House
Study
Bill
76
-
Introduced
SENATE/HOUSE
FILE
_____
BY
(PROPOSED
DEPARTMENT
OF
HUMAN
SERVICES
BILL)
A
BILL
FOR
An
Act
relating
to
the
frequency
of
the
reporting
of
the
annual
1
analysis
and
findings
relative
to
Medicaid
managed
care
2
member
appeals.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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S.F.
_____
H.F.
_____
Section
1.
2018
Iowa
Acts,
chapter
1165,
section
128,
1
subsection
2,
paragraph
d,
is
amended
to
read
as
follows:
2
d.
The
department
of
human
services,
on
an
annual
basis,
3
shall
conduct
an
analysis
of
all
Medicaid
member
appeals
that
4
have
been
dismissed,
withdrawn,
or
overturned
to
determine
5
if
there
are
any
negative
patterns
or
trends
based
on
the
6
analysis.
The
services
of
any
member
whose
appeal
is
subject
7
to
the
analysis
shall
continue
for
the
period
during
which
an
8
interdisciplinary
team
conducts
a
new
assessment
to
determine
9
which
services
are
medically
necessary
for
that
member,
which
10
period
shall
not
exceed
ninety
days.
A
report
of
the
analysis
11
and
findings
shall
be
submitted
to
the
governor
and
the
general
12
assembly
on
a
biannual
an
annual
basis
and
the
department
shall
13
develop
a
plan
as
necessary
to
address
any
negative
patterns
or
14
trends
identified
by
the
analysis.
15
EXPLANATION
16
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
17
the
explanation’s
substance
by
the
members
of
the
general
assembly.
18
This
bill
amends
a
Medicaid
program
administration
19
requirement
to
require
the
department
of
human
services
to
20
report
to
the
governor
and
the
general
assembly,
on
an
annual
21
rather
than
biannual
basis,
the
department’s
analysis
and
22
findings
relative
to
Medicaid
member
appeals
that
have
been
23
dismissed,
withdrawn,
or
overturned
to
determine
if
there
24
are
any
negative
patterns
or
trends
identified
based
on
the
25
analysis.
26
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