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House Journal: Page 1543: Monday, April 13, 1998

21     (4)  Options for enrollment of children with
22   special health care needs in and disenrollment of
23   children with special health care needs from qualified
24   child health plans utilizing a capitated fee form of
25   payment.
26     (5)  The appropriateness and quality of care for
27   children with special health care needs.
28     (6)  The coordination of health services provided
29   for children with special health care needs under the
30   program with services provided by other publicly
31   funded programs."
32     34.  Page 6, line 20, by striking the word
33   "cooperation" and inserting the following:
34   "consultation".
35     35.  Page 6, by striking lines 30 and 31 and
36   inserting the following:  "insurers for the program."
37     36.  Page 6, by striking lines 33 and 34 and
38   inserting the following:  "plan which are those
39   included in a benchmark or benchmark equivalent plan
40   and which comply".
41     37.  Page 6, line 35, by striking the words "and
42   which".
43     38.  Page 7, by striking lines 1 and 2, and
44   inserting the following:  ".  Benefits covered shall
45   include but are not limited to all of the following:"
46     39.  Page 7, line 22, by striking the word
47   "preventative" and inserting the following:
48   "preventive".
49     40.  Page 7, by striking lines 32 and 33 and
50   inserting the following:

Page 6

 1     "g.  Presumptive eligibility criteria for the
 2   program."
 3     41.  By striking page 7, line 35, through page 8,
 4   line 2, and inserting the following:  "shall be
 5   assessed on a sliding fee scale based on family
 6   income, which provides for a minimum amount of cost
 7   sharing, and which complies with federal law."
 8     42.  Page 8, line 14, by striking the word "board"
 9   and inserting the following:  "department".
10     43.  Page 9, by striking lines 21 and 22.
11     44.  Page 9, by inserting after line 29, the
12   following:
13     "4A.  Require that any plan provided by the
14   participating insurer establishes and maintains a
15   conflict management system that includes methods for
16   both preventing and resolving disputes involving the
17   health care needs of eligible children, and a process
18   for resolution of such disputes."
19     45.  Page 10, by striking lines 1 and 2 and
20   inserting the following:

© 1998 Cornell College and League of Women Voters of Iowa

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Last update: Tue Apr 14 13:40:03 CDT 1998
URL: /DOCS/GA/77GA/Session.2/HJournal/01500/01543.html
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