Bill Text: IA SF2045 | 2017-2018 | 87th General Assembly | Introduced

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Bill Title: A bill for an act relating to the provision of benefits to residents of health care facilities, including the creation of a provisional application for the medical assistance program by or for a resident of a health care facility.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2018-01-23 - Subcommittee: C. Johnson, Quirmbach, and Shipley. S.J. 144. [SF2045 Detail]

Download: Iowa-2017-SF2045-Introduced.html

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Senate File 2045 - Introduced




                                 SENATE FILE       
                                 BY  CHELGREN

                                      A BILL FOR

  1 An Act relating to the provision of benefits to residents
  2    of health care facilities, including the creation of a
  3    provisional application for the medical assistance program
  4    by or for a resident of a health care facility.
  5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN



  1  1    Section 1.  Section 135C.31A, Code 2018, is amended to read
  1  2 as follows:
  1  3    135C.31A  Assessment of residents == program eligibility ==
  1  4 prescription drug coverage == provisional medical assistance
  1  5 program application for private pay residents.
  1  6    1.  A health care facility shall assist the Iowa department
  1  7 of veterans affairs in identifying, upon admission of a
  1  8 resident, the resident's eligibility for benefits through the
  1  9 United States department of veterans affairs. The department
  1 10 of inspections and appeals, in cooperation with the department
  1 11 of human services, shall adopt rules to administer this
  1 12 section, including a provision that ensures that if a resident
  1 13 is eligible for benefits through the United States department
  1 14 of veterans affairs or other third=party payor, the payor of
  1 15 last resort for reimbursement to the health care facility is
  1 16 the medical assistance program. The rules shall also require
  1 17 the health care facility to request information from a resident
  1 18 or resident's personal representative regarding the resident's
  1 19 veteran status and to report to the Iowa department of veterans
  1 20 affairs only the names of residents identified as potential
  1 21 veterans along with the names of their spouses and any
  1 22 dependents. Information reported by the health care facility
  1 23 shall be verified by the Iowa department of veterans affairs.
  1 24 This section shall not apply to the admission of an individual
  1 25 to a state mental health institute for acute psychiatric care
  1 26 or to the admission of an individual to the Iowa veterans home.
  1 27    2.  a.  If a resident is identified, upon admission to a
  1 28 health care facility, as eligible for benefits through the
  1 29 United States department of veterans affairs pursuant to
  1 30 subsection 1 or through other means, the health care facility
  1 31 shall allow the resident to access any prescription drug
  1 32 benefit included in such benefits for which the resident is
  1 33 also eligible. The health care facility shall also assist the
  1 34 Iowa department of veterans affairs in identifying individuals
  1 35 residing in such health care facilities on July 1, 2009, who
  2  1 are eligible for the prescription drug benefit.
  2  2    b.  The department of inspections and appeals, the department
  2  3 of veterans affairs, and the department of human services
  2  4 shall identify any barriers to residents in accessing such
  2  5 prescription drug benefits and shall assist health care
  2  6 facilities in adjusting their procedures for medication
  2  7 administration to comply with this subsection.
  2  8    3.  A health care facility, upon admission of a resident
  2  9 whose source of payment is private pay, shall assist the
  2 10 resident or the resident's personal representative in
  2 11 completing a provisional application for the medical assistance
  2 12 program. The department of inspections and appeals, in
  2 13 cooperation with the department of human services, shall
  2 14 adopt rules to administer this subsection, including the
  2 15 establishment of a process to ensure that approval of a
  2 16 resident's provisional application is expedited when the
  2 17 resident meets all financial and other eligibility requirements
  2 18 for the medical assistance program.
  2 19    4.  This section shall not apply to the admission of an
  2 20 individual to a state mental health institute for acute
  2 21 psychiatric care or to the admission of an individual to the
  2 22 Iowa veterans home.
  2 23                           EXPLANATION
  2 24 The inclusion of this explanation does not constitute agreement with
  2 25 the explanation's substance by the members of the general assembly.
  2 26    This bill provides for the completion of a provisional
  2 27 application for the medical assistance program by a resident
  2 28 or resident's personal representative, upon admission of a
  2 29 resident to a health care facility, if the resident's source
  2 30 of payment is private pay. The bill directs the department of
  2 31 inspections and appeals and the department of human services
  2 32 to adopt rules to administer the provision, including the
  2 33 establishment of a process to ensure that approval of a
  2 34 resident's provisional application is expedited when the
  2 35 resident meets all financial and other eligibility requirements
  3  1 for the medical assistance program.   The bill also eliminates
  3  2 an outdated reference to identification of individuals residing
  3  3 in health care facilities on July 1, 2009, who were eligible
  3  4 for the department of veterans affairs prescription drug
  3  5 benefit.
  3  6    The provisions of the bill do not apply to the admission of
  3  7 an individual to a state mental health institution for acute
  3  8 psychiatric care or to the admission of an individual to the
  3  9 Iowa veterans home.
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