Text: HF00381                           Text: HF00383
Text: HF00300 - HF00399                 Text: HF Index
Bills and Amendments: General Index     Bill History: General Index



House File 382

Partial Bill History

Bill Text

PAG LIN
  1  1    Section 1.  Section 514I.4, subsection 4, Code 2001, 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 sharing amount, based on a
  1 11 sliding fee scale, if established by amounts 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 18    c. 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 2001, 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 media
  1 30 campaign, 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  1 select a single, nationally recognized develop a functional
  2  2 health assessment form for an initial assessment of all
  2  3 eligible children participating in the program, establish a
  2  4 baseline for comparison purposes, and develop appropriate
  2  5 indicators to measure the health status of eligible children
  2  6 participating in the program.
  2  7    Sec. 3.  Section 514I.5, subsection 7, paragraph i, Code
  2  8 2001, is amended by striking the paragraph.
  2  9    Sec. 4.  Section 514I.5, subsection 7, paragraph l,
  2 10 unnumbered paragraph 1, Code 2001, is amended to read as
  2 11 follows:
  2 12    Establish an advisory committee to make recommendations to
  2 13 the board and to the general assembly on or before by 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 2001, are amended to read as follows:
  2 22    h.  The amount of any cost sharing under the program which
  2 23 shall be assessed on a sliding fee scale based 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)  Change in employment to a new employer that does not
  2 35 provide an option for dependent coverage.
  3  1    (4) (2)  Change of address so that no employer-sponsored
  3  2 coverage is available.
  3  3    (5) (3)  Discontinuation of health benefits to all
  3  4 employees of the applicant's employer.
  3  5    (6) (4)  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) (5)  Self-employment.
  3  9    (8)  Termination of health benefits due to a long-term
  3 10 disability.
  3 11    (9) (6)  Termination of dependent coverage due to an
  3 12 extreme economic hardship on the part of either the employee
  3 13 or the employer, as determined by rule.
  3 14    (10)  Substantial reduction in either lifetime medical
  3 15 benefits or benefit category available to an employee and
  3 16 dependents 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 2001, is
  3 26 amended by striking the subsection.
  3 27    Sec. 7.  Section 514I.7, subsection 2, paragraph c, Code
  3 28 2001, is amended to read as follows:
  3 29    c.  Forward names of children who appear to be eligible for
  3 30 medical assistance or other public health insurance coverage
  3 31 to local to the department of human services offices or other
  3 32 appropriate person or agency for follow up follow-up and
  3 33 retain the identifying data on children who are referred.
  3 34    Sec. 8.  Section 514I.7, subsection 2, paragraph h, Code
  3 35 2001, is amended by striking the paragraph.
  4  1    Sec. 9.  Section 514I.8, subsection 2, paragraph e, Code
  4  2 2001, is amended to read as follows:
  4  3    e.  Is not currently covered under or was not covered
  4  4 within the prior six months under a group health plan as
  4  5 defined in 42 U.S.C. } 300gg-91(a)(1) or other health benefit
  4  6 plan, unless the coverage was involuntarily lost or unless
  4  7 dropping the coverage is allowed by rule of the board.
  4  8    Sec. 10.  Section 514I.10, Code 2001, is amended to read as
  4  9 follows:
  4 10    514I.10  COST SHARING.
  4 11    1.  Cost sharing for eligible children whose family income
  4 12 is at or below one hundred fifty percent of the federal
  4 13 poverty level shall not exceed the standards permitted under
  4 14 42 U.S.C. } 1396(o)(a)(3) or } 1396(o)(b)(1).
  4 15    2.  Cost sharing for eligible children whose family income
  4 16 is between equals or exceeds one hundred fifty percent and two
  4 17 hundred percent of the federal poverty level shall include a
  4 18 premium or copayment amount which is at least a minimum amount
  4 19 but which does not exceed five percent of the annual family
  4 20 income.  The amount of the premium or the copayment amount
  4 21 shall be based on family income and size.  
  4 22                           EXPLANATION
  4 23    This bill amends portions of the Code relating to the
  4 24 healthy and well kids in Iowa (HAWK-I) program.
  4 25    The bill deletes the requirement that the department of
  4 26 human services (DHS) establish family cost sharing based on a
  4 27 sliding fee scale.  The new language reflects current practice
  4 28 which is establishment of a cost sharing amount approved by
  4 29 the HAWK-I board.  The bill also directs DHS to perform
  4 30 periodic, random reviews of enrollee applications to ensure
  4 31 program compliance.  Quality assurance reports are to be made
  4 32 to the board and to DHS based upon the data maintained by the
  4 33 administrative contractor of the program.
  4 34    The bill eliminates the requirement that the outreach
  4 35 efforts developed by the board include a comprehensive
  5  1 statewide media campaign.  The bill directs the board to
  5  2 develop a functional health assessment form rather than
  5  3 selecting a single, nationally recognized assessment form for
  5  4 children participating in the program.  The bill eliminates
  5  5 the requirement that the board perform periodic random reviews
  5  6 of enrollee applications to assure program compliance, as this
  5  7 function is given to the department under the bill.  The bill
  5  8 also directs the advisory committee on children with special
  5  9 health care needs to make recommendations, annually, by
  5 10 January 1, rather than only one time by January 1, 1999.
  5 11    The bill eliminates, as reasons allowed for approval of an
  5 12 application in cases in which prior employer-sponsored
  5 13 coverage ended less than six months prior to determination of
  5 14 eligibility for the program, the death of a parent, change in
  5 15 employment to a new employer that does not provide an option
  5 16 for dependent care coverage, termination of health benefits
  5 17 due to a long-term disability, and a substantial reduction in
  5 18 either lifetime medical benefits or benefit category available
  5 19 to an employee and dependents under an employer's health care
  5 20 plan.  An existing reason for approval under these
  5 21 circumstances, loss of employment due to factors other than
  5 22 voluntary termination, is amended to provide that any loss of
  5 23 employment is reason for the approval.  Another existing
  5 24 reason for approval of an application under these
  5 25 circumstances is amended so that termination of dependent
  5 26 coverage due to an extreme economic hardship on the part of
  5 27 only the employee, and not on the part of either the employee
  5 28 or employer, is reason to allow approval of an application.
  5 29 The bill also eliminates a requirement that participating
  5 30 insurers submit a marketing plan to the HAWK-I board
  5 31 consistent with the board's outreach plan, for approval by the
  5 32 board.
  5 33    The bill amends the directive to the administrative
  5 34 contractor to forward names of children who appear to be
  5 35 eligible for health insurance coverage, other than medical
  6  1 assistance, to local offices of DHS or other appropriate
  6  2 persons, and limits the directive to forwarding the names of
  6  3 children who appear to be eligible for medical assistance only
  6  4 to the state offices of DHS.  The bill also eliminates the
  6  5 directive to the administrative contractor to make program
  6  6 applications available through the mail and through local
  6  7 sites, as determined by DHS, including to schools, local
  6  8 health departments, local department of human services
  6  9 offices, and other locations.
  6 10    The bill also provides for cost sharing based upon the
  6 11 family income percentage which is either below 150 percent of
  6 12 the federal poverty level or which equals or exceeds 150
  6 13 percent of the federal poverty level.  
  6 14 LSB 1084HV 79
  6 15 pf/gg/8
     

Text: HF00381                           Text: HF00383
Text: HF00300 - HF00399                 Text: HF Index
Bills and Amendments: General Index     Bill History: General Index

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