Bill Text: IA SSB1210 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to the integration of Medicaid and healthy and well kids in Iowa program eligibility, payment, and administrative functions under the department of human services.
Spectrum: Unknown
Status: (N/A - Dead) 2019-02-28 - Subcommittee recommends passage. [SSB1210 Detail]
Download: Iowa-2019-SSB1210-Introduced.html
Senate
Study
Bill
1210
-
Introduced
SENATE/HOUSE
FILE
_____
BY
(PROPOSED
DEPARTMENT
OF
HUMAN
SERVICES
BILL)
A
BILL
FOR
An
Act
relating
to
the
integration
of
Medicaid
and
healthy
1
and
well
kids
in
Iowa
program
eligibility,
payment,
and
2
administrative
functions
under
the
department
of
human
3
services.
4
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
5
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Section
1.
Section
514I.2,
subsection
1,
Code
2019,
is
1
amended
by
striking
the
subsection.
2
Sec.
2.
Section
514I.4,
subsection
3,
Code
2019,
is
amended
3
by
striking
the
subsection.
4
Sec.
3.
Section
514I.4,
subsection
5,
Code
2019,
is
amended
5
to
read
as
follows:
6
5.
The
department
shall
do
or
shall
provide
for
all
of
the
7
following:
8
a.
Determine
eligibility
for
program
enrollment
as
9
prescribed
by
federal
law
and
regulation,
using
policies
and
10
procedures
adopted
by
rule
of
the
department
pursuant
to
11
chapter
17A.
The
department
shall
not
enroll
a
child
who
has
12
group
health
coverage
unless
expressly
authorized
by
such
13
rules.
14
b.
Enroll
qualifying
children
in
the
program
with
15
maintenance
of
a
supporting
eligibility
file
or
database.
16
c.
Utilize
the
department’s
eligibility
system
to
maintain
17
eligibility
files
with
pertinent
eligibility
determination
and
18
ongoing
enrollment
information
including
but
not
limited
to
19
data
regarding
beneficiaries,
enrollment
dates,
disenrollments,
20
and
annual
financial
redeterminations.
21
d.
Provide
for
administrative
oversight
and
monitoring
of
22
federal
requirements.
23
e.
Perform
annual
financial
reviews
of
eligibility
for
each
24
beneficiary.
25
f.
Collect
and
track
monthly
family
premiums
to
assure
that
26
payments
are
current.
27
g.
Notify
each
participating
insurer
of
new
program
28
enrollees
who
are
enrolled
by
the
department
in
that
29
participating
insurer’s
plan.
30
h.
Verify
the
number
of
program
enrollees
with
each
31
participating
insurer
for
determination
of
the
amount
of
32
premiums
to
be
paid
to
each
participating
insurer.
33
i.
Maintain
data
for
the
purpose
of
quality
assurance
34
reports
as
required
by
rule
of
the
board.
35
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a.
j.
(1)
Establish
the
family
cost
sharing
amounts
for
1
children
of
families
with
incomes
of
one
hundred
fifty
percent
2
or
more
but
not
exceeding
two
hundred
percent
of
the
federal
3
poverty
level,
of
not
less
than
ten
dollars
per
individual
4
and
twenty
dollars
per
family,
if
not
otherwise
prohibited
by
5
federal
law,
with
the
approval
of
the
board.
6
(2)
Establish
for
children
of
families
with
incomes
7
exceeding
two
hundred
percent
but
not
exceeding
three
hundred
8
percent
of
the
federal
poverty
level,
family
cost
sharing
9
amounts,
and
graduated
premiums
based
on
a
rationally
developed
10
sliding
fee
schedule,
in
accordance
with
federal
law,
with
the
11
approval
of
the
board.
12
b.
k.
Perform
annual,
random
reviews
of
enrollee
13
applications
to
ensure
compliance
with
program
eligibility
and
14
enrollment
policies.
Quality
assurance
reports
shall
be
made
15
to
the
board
and
the
department
based
upon
the
data
maintained
16
by
the
administrative
contractor
department
.
17
c.
l.
Perform
other
duties
as
determined
by
the
department
18
with
the
approval
of
the
board.
19
Sec.
4.
Section
514I.5,
subsection
2,
Code
2019,
is
amended
20
by
striking
the
subsection.
21
Sec.
5.
Section
514I.5,
subsection
7,
paragraph
a,
Code
22
2019,
is
amended
by
striking
the
paragraph.
23
Sec.
6.
Section
514I.5,
subsection
8,
paragraph
b,
Code
24
2019,
is
amended
by
striking
the
paragraph.
25
Sec.
7.
Section
514I.5,
subsection
8,
paragraphs
h
and
k,
26
Code
2019,
are
amended
to
read
as
follows:
27
h.
Conflict
of
interest
provisions
applicable
to
the
28
administrative
contractor
and
participating
insurers
,
and
29
between
public
members
of
the
board
and
the
administrative
30
contractor
and
participating
insurers.
31
k.
The
data
to
be
maintained
by
the
administrative
32
contractor
department
including
data
to
be
collected
for
the
33
purposes
of
quality
assurance
reports.
34
Sec.
8.
Section
514I.6,
subsection
4,
unnumbered
paragraph
35
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1,
Code
2019,
is
amended
to
read
as
follows:
1
Provide
the
administrative
contractor
department
with
all
2
of
the
following
information
pertaining
to
the
participating
3
insurer’s
plan:
4
Sec.
9.
REPEAL.
Section
514I.7,
Code
2019,
is
repealed.
5
EXPLANATION
6
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
7
the
explanation’s
substance
by
the
members
of
the
general
assembly.
8
This
bill
integrates
Medicaid
and
healthy
and
well
kids
in
9
Iowa
(hawk-i)
program
eligibility,
payment,
and
administrative
10
functions
by
eliminating
the
utilization
of
an
administrative
11
contractor
under
the
hawk-i
program
and
transferring
the
duties
12
of
the
administrative
contractor
to
the
department
of
human
13
services.
14
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