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House Journal: Page 2028: Tuesday, April 30, 1996

 cooperation with durable medical equipment and supply dealers,
audiologists, and hearing aid dealers.
b.  For the fiscal year beginning July 1, 1996, skilled nursing
facilities shall remain at the rates in effect on June 30, 1996.
c.  The dispensing fee for pharmacists shall remain at the rate
in effect on June 30, 1996.  The reimbursement policy for drug
product costs shall be in accordance with federal requirements.
d.  Reimbursement rates for in-patient and outpatient hospital
services shall remain at the rates in effect on June 30, 1996. 
The department shall continue the outpatient hospital
reimbursement system based upon ambulatory patient groups
implemented pursuant to 1994 Iowa Acts, chapter 1186, section
25, subsection 1, paragraph "f".  Reimbursements made between
July 1, 1996, and June 30, 1997, under the outpatient hospital
reimbursement system implemented pursuant to 1994 Iowa Acts,
chapter 1186, section 25, subsection 1, paragraph "f", shall be
retrospectively adjusted so that the reimbursement made is
within a ten percent deviation of the lower of the cost or the
charges for the services provided during the fiscal year ending
June 30, 1996.  In addition, the department shall continue the
revised medical assistance payment policy implemented pursuant
to that paragraph to provide reimbursement for costs of
screening and treatment provided in the hospital emergency room
if made pursuant to the prospective payment methodology
developed by the department for the payment of outpatient
services provided under the medical assistance program.
e.  Reimbursement rates for rural health clinics shall be
increased in accordance with increases under the federal
medicare program.
f.  Home health agencies certified for the federal Medicare
program, hospice services, and acute care mental hospitals shall
be reimbursed for their current federal Medicare audited costs.
g.  The basis for establishing the maximum medical assistance
reimbursement rate for nursing facilities shall be the 70th
percentile of facility costs as calculated from the June 30,
1996, unaudited compilation of cost and statistical data. 
However, to the extent funds are available within the amount
projected for reimbursement of nursing facilities within the
appropriation for medical assistance in this Act, and within the
appropriation for medical assistance as a whole, the department
shall adjust the maximum medical assistance reimbursement for
nursing facilities to the 70th percentile, as calculated on
December 31, 1996, unaudited compilation of cost and statistical
data and the adjustment shall take effect January 1, 1997.
h.  The department may modify the reimbursement methodology for
skilled nursing facilities which participated in the medical
assistance program on or before May 31, 1993, and which met the
departmental disproportionate share payment provisions as of May
31, 1993, if it is possible to demonstrate that the modification
would result in a cost savings to the medical assistance program.
i.  The department may revise the fee schedule used for
physician reimbursement.
j.  Federally qualified health centers shall be reimbursed at
100 percent of reasonable costs as determined by the department
in accordance with federal requirements.
k.  The department may allocate increases among items and
procedures for dental procedures as deemed appropriate in
cooperation with dentists.

Iowa General Assembly

Index: House Journal (76th General Assembly: Session 2)

© 1996 Cornell College and League of Women Voters of Iowa

Comments? hjourn@legis.iowa.gov.

Last update: Wed May 1 22:20:02 CDT 1996
URL: /DOCS/GA/76GA/Session.2/HJournal/02000/02028.html
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