Senate File 2092 - Introduced SENATE FILE 2092 BY CHELGREN A BILL FOR An Act relating to the provision of integrated health home 1 services under Medicaid managed care, and including 2 effective date provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 5792XS (3) 87 pf/rh

S.F. 2092 Section 1. PROVISION OF INTEGRATED HEALTH HOME SERVICES 1 UNDER MEDICAID MANAGED CARE. The department of human services 2 shall amend Medicaid managed care contracts and adopt rules 3 pursuant to chapter 17A to require all of the following: 4 1. That integrated health home services be provided 5 in accordance with the state plan amendment, IA-16-013, 6 including the requirement that comprehensive care coordination 7 services be provided by care coordinators who are part of the 8 integrated health home’s team of health care professionals 9 to meet provider standards and deliver health home services 10 to qualified members. Comprehensive care coordination for 11 Medicaid members receiving integrated health home services 12 shall not be provided in a manner other than through the use of 13 integrated health home provider types as specified in the state 14 plan amendment, and shall not be provided by the managed care 15 organization through internal resources or other contracted 16 providers. 17 2. That if a Medicaid member is receiving integrated health 18 home services, and based on the member’s array of services 19 would potentially have more than one case manager or care 20 coordinator, the member shall be provided the opportunity to 21 select the member’s own case manager or care coordinator. 22 Additionally, such Medicaid member shall be allowed to change 23 the integrated health home provider from whom the member 24 receives integrated health home services. 25 Sec. 2. EFFECTIVE DATE. This Act, being deemed of immediate 26 importance, takes effect upon enactment. 27 EXPLANATION 28 The inclusion of this explanation does not constitute agreement with 29 the explanation’s substance by the members of the general assembly. 30 This bill requires the department of human services (DHS) to 31 amend Medicaid managed care contracts to require the following: 32 1. That integrated health home services be provided 33 in accordance with the state plan amendment, IA-16-013, 34 including the requirement that comprehensive care coordination 35 -1- LSB 5792XS (3) 87 pf/rh 1/ 2

S.F. 2092 services be provided by care coordinators who are part of the 1 integrated health home’s team of health care professionals 2 to meet provider standards and deliver health home services 3 to qualified members. Comprehensive care coordination shall 4 not be provided in a manner other than through the use of the 5 integrated health home provider types as specified in the state 6 plan amendment, and shall not be provided by the managed care 7 organization through internal resources or other contracted 8 providers. 9 2. That if a Medicaid member is receiving integrated health 10 home services, and based on the member’s array of services 11 would potentially have more than one case manager or care 12 coordinator, the member shall be given the opportunity to 13 select the member’s own case manager or care coordinator. 14 Additionally, such Medicaid member shall be allowed to change 15 the integrated health home provider from whom the member 16 receives integrated health home services. 17 The bill takes effect upon enactment. 18 -2- LSB 5792XS (3) 87 pf/rh 2/ 2