HF 2386 (LSB 6037YH (4) 87)

HOUSE FILE 2386

BY  HEATON

A BILL FOR

An Act relating to home health provider reimbursement under the Medicaid program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  HOME HEALTH PROVIDER REIMBURSEMENT —— MEDICAID PROGRAM.  The department of human services shall adopt rules pursuant to chapter 17A to require that under both the Medicaid fee-for-service and managed care reimbursement and delivery systems, home health providers shall be exempt from prior authorization and shall be reimbursed in accordance with the reimbursement methodology and payment rates specified in 42 C.F.R. §484.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill requires the department of human services to adopt administrative rules to require that under both Medicaid fee-for-service and managed care reimbursement and delivery systems, home health providers shall be exempt from prior authorization and shall be reimbursed in accordance with the reimbursement methodology and payment rates specified in the code of federal regulations which provides for a home health prospective payment system rate update and case-mix adjustment methodology refinements.