Text: HSB00609 Text: HSB00611 Text: HSB00600 - HSB00699 Text: HSB Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Section 1. Section 514I.4, subsection 4, Code 1999, is 1 2 amended to read as follows: 1 3 4. The department shall do or shall provide for all of the 1 4 following: 1 5 a. Develop a program application form not to exceed two 1 6 pages in length, which is consistent with the rules of the 1 7 board, which is easy to understand, complete, and concise, and 1 8 which, to the greatest extent possible, coordinates with the 1 9 medical assistance program. 1 10 b. Establish the family cost sharingamount, based on a1 11sliding fee scale, if established byamounts with the approval 1 12 of the board. 1 13 c. Perform periodic, random reviews of enrollee 1 14 applications to ensure compliance with program eligibility and 1 15 enrollment policies. Quality assurance reports shall be made 1 16 to the board and the department based upon the data maintained 1 17 by the administrative contractor. 1 18c.d. Perform other duties as determined by the department 1 19 with the approval of the board. 1 20 Sec. 2. Section 514I.5, subsection 7, paragraphs d and e, 1 21 Code Supplement 1999, are amended to read as follows: 1 22 d. Develop, with the assistance of the department, an 1 23 outreach plan, and provide for periodic assessment of the 1 24 effectiveness of the outreach plan. The plan shall provide 1 25 outreach to families of children likely to be eligible for 1 26 assistance under the program, to inform them of the 1 27 availability of and to assist the families in enrolling 1 28 children in the program. The outreach efforts may include, 1 29 but are not limited to,a comprehensive statewide media1 30campaign,solicitation of cooperation from programs, agencies, 1 31 and other persons who are likely to have contact with eligible 1 32 children, including but not limited to those associated with 1 33 the educational system, and the development of community plans 1 34 for outreach and marketing. 1 35 e. In consultation with the clinical advisory committee, 2 1select a single, nationally recognizeddevelop a functional 2 2 health assessment form for an initial assessment ofall2 3eligiblechildren participating in the program, establish a 2 4 baseline for comparison purposes, and develop appropriate 2 5 indicators to measure the health status ofeligiblechildren 2 6 participating in the program. 2 7 Sec. 3. Section 514I.5, subsection 7, paragraph i, Code 2 8 Supplement 1999, is amended by striking the paragraph. 2 9 Sec. 4. Section 514I.5, subsection 7, paragraph l, 2 10 unnumbered paragraph 1, Code Supplement 1999, is amended to 2 11 read as follows: 2 12 Establish an advisory committee to make recommendations to 2 13 the board and to the general assemblyon or beforeby January 2 14 1,1999,annually concerning the provision of health insurance 2 15 coverage to children with special health care needs under the 2 16 program. The committee shall include individuals with 2 17 experience in, knowledge of, or expertise in this area. The 2 18 recommendations shall address, but are not limited to, all of 2 19 the following: 2 20 Sec. 5. Section 514I.5, subsection 8, paragraphs h and m, 2 21 Code Supplement 1999, are amended to read as follows: 2 22 h. The amount of any cost sharing under the program which 2 23 shall be assessedon a sliding fee scalebased on family 2 24 income, which provides for a minimum amount of cost sharing, 2 25 and which complies with federal law. 2 26 m. The reasons allowed for approval of an application in 2 27 cases in which prior employer-sponsored coverage ended less 2 28 than six months prior to the determination of eligibility for 2 29 the HAWK-I program. The reasons established by rule shall 2 30 include, but are not limited to, all of the following: 2 31 (1) Loss of employment due to factors other than voluntary 2 32 termination. 2 33(2) Death of a parent.2 34(3)(2) Change in employment to a new employer that does 2 35 not provide an option for dependent coverage. 3 1(4)(3) Change of address so that no employer-sponsored 3 2 coverage is available. 3 3(5)(4) Discontinuation of health benefits to all 3 4 employees of the applicant's employer. 3 5(6)(5) Expiration of the coverage periods established by 3 6 the federal Consolidated Omnibus Budget Reconciliation Act of 3 7 1986, Pub. L. No. 99-272, as amended. 3 8(7)(6) Self-employment. 3 9(8) Termination of health benefits due to a long-term3 10disability.3 11(9)(7) Termination of dependent coverage due to an 3 12 extreme economic hardship on the part ofeitherthe employee 3 13or the employer, as determined by rule. 3 14(10) Substantial reduction in either lifetime medical3 15benefits or benefit category available to an employee and3 16dependents under an employer's health care plan.3 17 If the board determines that the allowance of the six-month 3 18 period from the time of dropping coverage to be eligible for 3 19 participation in the HAWK-I program is insufficient to 3 20 effectively deter applicants or employers of applicants from 3 21 discontinuing employer-sponsored dependent care coverage for 3 22 the purpose of participation in the HAWK-I program, the board 3 23 may adopt rules to extend the time period to a period not to 3 24 exceed twelve months. 3 25 Sec. 6. Section 514I.6, subsection 3, Code 1999, is 3 26 amended by striking the subsection. 3 27 Sec. 7. Section 514I.7, subsection 2, paragraph c, Code 3 28 Supplement 1999, is amended to read as follows: 3 29 c. Forward names of children who appear to be eligible for 3 30 medical assistanceor other public health insurance coverage3 31to localto the department of human servicesoffices or other3 32appropriate person or agencyfor follow up and retainthe3 33 identifying data on children who are referred. 