House Amendment 1630


PAG LIN




     1  1    Amend House File 811 as amended, passed, and
     1  2 reprinted by the House, as follows:
     1  3 #1.  Page 16, line 29, by striking the figure
     1  4 <5,266,946> and inserting the following:  <5,496,946>.
     1  5 #2.  Page 18, by inserting after line 4 the
     1  6 following:
     1  7    <5A.  It is the intent of the general assembly that
     1  8 the department of human services review the
     1  9 feasibility of expanding categorical food assistance
     1 10 program eligibility in Iowa to at least 160 percent of
     1 11 the applicable federal poverty level and simplifying
     1 12 administrative requirements by eliminating current
     1 13 asset tests for food assistance program eligibility.
     1 14 The department shall estimate the potential economic
     1 15 benefits and fiscal impact of making these changes on
     1 16 individual Iowa families and the state.  The
     1 17 department shall report on or before December 15,
     1 18 2009, concerning the review, providing findings and
     1 19 recommendations, to the persons designated by this
     1 20 division of this Act for submission of reports.>
     1 21 #3.  Page 18, line 17, by striking the figure
     1 22 <34,342,700> and inserting the following:
     1 23 <34,592,700>.
     1 24 #4.  Page 18, line 20, by striking the figure
     1 25 <2,268,271> and inserting the following:  <2,518,271>.
     1 26 #5.  Page 21, line 24, by striking the figure
     1 27 <678,038,847> and inserting the following:
     1 28 <677,613,847>.
     1 29 #6.  Page 29, line 29, by striking the figure
     1 30 <37,799,472> and inserting the following:
     1 31 <37,974,472>.
     1 32 #7.  Page 31, line 20, by striking the figure
     1 33 <175,000> and inserting the following:  <350,000>.
     1 34 #8.  Page 32, by striking lines 1 through 8.
     1 35 #9.  Page 33, line 30, by striking the figure
     1 36 <34,280,400> and inserting the following:
     1 37 <34,200,400>.
     1 38 #10.  Page 39, by striking lines 14 through 22.
     1 39 #11.  Page 39, by inserting before line 23 the
     1 40 following:
     1 41    <   .  Of the funds appropriated in this section,
     1 42 $80,000 shall be transferred to the appropriation made
     1 43 in this division of this Act for the family support
     1 44 subsidy program to supplement that appropriation.>
     1 45 #12.  Page 40, by striking lines 13 through 21.
     1 46 #13.  Page 41, by inserting after line 20 the
     1 47 following:
     1 48    <3.  If at any time during the fiscal year, the
     1 49 amount of funding available for the family support
     1 50 subsidy program is reduced from the amount initially
     2  1 used to establish the figure for the number of family
     2  2 members for whom a subsidy is to be provided at any
     2  3 one time during the fiscal year, notwithstanding
     2  4 section 225C.38, subsection 2, the department shall
     2  5 revise the figure as necessary to conform to the
     2  6 amount of funding available.>
     2  7 #14.  By striking page 42, line 34, through page
     2  8 43, line 9.
     2  9 #15.  Page 44, by striking lines 21 through 27.
     2 10 #16.  Page 46, lines 33 and 34, by striking the
     2 11 words <approved county management plan> and inserting
     2 12 the following:  <county management plan approved by
     2 13 the board of supervisors>.
     2 14 #17.  Page 61, by striking lines 21 through 30.
     2 15 #18.  Page 61, by inserting before line 31 the
     2 16 following:
     2 17    <Sec.    .  PHARMACY=RELATED ISSUES == INTERIM.
     2 18    1.  The legislative council is requested to
     2 19 establish a legislative study committee for the 2009
     2 20 interim to identify strategies and solutions to
     2 21 address problems arising from inappropriate medication
     2 22 use in the health care system.
