House File 49

                                       HOUSE FILE       
                                       BY  GREIMANN and B. HANSEN


    Passed House,  Date               Passed Senate, Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act relating to the healthy and well kids in Iowa program.
  2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  3 TLSB 1058HH 80
  4 pf/sh/8

PAG LIN

  1  1    Section 1.  Section 514I.4, subsection 4, Code 2003, is
  1  2 amended to read as follows:
  1  3    4.  The department shall do or shall provide for all of the
  1  4 following:
  1  5    a.  Develop a program application form not to exceed two
  1  6 pages in length, which is consistent with the rules of the
  1  7 board, which is easy to understand, complete, and concise, and
  1  8 which, to the greatest extent possible, coordinates with the
  1  9 medical assistance program.
  1 10    b.  Establish the family cost sharing amount, based on a
  1 11 sliding fee scale, if established by amounts with the approval
  1 12 of the board.
  1 13    c.  Perform annual, random reviews of enrollee applications
  1 14 to ensure compliance with program eligibility and enrollment
  1 15 policies.  Quality assurance reports shall be made to the
  1 16 board and the department based upon the data maintained by the
  1 17 administrative contractor.
  1 18    c. d.  Perform other duties as determined by the department
  1 19 with the approval of the board.
  1 20    Sec. 2.  Section 514I.5, subsection 7, paragraphs d and e,
  1 21 Code 2003, are amended to read as follows:
  1 22    d.  Develop, with the assistance of the department, an
  1 23 outreach plan, and provide for periodic assessment of the
  1 24 effectiveness of the outreach plan.  The plan shall provide
  1 25 outreach to families of children likely to be eligible for
  1 26 assistance under the program, to inform them of the
  1 27 availability of and to assist the families in enrolling
  1 28 children in the program.  The outreach efforts may include,
  1 29 but are not limited to, a comprehensive statewide media
  1 30 campaign, solicitation of cooperation from programs, agencies,
  1 31 and other persons who are likely to have contact with eligible
  1 32 children, including but not limited to those associated with
  1 33 the educational system, and the development of community plans
  1 34 for outreach and marketing.
  1 35    e.  In consultation with the clinical advisory committee,
  2  1 select a single, nationally recognized functional health
  2  2 assessment form for an initial assessment of all eligible
  2  3 assess the initial health status of children participating in
  2  4 the program, establish a baseline for comparison purposes, and
  2  5 develop appropriate indicators to measure the subsequent
  2  6 health status of eligible children participating in the
  2  7 program.
  2  8    Sec. 3.  Section 514I.5, subsection 7, paragraph i, Code
  2  9 2003, is amended by striking the paragraph.
  2 10    Sec. 4.  Section 514I.5, subsection 7, paragraph l,
  2 11 unnumbered paragraph 1, Code 2003, is amended to read as
  2 12 follows:
  2 13    Establish an advisory committee to make recommendations to
  2 14 the board and to the general assembly on or before by January
  2 15 1, 1999, annually concerning the provision of health insurance
  2 16 coverage to children with special health care needs under the
  2 17 program.  The committee shall include individuals with
  2 18 experience in, knowledge of, or expertise in this area.  The
  2 19 recommendations shall address, but are not limited to, all of
  2 20 the following:
  2 21    Sec. 5.  Section 514I.5, subsection 8, paragraph h, Code
  2 22 2003, is amended to read as follows:
  2 23    h.  The amount of any cost sharing under the program which
  2 24 shall may be assessed on a sliding fee scale based on family
  2 25 income, which provides for a minimum amount of cost sharing,
  2 26 and which complies with federal law.
  2 27    Sec. 6.  Section 514I.5, subsection 8, paragraph m, Code
  2 28 2003, is amended by striking the paragraph.
  2 29    Sec. 7.  Section 514I.6, subsection 3, Code 2003, is
  2 30 amended by striking the subsection.
  2 31    Sec. 8.  Section 514I.7, subsection 2, paragraph c, Code
  2 32 2003, is amended to read as follows:
  2 33    c.  Forward names of children who appear to be eligible for
  2 34 medical assistance or other public health insurance coverage
  2 35 to local to the department of human services offices or other
  3  1 appropriate person or agency for follow up follow=up and
  3  2 retain the identifying data on children who are referred.
  3  3    Sec. 9.  Section 514I.7, subsection 2, paragraph h, Code
  3  4 2003, is amended by striking the paragraph.
  3  5    Sec. 10.  Section 514I.8, subsection 2, paragraph e, Code