3 34 Sec. 8. Section 514I.7, subsection 2, paragraph h, Code 3 35 Supplement 1999, is amended by striking the paragraph. 4 1 Sec. 9. Section 514I.8, subsection 2, paragraphs c and e, 4 2 Code 1999, are amended to read as follows: 4 3 c. Is a member of a family whoseadjusted grossincome 4 4 does not exceed one hundred eighty-five percent of the federal 4 5 poverty level, as defined in 42 U.S.C. } 9902(2), including 4 6 any revision required by such section. 4 7 e. Is not currently covered under or was not covered 4 8 within the prior six months under a group health plan as 4 9 defined in 42 U.S.C. } 300gg-91(a)(1)or other health benefit4 10plan, unlessthe coverage was involuntarily lost or unless4 11dropping the coverage isallowed by rule of the board. 4 12 Sec. 10. Section 514I.10, Code 1999, is amended to read as 4 13 follows: 4 14 514I.10 COST SHARING. 4 15 1. Cost sharing for eligible children whose family 4 16adjusted grossincome is at or below one hundred fifty percent 4 17 of the federal poverty level shall not exceed the standards 4 18 permitted under 42 U.S.C. } 1396(o)(a)(3) or } 1396(o)(b)(1). 4 19 2. Cost sharing for eligible children whose family 4 20adjusted grossincome is between one hundred fifty percent and 4 21 one hundred eighty-five percent of the federal poverty level 4 22 shall include a premium or copayment amount which is at least 4 23 a minimum amount but which does not exceed five percent of the 4 24 annual familyadjusted grossincome. The amount of the 4 25 premium or the copayment amount shall be based ona sliding4 26fee scale established by rule which is based onfamily 4 27adjusted grossincome andthesizeof the family. 4 28 EXPLANATION 4 29 This bill amends portions of the Code relating to the 4 30 healthy and well kids in Iowa (HAWK-I) program. 4 31 The bill deletes the requirement that the department of 4 32 human services (DHS) establish family cost sharing based on a 4 33 sliding fee scale. The new language reflects current practice 4 34 which is establishment of a cost sharing amount approved by 4 35 the HAWK-I board. The bill also directs DHS to perform 5 1 periodic, random reviews of enrollee applications to ensure 5 2 program compliance. Quality assurance reports are to be made 5 3 to the board and to DHS based upon the data maintained by the 5 4 administrative contractor of the program. 5 5 The bill eliminates the requirement that the outreach 5 6 efforts developed by the board include a comprehensive 5 7 statewide media campaign. The bill directs the board to 5 8 develop a functional health assessment form rather than 5 9 selecting a single, nationally recognized assessment form for 5 10 children participating in the program. The bill eliminates 5 11 the requirement that the board perform periodic random reviews 5 12 of enrollee applications to assure program compliance, as this 5 13 function is given to the department under the bill. The bill 5 14 also directs the advisory committee on children with special 5 15 health care needs to make recommendations annually by January 5 16 1, rather than only one time by January 1, 1999. 5 17 The bill eliminates, as reasons allowed for approval of an 5 18 application in cases in which prior employer-sponsored 5 19 coverage ended less than six months prior to determination of 5 20 eligibility for the program, the death of a parent, 5 21 termination of health benefits due to a long-term disability, 5 22 and a substantial reduction in either lifetime medical 5 23 benefits or benefit category available to an employee and 5 24 dependents under an employer's health care plan. Another 5 25 existing reason for approval of an application under these 5 26 circumstances is amended so that termination of dependent 5 27 coverage due to an extreme economic hardship on the part of 5 28 only the employee, and not on the part of either the employee 5 29 or employer, is reason to allow approval of an application. 5 30 The bill also eliminates a requirement that participating 5 31 insurers submit a marketing plan to the HAWK-I board 5 32 consistent with the board's outreach plan, for approval by the 5 33 board. 5 34 The bill amends the directive to the administrative 5 35 contractor to forward names of children who appear to be 6 1 eligible for health insurance coverage, other than medical 6 2 assistance, to local offices of DHS or other appropriate 6 3 persons, and limits the directive to forwarding the names of 6 4 children who appear to be eligible for medical assistance only 6 5 to the state offices of DHS. The bill also eliminates the 6 6 directive to the administrative contractor to make program 6 7 applications available through the mail and through local 6 8 sites, as determined by DHS, including to schools, local 6 9 health departments, local department of human services 6 10 offices, and other locations. 6 11 The bill also removes the reference to "adjusted gross 6 12 income" in establishing eligibility for the program, and 6 13 refers only to income, which is defined by rule. 6 14 LSB 5240DP 78 6 15 pf/gg/8.1
Text: HSB00609 Text: HSB00611 Text: HSB00600 - HSB00699 Text: HSB Index Bills and Amendments: General Index Bill History: General Index
© 2000 Cornell College and League of Women Voters of Iowa
Comments about this site or page?
webmaster@legis.iowa.gov.
Please remember that the person listed above does not vote on bills. Direct all comments concerning legislation to State Legislators.
Last update: Fri Feb 4 03:35:35 CST 2000
URL: /DOCS/GA/78GA/Legislation/HSB/00600/HSB00610/000203.html
jhf