Text: HF00048 Text: HF00050 Text: HF00000 - HF00099 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN 1 1 Section 1. Section 514I.4, subsection 4, Code 2003, 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 annual, random reviews of enrollee applications 1 14 to ensure compliance with program eligibility and enrollment 1 15 policies. Quality assurance reports shall be made to the 1 16 board and the department based upon the data maintained by the 1 17 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 2003, 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 recognized functional health2 2assessment form for an initial assessment of all eligible2 3 assess the initial health status of children participating in 2 4 the program, establish a baseline for comparison purposes, and 2 5 develop appropriate indicators to measure the subsequent 2 6 health status ofeligiblechildren participating in the 2 7 program. 2 8 Sec. 3. Section 514I.5, subsection 7, paragraph i, Code 2 9 2003, is amended by striking the paragraph. 2 10 Sec. 4. Section 514I.5, subsection 7, paragraph l, 2 11 unnumbered paragraph 1, Code 2003, is amended to read as 2 12 follows: 2 13 Establish an advisory committee to make recommendations to 2 14 the board and to the general assemblyon or beforeby January 2 15 1,1999,annually concerning the provision of health insurance 2 16 coverage to children with special health care needsunder the2 17program. The committee shall include individuals with 2 18 experience in, knowledge of, or expertise in this area. The 2 19 recommendations shall address, but are not limited to, all of 2 20 the following: 2 21 Sec. 5. Section 514I.5, subsection 8, paragraph h, Code 2 22 2003, is amended to read as follows: 2 23 h. The amount of any cost sharing under the program which 2 24shallmay be assessedon a sliding fee scalebased on family 2 25 income, which provides for a minimum amount of cost sharing,2 26 and which complies with federal law. 2 27 Sec. 6. Section 514I.5, subsection 8, paragraph m, Code 2 28 2003, is amended by striking the paragraph. 2 29 Sec. 7. Section 514I.6, subsection 3, Code 2003, is 2 30 amended by striking the subsection. 2 31 Sec. 8. Section 514I.7, subsection 2, paragraph c, Code 2 32 2003, is amended to read as follows: 2 33 c. Forward names of children who appear to be eligible for 2 34 medical assistanceor other public health insurance coverage2 35to localto the department of human servicesoffices or other3 1appropriate person or agencyforfollow upfollow-up and 3 2 retaintheidentifying data on children who are referred. 3 3 Sec. 9. Section 514I.7, subsection 2, paragraph h, Code 3 4 2003, is amended by striking the paragraph. 3 5 Sec. 10. Section 514I.8, subsection 2, paragraph e, Code 3 6 2003, is amended to read as follows: 3 7 e. Is not currently covered under or was not covered 3 8 within the prior six months under a group health plan as 3 9 defined in 42 U.S.C. } 300gg-91(a)(1)or other health benefit3 10plan, unless the coverage was involuntarily lost orunless 3 11dropping the coverage isallowed by rule of the board. 3 12 Sec. 11. Section 514I.10, Code 2003, is amended to read as 3 13 follows: 3 14 514I.10 COST SHARING. 3 15 1. Cost sharing for eligible children whose family income 3 16 isat orbelow one hundred fifty percent of the federal 3 17 poverty level shall not exceed the standards permitted under 3 18 42 U.S.C. } 1396(o)(a)(3) or } 1396(o)(b)(1). 3 19 2. Cost sharing for eligible children whose family income 3 20is betweenequals or exceeds one hundred fifty percentand two3 21hundred percentof the federal poverty levelshallmay include 3 22 a premium or copayment amountwhich is at least a minimum3 23amount butwhich does not exceed five percent of the annual 3 24 family income. The amount oftheany premium or the copayment 3 25 amount shall be based on family income and size. 3 26 EXPLANATION 3 27 This bill amends portions of the Code relating to the 3 28 healthy and well kids in Iowa (hawk-i) program and the medical 3 29 assistance program. 3 30 The bill deletes the requirement that the department of 3 31 human services (DHS) establish family cost sharing based on a 3 32 sliding fee scale. The new language reflects current practice 3 33 which is establishment of a cost sharing amount approved by 3 34 the hawk-i board. The bill also directs DHS to perform 3 35 annual, random reviews of enrollee applications to ensure 4 1 program compliance. Quality assurance reports are to be made 4 2 to the board and to DHS based upon the data maintained by the 4 3 administrative contractor of the program. 4 4 The bill eliminates the requirement that the outreach 4 5 efforts developed by the board include a comprehensive 4 6 statewide media campaign. The bill directs the board, in 4 7 consultation with the clinical advisory committee, to assess 4 8 the initial health status of children participating in the 4 9 program, establish a baseline, and develop appropriate 4 10 indicators to assess the subsequent health status of children 4 11 participating in the program, rather than directing the board 4 12 to select a single, nationally recognized assessment form for 4 13 children participating in the program. The bill eliminates 4 14 the requirement that the board perform periodic random reviews 4 15 of enrollee applications to assure program compliance, as this 4 16 function is given to the department under the bill. The bill 4 17 also directs the advisory committee on children with special 4 18 health care needs to make recommendations, annually, by 4 19 January 1, rather than only one time by January 1, 1999. 4 20 The bill eliminates the directive to the hawk-i board to 4 21 adopt rules to address approval of a program application in 4 22 cases in which prior employer-sponsored coverage ended less 4 23 than six months prior to determination of eligibility for the 4 24 program. The bill also eliminates a requirement that 4 25 participating insurers submit a marketing plan to the hawk-i 4 26 board consistent with the board's outreach plan, for approval 4 27 by the board. 4 28 The bill amends the directive to the administrative 4 29 contractor to forward names of children who appear to be 4 30 eligible for health insurance coverage, other than medical 4 31 assistance, to local offices of DHS or other appropriate 4 32 persons, and limits the directive to forwarding the names of 4 33 children who appear to be eligible for medical assistance only 4 34 to the state offices of DHS. The bill also eliminates the 4 35 directive to the administrative contractor to make program 5 1 applications available through the mail and through local 5 2 sites, as determined by DHS, including to schools, local 5 3 health departments, local department of human services 5 4 offices, and other locations. 5 5 The bill also provides that a child may participate in the 5 6 hawk-i program if, among other criteria, the child is not 5 7 currently covered or was not covered in the past six months 5 8 under a group health plan unless allowed by rule of the board. 5 9 The bill also allows for cost sharing based upon the family 5 10 income percentage which is either below 150 percent of the 5 11 federal poverty level or which equals or exceeds 150 percent 5 12 of the federal poverty level. 5 13 LSB 1058HH 80 5 14 pf/sh/8.2
Text: HF00048 Text: HF00050 Text: HF00000 - HF00099 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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