population over 350,000 that is a 30 participating provider for specialty services. 31 3. Reimburse federally qualified health centers for all 32 medical, oral, and behavioral health care services provided to 33 a Medicaid program recipient on the same day at the federally 34 qualified health center. 35 -1- LSB 5350XS (4) 84 pf/nh 1/ 2

S.F. 2027 EXPLANATION 1 This bill directs the department of human services (DHS) to 2 submit any waiver or state plan amendments under the medical 3 assistance program to the centers for Medicare and Medicaid 4 services of the United States department of health and human 5 services as necessary to implement three directives: 6 1. Amend the specifications for utilization of funds 7 appropriated to DHS for a laboratory test and radiology pool 8 to allow federally qualified health centers (FQHCs) that are 9 regional providers under the IowaCare program to utilize 10 laboratory and radiology providers selected by the individual 11 FQHC in addition to those laboratory and radiology providers 12 designated by the department. The bill also provides for 13 restriction of expenditures of funds under the pool for 14 routine screening and basic diagnostic testing and provides 15 for adjustment of reimbursement for covered services to 16 provide reimbursement that is not greater than the Medicaid 17 reimbursement rate. 18 2. Allow FQHCs that are not participating regional 19 providers under the IowaCare program to refer patients 20 directly to the university of Iowa hospitals and clinics or to 21 Broadlawns medical center in Des Moines for specialty services. 22 3. Reimburse FQHCs for all medical, oral, and behavioral 23 health care services provided to a Medicaid program recipient 24 on the same day at the FQHC. 25 -2- LSB 5350XS (4) 84 pf/nh 2/ 2