HF 2215 (LSB 5980YH (7) 88)

HOUSE FILE 2215

BY  JONES

A BILL FOR

An Act relating to Medicaid reimbursement for breast pumps and associated supplies.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  MEDICAID REIMBURSEMENT FOR BREAST PUMPS.  Under both fee-for-service and managed care administration of Medicaid, the department of human services shall adopt rules pursuant to chapter 17A, amend any contract with a managed care organization, and apply for any Medicaid state plan amendment or waiver as may be necessary to provide reimbursement for breast pumps, including electric breast pumps and associated breast pump supplies, as prescribed by a Medicaid member’s health care provider based on a determination of medical necessity. The rules adopted by the department shall include the specifications that a breast pump must meet to be covered and the reimbursement rate applicable to the specific type of breast pump and associated breast pump supplies.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill directs the department of human services (DHS) under both fee-for-service and managed care administration of Medicaid to adopt administrative rules, amend any contract with a managed care organization, and apply for any Medicaid state plan amendment or waiver as may be necessary to provide reimbursement for breast pumps, including electric breast pumps and associated breast pump supplies, as prescribed by a Medicaid member’s health care provider based on a determination of medical necessity. The rules adopted by the DHS shall include the specifications that a covered breast pump must meet and the reimbursement rate applicable to the specific type of breast pump and associated breast pump supplies.