Bill Text: IA SF2062 | 2019-2020 | 88th General Assembly | Introduced

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Bill Title: A bill for an act relating to maternal and child health.

Spectrum: Partisan Bill (Democrat 18-0)

Status: (Introduced - Dead) 2020-01-27 - Subcommittee: Johnson, Garrett, and Mathis. S.J. 151. [SF2062 Detail]

Download: Iowa-2019-SF2062-Introduced.html

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Senate File 2062 - Introduced
SENATE FILE 2062
BY PETERSEN , RAGAN , MATHIS ,
BOULTON , CELSI , J. SMITH ,
JOCHUM , WAHLS , KINNEY ,
DOTZLER , R. TAYLOR ,
BISIGNANO , LYKAM , GIDDENS ,
BOLKCOM , QUIRMBACH , HOGG ,
and T. TAYLOR
A BILL FOR
An Act relating to maternal and child health.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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DIVISION I
MEDICAID COVERAGE —— MATERNAL AND CHILD HEALTH IMPROVEMENTS
Section 1. Section 249A.3, subsection 1, paragraph h, Code
2020, is amended to read as follows:
h. Is a woman who, while pregnant, meets eligibility
requirements for assistance under the federal Social Security
Act, section 1902(l), and continues to meet the requirements
except for income. The woman is eligible to receive assistance
until sixty days twelve months after the date pregnancy ends.
Sec. 2. MEDICAID REIMBURSEMENT FOR MATERNAL HEALTH. Under
both fee-for-service and managed care administration of
Medicaid, the department of human services shall adopt rules
pursuant to chapter 17A, amend any contract with a managed
care organization, and apply for any Medicaid state plan
amendment or waiver as may be necessary to provide for all of
the following:
1. Reimbursement in an amount appropriate to cover the
entire standard of care costs for labor and delivery.
2. The same reimbursement for maternal-fetal medicine
services and comprehensive maternity care, including both
facility and professional fees, whether provided in person or
through the use of telehealth.
3. Continuous Medicaid eligibility for a woman for a
twelve-month postpartum period, if the woman applied for
Medicaid coverage before the end of the woman’s pregnancy, was
determined Medicaid eligible, and remains eligible for coverage
during the month in which the woman’s pregnancy ends. The
woman’s eligibility for coverage shall continue during the
twelve-month postpartum period beginning with the last day of
the woman’s pregnancy through the end of the month in which the
twelve-month period ends; shall continue without regard to the
basis for the woman’s eligibility or changes in family income
or resources; and shall continue in the same coverage group
under which the woman received Medicaid coverage while pregnant
unless the woman qualifies for Medicaid under another coverage
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S.F. 2062
group once the pregnancy ends or unless the woman’s eligibility
is through the medically needy program.
4. Comprehensive maternity care, to include the basic
number of prenatal and postpartum visits recommended by the
American college of obstetricians and gynecologists; additional
prenatal and postpartum visits that are medically necessary;
necessary laboratory, nutritional assessment and counseling,
health education, personal counseling, managed care, outreach,
and follow-up services; treatment of conditions which may
complicate pregnancy; and doula care. For the purposes of this
subsection, “doula” means a trained professional who provides
continuous physical, emotional, and informational support to a
woman before, during, and after childbirth, to help the woman
achieve the healthiest, most satisfying experience possible.
5. Reimbursement for breast-feeding supports, counseling,
and supplies including the standard cost of breast pumps,
including electronic breast pumps.
6. Reimbursement for transportation to all prenatal and
postpartum care appointments.
7. Reimbursement for all postpartum care products such as
breast pads, period pads, comfort products, pain relievers, and
other similar products.
DIVISION II
MATERNAL BEST PRACTICES OR SAFETY BUNDLES —— REQUIREMENTS FOR
HOSPITALS
Sec. 3. NEW SECTION . 135B.36 Maternal best practices or
safety bundles —— information.
A hospital licensed under this chapter that provides labor
and delivery services shall do all of the following:
1. Adopt and implement the current best practices or safety
bundles recommended by the American college of obstetricians
and gynecologists and the alliance for innovation on maternal
health including but not limited to action measures for
obstetrical hemorrhage, severe hypertension or preeclampsia,
prevention of venous thromboembolism, reduction of low-risk
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primary cesarean births and support for intended vaginal
births, reduction of peripartum racial disparities, and
postpartum care access and standards.
2. Provide all of the following information to the public:
a. Maternity and neonatal level of care status and the
meaning of a maternity or neonatal level of care status.
b. Cesarean birth statistics.
c. Vaginal birth after cesarean statistics.
d. Vaginal birth after two cesarean sections statistics.
e. The rate of exclusive breastfeeding upon discharge from
a hospital.
3. Provide all women receiving labor and delivery services
with information and assistance in applying for services
and health care coverage available for the woman and the
infant including but not limited to those available through
Medicaid; area education agencies; the federal women, infants,
and children program; and home visiting programs; and other
relevant programs prior to discharge from the hospital.
4. Have in place a comprehensive labor and delivery unit
closure plan that includes a plan for future births and
pregnancies and the capacity of other providers to absorb the