     2 23    2.  The study committee shall consist of members of
     2 24 the general assembly, and representatives of the
     2 25 department of public health, the Iowa pharmacy
     2 26 association, the Iowa medical society, wellmark blue
     2 27 cross blue shield, the principal financial group, the
     2 28 university of Iowa college of public health, the Iowa
     2 29 retail federation, the prevention and chronic care
     2 30 management advisory council established in section
     2 31 135.161, the medical home system advisory council
     2 32 established in section 135.159, the Iowa healthcare
     2 33 collaborative, as defined in section 135.40, the
     2 34 health policy corporation of Iowa, and the Iowa
     2 35 foundation for medical care.
     2 36    3.  The study committee shall document the extent
     2 37 and causes of medication use problems and examine
     2 38 potential solutions including medication therapy
     2 39 management programs, evidence=based prescriber
     2 40 education programs, clinical pharmacy services in the
     2 41 primary medical home, collaborative practice models of
     2 42 care, and quality and performance=based payment
     2 43 systems.
     2 44    4.  The study committee shall submit a report of
     2 45 its findings and recommendations to the general
     2 46 assembly for consideration during the 2010 legislative
     2 47 session.>
     2 48 #19.  Page 71, by inserting after line 9 the
     2 49 following:
     2 50    <Sec.    .  Section 426B.5, subsection 2, paragraph
     3  1 i, subparagraph (3), Code 2009, is amended to read as
     3  2 follows:
     3  3    (3)  Avoiding the need for reduction or elimination
     3  4 of a mobile crisis team or other critical emergency
     3  5 services when the reduction or elimination places the
     3  6 public's health or safety at risk.>
     3  7 #20.  Page 76, by striking lines 10 through 13, and
     3  8 inserting the following:  <efforts of the bodies.>
     3  9 #21.  Page 78, line 10, by striking the figure
     3 10 <891,219> and inserting the following:  <999,219>.
     3 11 #22.  Page 78, line 13, by striking the figure
     3 12 <346,224> and inserting the following:  <454,224>.
     3 13 #23.  Page 78, line 24, by striking the figure
     3 14 <2,253,507> and inserting the following:  <2,720,507>.
     3 15 #24.  Page 80, line 22, by striking the figure
     3 16 <61,350> and inserting the following:  <225,350>.
     3 17 #25.  Page 80, line 27, by inserting after the
     3 18 figure <2006.> the following:  <The department of
     3 19 public health shall report to the persons designated
     3 20 in division I of this Act for submission of reports
     3 21 regarding use of the funds allocated in this lettered
     3 22 paragraph, on or before January 10, 2010.>
     3 23 #26.  Page 80, by striking line 28, and inserting
     3 24 the following:
     3 25    <g.  (1)  Of the funds appropriated in this
     3 26 subsection, $347,520>.
     3 27 #27.  Page 80, by inserting after line 33 the
     3 28 following:
     3 29    <(2)  Of the funds appropriated in this subsection,
     3 30 $70,000 shall be used to provide conference
     3 31 scholarships to direct care workers.
     3 32    (3)  The association specified in this lettered
     3 33 paragraph shall report to the persons designated in
     3 34 division I of this Act for submission of reports on or
     3 35 before January 1, 2010, the use of the funds allocated
     3 36 in this lettered paragraph, any progress made
     3 37 regarding the initiatives specified and in expanding
     3 38 the association statewide, and the number of
     3 39 scholarships provided, and shall include in the report
     3 40 a copy of the association's internal revenue service
     3 41 form 990.>
     3 42 #28.  Page 81, line 15, by striking the figure
     3 43 <111,409,156> and inserting the following:
     3 44 <111,834,156>.
     3 45 #29.  Page 81, line 29, by striking the word
     3 46 <sixteen> and inserting the following:  <seventeen>.
     3 47 #30.  Page 84, by striking lines 5 through 12.
