SF 2092 (LSB 5792XS (3) 87)

SENATE FILE 2092

BY  CHELGREN

A BILL FOR

An Act relating to the provision of integrated health home services under Medicaid managed care, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  PROVISION OF INTEGRATED HEALTH HOME SERVICES UNDER MEDICAID MANAGED CARE.  The department of human services shall amend Medicaid managed care contracts and adopt rules pursuant to chapter 17A to require all of the following:
   1.  That integrated health home services be provided in accordance with the state plan amendment, IA-16-013, including the requirement that comprehensive care coordination services be provided by care coordinators who are part of the integrated health home’s team of health care professionals to meet provider standards and deliver health home services to qualified members. Comprehensive care coordination for Medicaid members receiving integrated health home services shall not be provided in a manner other than through the use of integrated health home provider types as specified in the state plan amendment, and shall not be provided by the managed care organization through internal resources or other contracted providers.
   2.  That if a Medicaid member is receiving integrated health home services, and based on the member’s array of services would potentially have more than one case manager or care coordinator, the member shall be provided the opportunity to select the member’s own case manager or care coordinator. Additionally, such Medicaid member shall be allowed to change the integrated health home provider from whom the member receives integrated health home services.
    Sec. 2.  EFFECTIVE DATE.  This Act, being deemed of immediate importance, takes effect upon enactment.
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 (DHS) to amend Medicaid managed care contracts to require the following:

   1. That integrated health home services be provided in accordance with the state plan amendment, IA-16-013, including the requirement that comprehensive care coordination services be provided by care coordinators who are part of the integrated health home’s team of health care professionals to meet provider standards and deliver health home services to qualified members. Comprehensive care coordination shall not be provided in a manner other than through the use of the integrated health home provider types as specified in the state plan amendment, and shall not be provided by the managed care organization through internal resources or other contracted providers.

   2. That if a Medicaid member is receiving integrated health home services, and based on the member’s array of services would potentially have more than one case manager or care coordinator, the member shall be given the opportunity to select the member’s own case manager or care coordinator. Additionally, such Medicaid member shall be allowed to change the integrated health home provider from whom the member receives integrated health home services.
   The bill takes effect upon enactment.