Bill Text: IA SF2284 | 2017-2018 | 87th General Assembly | Introduced

Iowa Senate Bill 2284 (Prior Session Legislation)

Introduced

Bill Title: A bill for an act relating to the provision of health home services under Medicaid managed care, and including effective date provisions. (Formerly SF 2092.)

Spectrum: Committee Bill

Status: (Introduced - Dead) 2018-03-22 - Referred to Human Resources. S.J. 753. [SF2284 Detail]

Download: Iowa-2017-SF2284-Introduced.html


Senate File 2284 - Introduced




                                 SENATE FILE       
                                 BY  COMMITTEE ON HUMAN
                                     RESOURCES

                                 (SUCCESSOR TO SF 2092)

                                      A BILL FOR

  1 An Act relating to the provision of health home services
  2    under Medicaid managed care, and including effective date
  3    provisions.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
    TLSB 5792SV (3) 87
    pf/rh

PAG LIN



  1  1    Section 1.  PROVISION OF HEALTH HOME SERVICES UNDER MEDICAID
  1  2 MANAGED CARE.  The department of human services shall amend
  1  3 Medicaid managed care contracts and adopt rules pursuant to
  1  4 chapter 17A to require all of the following:
  1  5    1.  That health home services be provided in accordance
  1  6 with the state plan amendments approved pursuant to section
  1  7 2703 of the federal Patient Protection and Affordable Care
  1  8 Act for health home services for Medicaid members with
  1  9 chronic conditions or serious and persistent mental health
  1 10 conditions, including the requirement that comprehensive care
  1 11 coordination services be provided by care coordinators who are
  1 12 part of the health home's team of health care professionals or
  1 13 designated providers to meet provider standards and provider
  1 14 infrastructure requirements, and to deliver health home
  1 15 services to qualified members. Comprehensive care coordination
  1 16 for Medicaid members receiving health home services shall not
  1 17 be provided in a manner other than through the use of health
  1 18 home provider types as specified in the applicable state plan
  1 19 amendment, and shall not be provided by the managed care
  1 20 organization through internal resources or other contracted
  1 21 providers.
  1 22    2.  That if a Medicaid member is receiving health home
  1 23 services, and based on the member's array of services
  1 24 would potentially have more than one case manager or care
  1 25 coordinator, the member shall be provided the opportunity to
  1 26 select the member's own case manager or care coordinator.
  1 27 Additionally, such Medicaid member shall be allowed to change
  1 28 the health home provider from whom the member receives health
  1 29 home services.
  1 30    Sec. 2.  HEALTH HOME EVALUATION == ADMINISTRATIVE RULES
  1 31 REQUIRED.  The department of human services shall continue to
  1 32 administer the health homes state plan option for Medicaid
  1 33 members as specified in state plan amendments IA=16=012 and
  1 34 IA=16=013, and as administered on or before June 30, 2017.
  1 35 The department shall evaluate the health home program for
  2  1 quality assurance purposes, and shall report the results
  2  2 of the evaluation to the governor and the general assembly
  2  3 by October 1, 2018.  The department shall make any future
  2  4 changes to the health home program only through the rulemaking
  2  5 process pursuant to chapter 17A, and such changes shall not be
  2  6 implemented until such rules are effective.
  2  7    Sec. 3.  EFFECTIVE DATE.  This Act, being deemed of immediate
  2  8 importance, takes effect upon enactment.
  2  9                           EXPLANATION
  2 10 The inclusion of this explanation does not constitute agreement with
  2 11 the explanation's substance by the members of the general assembly.
  2 12    This bill requires the department of human services (DHS) to
  2 13 amend Medicaid managed care contracts and adopt administrative
  2 14 rules to require the following:
  2 15    1.  That health home services be provided in accordance
  2 16 with the state plan amendments, including the requirement
  2 17 that comprehensive care coordination services be provided
  2 18 by care coordinators who are part of the health home's team
  2 19 of health care professionals or designated providers to
  2 20 meet provider standards and deliver health home services to
  2 21 qualified members. Comprehensive care coordination shall not
  2 22 be provided in a manner other than through the use of the
  2 23 health home provider types as specified in the applicable state
  2 24 plan amendment, and shall not be provided by the managed care
  2 25 organization through internal resources or other contracted
  2 26 providers.
  2 27    2.  That if a Medicaid member is receiving health home
  2 28 services, and based on the member's array of services
  2 29 would potentially have more than one case manager or care
  2 30 coordinator, the member shall be given the opportunity to
  2 31 select the member's own case manager or care coordinator.
  2 32 Additionally, such Medicaid member shall be allowed to change
  2 33 the health home provider from whom the member receives health
  2 34 home services.
  2 35    The bill also requires DHS to continue to administer the
  3  1 health home state plan option as administered on or before June
  3  2 30, 2017.  DHS is required to evaluate the health home program
  3  3 and submit a report of the results of the evaluation to the
  3  4 governor and the general assembly by October 1, 2018. DHS is
  3  5 required to make any future changes to the health home program
  3  6 only through the rulemaking process and such changes shall not
  3  7 be implemented until such rules are effective.
  3  8    The bill takes effect upon enactment.
       LSB 5792SV (3) 87
       pf/rh