services in case of unit closure.
DIVISION III
MATERNAL AND INFANT HOME VISITING PROGRAM
Sec. 4. MATERNAL AND INFANT HOME VISITING PROGRAM. The
department of human services shall engage in a cross-agency
collaboration with the department of public health and the
department of education to identify and leverage funding
sources and opportunities, including Medicaid, to expand home
visiting services for women and infants that promote healthy
pregnancies, positive birth outcomes, and healthy infant
growth and development. The departments shall involve key
stakeholders in designing a home visiting services approach
for the state that maximizes the coordination and integration
of programs and funding streams, reduces duplication of
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efforts, and ensures that the services provided meet federal
evidence-based criteria. The approach shall ensure that home
visiting services shall be available to women prenatally,
throughout the pregnancy, and postpartum, and shall include
mental and physical health, social, educational, and other
services and interventions based upon the risk factors and
needs identified. The departments may conduct a feasibility
study to consider the various options available to increase
Medicaid coverage and funding of home visiting services, either
through a state plan amendment or waiver. The department of
human services shall seek federal approval of any Medicaid
state plan amendment or waiver necessary to administer this
section.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
This bill relates to maternal and child health.
Division I of the bill relates to maternal and child health
improvements under the Medicaid program. The bill directs the
department of human services (DHS) under both fee-for-service
and managed care administration of Medicaid to adopt rules
pursuant to Code chapter 17A, amend any contract with a managed
care organization, and apply for any Medicaid state plan
amendment or waiver as may be necessary to provide all of the
following: 1) reimbursement in an amount appropriate to cover
the entire standard of care costs for labor and delivery, 2)
the same reimbursement for maternal-fetal medicine services
and comprehensive maternity care, including facility and
professional fees, whether provided in person or through the
use of telehealth, 3) continuous Medicaid eligibility for
a woman for a 12-month postpartum period, 4) comprehensive
maternity care, to include the basic number of prenatal and
postpartum visits recommended by the American college of
obstetricians and gynecologists; additional prenatal and
postpartum visits that are medically necessary; necessary
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laboratory, nutritional assessment and counseling, health
education, personal counseling, managed care, outreach,
and follow-up services; treatment of conditions which may
complicate pregnancy; and doula care, 5) reimbursement for
breastfeeding supports, counseling, and supplies including
the standard cost of breast pumps including electronic breast
pumps, 6) reimbursement for transportation to all prenatal and
postpartum care appointments, and 7) reimbursement for all
postpartum care products such as breast pads, period pads,
comfort products, pain relievers, and other similar products.
Division II of the bill relates to maternal best practices or
safety bundle requirements for hospitals. The bill requires
a licensed hospital that provides labor and delivery services
to 1) adopt and implement the current best practices or safety
bundles recommended by the American college of obstetricians
and gynecologists and the alliance for innovation on maternal
health; 2) provide information to the public, including but
not limited to maternity and neonatal level of care status and
the meaning of a maternity and neonatal level of care status,
cesarean birth, vaginal births following cesarean births, and
exclusive breast-feeding statistics; 3) provide all women
receiving labor and delivery services with information and
assistance in applying for services and health care coverage
available for the woman and the infant including but not
limited to those available through Medicaid; area education
agencies; the federal women, infants, and children program; and
home visiting programs; and other programs prior to discharge
from the hospital; and 4) have in place a comprehensive labor
and delivery unit closure plan that includes a plan for future
births and pregnancies and the capacity of other providers to
absorb the services in case of unit closure.
Division III of the bill requires DHS to engage in a
cross-agency collaboration with the departments of public
health and education to identify and leverage funding sources
and opportunities, including Medicaid, to expand home visiting
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S.F. 2062
services for women, infants, and young children that promote
healthy pregnancies, positive birth outcomes, and healthy
infant growth and development. The departments shall involve
key stakeholders in designing a home visiting services approach
for the state. Home visiting services shall be available to
women prenatally, throughout the pregnancy, and postpartum, and
shall include mental and physical health, social, educational,
and other services and interventions based upon the risk
factors and needs identified. The departments may conduct a
feasibility study to consider the various options available
to increase Medicaid coverage and funding of home visiting
services, either through a state plan amendment or waiver.
DHS shall seek federal approval of any Medicaid state plan
amendment or waiver necessary to administer this division of
the bill.
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