     3 48 #31.  Page 85, by inserting after line 16 the
     3 49 following:
     3 50     <TRAINING FOR CHILD WELFARE SERVICES PROVIDERS
     4  1    Sec.    .  2008 Iowa Acts, chapter 1187, section 9,
     4  2 subsection 20, paragraph c, subparagraph (6), is
     4  3 amended to read as follows:
     4  4    (6)  For training for child welfare services
     4  5 providers, $250,000.  The training shall be developed
     4  6 by the department in collaboration with the coalition
     4  7 for children and family services in Iowa.
     4  8 Notwithstanding section 8.33, moneys allocated in this
     4  9 subparagraph that remain unencumbered or unobligated
     4 10 at the close of the fiscal year shall not revert but
     4 11 shall remain available for expenditure for the
     4 12 purposes designated until the close of the succeeding
     4 13 fiscal year.>
     4 14 #32.  Page 86, by inserting after line 6 the
     4 15 following:
     4 16              <FAMILY SUPPORT SUBSIDY SLOTS
     4 17    Sec.    .  2008 Iowa Acts, chapter 1187, section
     4 18 19, is amended by adding the following new subsection:
     4 19    NEW SUBSECTION.  3.  If at any time during the
     4 20 fiscal year, the amount of funding available for the
     4 21 family support subsidy program is reduced from the
     4 22 amount initially used to establish the figure for the
     4 23 number of family members for whom a subsidy is to be
     4 24 provided at any one time during the fiscal year,
     4 25 notwithstanding section 225C.38, subsection 2, the
     4 26 department shall revise the figure as necessary to
     4 27 conform to the amount of funding available.
     4 28                  PREGNANCY COUNSELING
     4 29    Sec.    .  2008 Iowa Acts, chapter 1187, section
     4 30 30, is amended by adding the following new unnumbered
     4 31 paragraph:
     4 32    NEW UNNUMBERED PARAGRAPH.  Notwithstanding section
     4 33 8.33, moneys appropriated in this section that remain
     4 34 unencumbered or unobligated at the close of the fiscal
     4 35 year shall remain available for expenditure for the
     4 36 purpose designated until the close of the fiscal year
     4 37 beginning July 1, 2010.>
     4 38 #33.  Page 97, by striking line 10 and inserting
     4 39 the following:  <chairperson, upon the request of a
     4 40 state agency, state medical examiner or as>.
     4 41 #34.  Page 111, by inserting after line 17 the
     4 42 following:
     4 43                      <DIVISION    
     4 44              IOWACARE == NONPARTICIPATING
     4 45                PROVIDER == REIMBURSEMENT
     4 46    Sec.     .   NEW SECTION.  249J.24A
     4 47 NONPARTICIPATING PROVIDER REIMBURSEMENT FOR COVERED
     4 48 SERVICES == REIMBURSEMENT FUND.
     4 49    1.  A nonparticipating provider may be reimbursed
     4 50 for covered expansion population services provided to
     5  1 an expansion population member by a nonparticipating
     5  2 provider, if the nonparticipating provider contacts
     5  3 the appropriate participating provider prior to
     5  4 providing covered services to verify consensus
     5  5 regarding one of the following courses of action:
     5  6    a.  If the nonparticipating provider and the
     5  7 participating provider agree that the medical status
     5  8 of the expansion population member indicates it is
     5  9 medically possible to postpone provision of services,
     5 10 the nonparticipating provider shall direct the
     5 11 expansion population member to the appropriate
     5 12 participating provider for services.
     5 13    b.  If the nonparticipating provider and the
     5 14 participating provider agree that the medical status
     5 15 of the expansion population member indicates it is not
     5 16 medically possible to postpone provision of services,
     5 17 the nonparticipating provider shall provide medically
     5 18 necessary services.
     5 19    c.  If the nonparticipating provider and the
     5 20 participating provider agree that transfer of the
     5 21 expansion population member is not possible due to
     5 22 lack of available inpatient capacity, the
     5 23 nonparticipating provider shall provide medically
     5 24 necessary services.