  3  6 2003, is amended to read as follows:
  3  7    e.  Is not currently covered under or was not covered
  3  8 within the prior six months under a group health plan as
  3  9 defined in 42 U.S.C. } 300gg=91(a)(1) or other health benefit
  3 10 plan, unless the coverage was involuntarily lost or unless
  3 11 dropping the coverage is allowed by rule of the board.
  3 12    Sec. 11.  Section 514I.10, Code 2003, is amended to read as
  3 13 follows:
  3 14    514I.10  COST SHARING.
  3 15    1.  Cost sharing for eligible children whose family income
  3 16 is at or below one hundred fifty percent of the federal
  3 17 poverty level shall not exceed the standards permitted under
  3 18 42 U.S.C. } 1396(o)(a)(3) or } 1396(o)(b)(1).
  3 19    2.  Cost sharing for eligible children whose family income
  3 20 is between equals or exceeds one hundred fifty percent and two
  3 21 hundred percent of the federal poverty level shall may include
  3 22 a premium or copayment amount which is at least a minimum
  3 23 amount but which does not exceed five percent of the annual
  3 24 family income.  The amount of the any premium or the copayment
  3 25 amount shall be based on family income and size.
  3 26                           EXPLANATION
  3 27    This bill amends portions of the Code relating to the
  3 28 healthy and well kids in Iowa (hawk=i) program and the medical
  3 29 assistance program.
  3 30    The bill deletes the requirement that the department of
  3 31 human services (DHS) establish family cost sharing based on a
  3 32 sliding fee scale.  The new language reflects current practice
  3 33 which is establishment of a cost sharing amount approved by
  3 34 the hawk=i board.  The bill also directs DHS to perform
  3 35 annual, random reviews of enrollee applications to ensure
  4  1 program compliance.  Quality assurance reports are to be made
  4  2 to the board and to DHS based upon the data maintained by the
  4  3 administrative contractor of the program.
  4  4    The bill eliminates the requirement that the outreach
  4  5 efforts developed by the board include a comprehensive
  4  6 statewide media campaign.  The bill directs the board, in
  4  7 consultation with the clinical advisory committee, to assess
  4  8 the initial health status of children participating in the
  4  9 program, establish a baseline, and develop appropriate
  4 10 indicators to assess the subsequent health status of children
  4 11 participating in the program, rather than directing the board
  4 12 to select a single, nationally recognized assessment form for
  4 13 children participating in the program.  The bill eliminates
  4 14 the requirement that the board perform periodic random reviews
  4 15 of enrollee applications to assure program compliance, as this
  4 16 function is given to the department under the bill.  The bill
  4 17 also directs the advisory committee on children with special
  4 18 health care needs to make recommendations, annually, by
  4 19 January 1, rather than only one time by January 1, 1999.
  4 20    The bill eliminates the directive to the hawk=i board to
  4 21 adopt rules to address approval of a program application in
  4 22 cases in which prior employer=sponsored coverage ended less
  4 23 than six months prior to determination of eligibility for the
  4 24 program.  The bill also eliminates a requirement that
  4 25 participating insurers submit a marketing plan to the hawk=i
  4 26 board consistent with the board's outreach plan, for approval
  4 27 by the board.
  4 28    The bill amends the directive to the administrative
  4 29 contractor to forward names of children who appear to be
  4 30 eligible for health insurance coverage, other than medical
  4 31 assistance, to local offices of DHS or other appropriate
  4 32 persons, and limits the directive to forwarding the names of
  4 33 children who appear to be eligible for medical assistance only
  4 34 to the state offices of DHS.  The bill also eliminates the
  4 35 directive to the administrative contractor to make program
  5  1 applications available through the mail and through local
  5  2 sites, as determined by DHS, including to schools, local
  5  3 health departments, local department of human services
  5  4 offices, and other locations.
  5  5    The bill also provides that a child may participate in the
  5  6 hawk=i program if, among other criteria, the child is not
  5  7 currently covered or was not covered in the past six months
  5  8 under a group health plan unless allowed by rule of the board.
  5  9    The bill also allows for cost sharing based upon the family
  5 10 income percentage which is either below 150 percent of the
  5 11 federal poverty level or which equals or exceeds 150 percent
  5 12 of the federal poverty level.
  5 13 LSB 1058HH 80
  5 14 pf/sh/8.2