Bill Text: IA SF2083 | 2017-2018 | 87th General Assembly | Introduced
Bill Title: A bill for an act relating to reimbursement of in-network and out-of-network providers under Medicaid managed care.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2018-02-01 - Subcommittee recommends amendment and passage. [SF2083 Detail]
Download: Iowa-2017-SF2083-Introduced.html
Senate File 2083 - Introduced SENATE FILE BY CHELGREN A BILL FOR 1 An Act relating to reimbursement of in=network and 2 out=of=network providers under Medicaid managed care. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 5966XS (1) 87 pf/rh PAG LIN 1 1 Section 1. MEDICAID MANAGED CARE ==== REIMBURSEMENT OF 1 2 IN=NETWORK AND OUT=OF=NETWORK PROVIDERS. The department of 1 3 human services shall adopt rules pursuant to chapter 17A and 1 4 shall amend all Medicaid managed care contracts to require that 1 5 beginning July 1, 2018, for each covered service, Medicaid 1 6 providers that have contracted with a Medicaid managed care 1 7 organization as an in=network provider be reimbursed at one 1 8 hundred percent of the fee=for=service reimbursement rate 1 9 established by the general assembly through the appropriations 1 10 process for the respective fiscal year, and that Medicaid 1 11 providers that have not contracted with a Medicaid managed care 1 12 organization and are considered an out=of=network provider 1 13 be reimbursed at ninety=five percent of the fee=for=service 1 14 reimbursement rate established by the general assembly through 1 15 the appropriations process for the respective fiscal year. 1 16 Sec. 2. EFFECTIVE DATE. This Act, being deemed of immediate 1 17 importance, takes effect upon enactment. 1 18 EXPLANATION 1 19 The inclusion of this explanation does not constitute agreement with 1 20 the explanation's substance by the members of the general assembly. 1 21 This bill directs the department of human services (DHS) 1 22 to adopt rules pursuant to Code chapter 17A and amend all 1 23 Medicaid managed care contracts to require that beginning July 1 24 1, 2018, for each covered service, Medicaid providers that 1 25 have contracted with a Medicaid managed care organization 1 26 as an in=network provider be reimbursed at 100 percent of 1 27 the fee=for=service reimbursement rate established by the 1 28 general assembly through the appropriations process for the 1 29 respective fiscal year, and that Medicaid providers that have 1 30 not contracted with a Medicaid managed care organization and 1 31 are considered an out=of=network provider be reimbursed at 95 1 32 percent of the fee=for=service reimbursement rate established 1 33 by the general assembly through the appropriations process for 1 34 the respective fiscal year. 1 35 The bill takes effect upon enactment. LSB 5966XS (1) 87 pf/rh