     5 25    d.  If the medical status of the expansion
     5 26 population member indicates a medical emergency and
     5 27 the nonparticipating provider is not able to contact
     5 28 the appropriate participating provider prior to
     5 29 providing medically necessary services, the
     5 30 nonparticipating provider shall document the medical
     5 31 emergency and inform the appropriate participating
     5 32 provider immediately after the member has been
     5 33 stabilized of any covered services provided.
     5 34    2.  a.  If the nonparticipating provider meets the
     5 35 requirements specified in subsection 1, the
     5 36 nonparticipating provider shall be reimbursed for
     5 37 covered expansion population services provided to the
     5 38 expansion population member through the
     5 39 nonparticipating provider reimbursement fund in
     5 40 accordance with rules adopted by the department of
     5 41 human services.  However, any funds received from
     5 42 participating providers, appropriated to participating
     5 43 providers, or deposited in the IowaCare account
     5 44 pursuant to section 249J.24, shall not be transferred
     5 45 or appropriated to the nonparticipating provider
     5 46 reimbursement fund or otherwise used to reimburse
     5 47 nonparticipating providers.
     5 48    b.  Reimbursement of nonparticipating providers
     5 49 under this section shall be based on the reimbursement
     5 50 rates and policies applicable to the nonparticipating
     6  1 provider under the full benefit medical assistance
     6  2 program, subject to the availability of funds in the
     6  3 nonparticipating provider reimbursement fund and
     6  4 subject to the appropriation of moneys in the fund to
     6  5 the department.
     6  6    c.  The department shall reimburse the
     6  7 nonparticipating provider only if the recipient of the
     6  8 services is an expansion population member with active
     6  9 eligibility status at the time the services are
     6 10 provided.
     6 11    3.  a.  A nonparticipating provider reimbursement
     6 12 fund is created in the state treasury under the
     6 13 authority of the department.  Moneys designated for
     6 14 deposit in the fund that are received from sources
     6 15 including but not limited to appropriations from the
     6 16 general fund of the state, grants, and contributions,
     6 17 shall be deposited in the fund.  However, any funds
     6 18 received from participating providers, appropriated to
     6 19 participating providers, or deposited in the IowaCare
     6 20 account pursuant to section 249J.24 shall not be
     6 21 transferred or appropriated to the nonparticipating
     6 22 provider reimbursement fund or otherwise used to
     6 23 reimburse nonparticipating providers.
     6 24    b.  Moneys in the fund shall be separate from the
     6 25 general fund of the state and shall not be considered
     6 26 part of the general fund of the state.  The moneys
     6 27 deposited in the fund are not subject to section 8.33
     6 28 and shall not be transferred, used, obligated,
     6 29 appropriated, or otherwise encumbered, except to
     6 30 provide for the purposes specified in this section.
     6 31 Notwithstanding section 12C.7, subsection 2, interest
     6 32 or earnings on moneys deposited in the fund shall be
     6 33 credited to the fund.
     6 34    c.  Moneys deposited in the fund shall be used only
     6 35 to reimburse nonparticipating providers who provide
     6 36 covered services to expansion population members if no
     6 37 other third party is liable for reimbursement and as
     6 38 specified in subsection 1.
     6 39    d.  The department shall attempt to maximize
     6 40 receipt of federal matching funds under the medical
     6 41 assistance program for covered services provided under
     6 42 this section if such attempt does not directly or
     6 43 indirectly limit the federal funds available to
     6 44 participating providers.
     6 45    4.  For the purposes of this section,
     6 46 "nonparticipating provider" means a hospital licensed
     6 47 pursuant to chapter 135B that is not a member of the
     6 48 expansion population provider network as specified in
     6 49 section 249J.7.
     6 50    Sec.    .  NONPARTICIPATING PROVIDER REIMBURSEMENT
     7  1 FOR COVERED SERVICES == IOWACARE PROGRAM WAIVER
     7  2 RENEWAL.
     7  3    1.  Beginning July 1, 2010, the department of human
     7  4 services shall include in any medical assistance
     7  5 program waiver relating to the continuation of the
     7  6 IowaCare program pursuant to chapter 249J, provisions
     7  7 for reimbursement of covered expansion population
     7  8 services provided to an expansion population member by
     7  9 a nonparticipating provider subject to all of the
     7 10 following:
     7 11    a.  A nonparticipating provider may be reimbursed
     7 12 if the nonparticipating provider contacts the
     7 13 appropriate participating provider prior to providing
     7 14 covered services to verify consensus regarding one of
     7 15 the following courses of action:
     7 16    (1)  If the nonparticipating provider and the
     7 17 participating provider agree that the medical status
     7 18 of the expansion population member indicates it is
     7 19 medically possible to postpone provision of services,
     7 20 the nonparticipating provider shall direct the
     7 21 expansion population member to the appropriate
     7 22 participating provider for services.
     7 23    (2)  If the nonparticipating provider and the
     7 24 participating provider agree that the medical status
     7 25 of the expansion population member indicates it is not
     7 26 medically possible to postpone provision of services,
     7 27 the nonparticipating provider shall provide medically
     7 28 necessary services.
     7 29    (3)  If the nonparticipating provider and the
     7 30 participating provider agree that transfer of the
     7 31 expansion population member is not possible due to
     7 32 lack of available inpatient capacity, the
     7 33 nonparticipating provider shall provide medically
     7 34 necessary services.
     7 35    (4)  If the medical status of the expansion
     7 36 population member indicates a medical emergency and
     7 37 the nonparticipating provider is not able to contact
     7 38 the appropriate participating provider prior to
     7 39 providing medically necessary services, the
     7 40 nonparticipating provider shall document the medical
     7 41 emergency and inform the appropriate participating
     7 42 provider immediately after the member has been
     7 43 stabilized of any covered services provided.
     7 44    b.  Reimbursement of a nonparticipating provider
     7 45 shall be based on the reimbursement rates and policies
     7 46 applicable to the nonparticipating provider under the
     7 47 full benefit medical assistance program, subject to
     7 48 the availability and appropriation of funds to the
     7 49 department for such purpose.
     7 50    c.  Reimbursement shall be made to a
     8  1 nonparticipating provider only if the recipient of the
     8  2 services is an expansion population member with active
     8  3 eligibility status at the time the services are
     8  4 provided.
     8  5    d.  For the purposes of this section,
     8  6 "nonparticipating provider" means a hospital licensed
     8  7 pursuant to chapter 135B that is not a member of the
     8  8 expansion population provider network as specified in
     8  9 section 249J.7.
     8 10    2.  Notwithstanding the requirement of this section
     8 11 directing the department of human services to include
     8 12 provisions for reimbursement of covered services
     8 13 provided to an expansion population member by a
     8 14 nonparticipating provider under any medical assistance
     8 15 program waiver relating to the continuation of the
     8 16 IowaCare program beginning July 1, 2010, if the
     8 17 department of human services in consultation with the
     8 18 governor determines that such requirement would
     8 19 adversely affect continuation of or would reduce the
     8 20 amount of funding available for the IowaCare waiver,
     8 21 the department shall not include such provisions in
     8 22 the IowaCare waiver.>
     8 23 #35.  Page 111, by inserting after line 19 the
     8 24 following:
     8 25    <Sec    .  NEW SECTION.  157.3B  EXAMINATION
     8 26 INFORMATION.
     8 27    Notwithstanding section 147.21, individual pass or
     8 28 fail examination results made available from the
     8 29 authorized national testing agency to the board may be
     8 30 disclosed to the board=approved education program from
     8 31 which the applicant for licensure graduated for
     8 32 purposes of verifying accuracy of national data and
     8 33 reporting aggregate licensure examination results as
     8 34 required for a program's continued accreditation.>
     8 35 HF 811.S
     8 36 pf/jp/jh/26

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