Senate Amendment 3224


PAG LIN




     1  1    Amend House File 580 as follows:
     1  2 #1.  By striking everything after the enacting
     1  3 clause, and inserting the following:
     1  4    <Section 1.  NEW SECTION.  249J.24A
     1  5 NONPARTICIPATING PROVIDER REIMBURSEMENT FOR COVERED
     1  6 SERVICES == REIMBURSEMENT FUND.
     1  7    1.  Beginning July 1, 2010, the department of human
     1  8 services shall include in any medical assistance
     1  9 program waiver relating to the continuation of the
     1 10 IowaCare program pursuant to this chapter, provisions
     1 11 for reimbursement of covered expansion population
     1 12 services provided to an expansion population member by
     1 13 a nonparticipating provider if the nonparticipating
     1 14 provider contacts the appropriate participating
     1 15 provider prior to providing covered services to verify
     1 16 consensus regarding one of the following courses of
     1 17 action:
     1 18    a.  If the nonparticipating provider and the
     1 19 participating provider agree that the medical status
     1 20 of the expansion population member indicates it is
     1 21 medically possible to postpone provision of services,
     1 22 the nonparticipating provider shall direct the
     1 23 expansion population member to the appropriate
     1 24 participating provider for services.
     1 25    b.  If the nonparticipating provider and the
     1 26 participating provider agree that the medical status
     1 27 of the expansion population member indicates it is not
     1 28 medically possible to postpone provision of services,
     1 29 the nonparticipating provider shall provide medically
     1 30 necessary services.
     1 31    c.   If the nonparticipating provider and the
     1 32 participating provider agree that transfer of the
     1 33 expansion population member is not possible due to
     1 34 lack of available inpatient capacity, the
     1 35 nonparticipating provider shall provide medically
     1 36 necessary services.
     1 37    d.   If the medical status of the expansion
     1 38 population member indicates a medical emergency and
     1 39 the nonparticipating provider is not able to contact
     1 40 the appropriate participating provider prior to
     1 41 providing medically necessary services, the
     1 42 nonparticipating provider shall document the medical
     1 43 emergency and inform the appropriate participating
     1 44 provider immediately after the member has been
     1 45 stabilized of any covered services provided.
     1 46    2.  If the nonparticipating provider meets the
     1 47 requirements specified in subsection 1, the
     1 48 nonparticipating provider shall be reimbursed for
     1 49 covered expansion population services provided to the
     1 50 expansion population member through the
     2  1 nonparticipating provider reimbursement fund in
     2  2 accordance with the following:
     2  3    a.  The nonparticipating provider shall request
     2  4 reimbursement from the department through an exception
     2  5 to policy request as provided in departmental rule.
     2  6 The nonparticipating provider shall submit a clean
     2  7 claim to the department for reimbursement within
     2  8 twenty days of provision of the covered service.  The
     2  9 department shall adopt rules relating to the format of
     2 10 and the information to be included in the request for
     2 11 reimbursement.
     2 12    b.  The nonparticipating provider shall include in
     2 13 the request for reimbursement only clean claims for
     2 14 inpatient hospital services provided to the expansion
     2 15 population member during the episode of care or
     2 16 treatment described in subsection 1.
     2 17    c.  Reimbursement shall be based on the
     2 18 reimbursement rates and policies applicable to the
     2 19 nonparticipating provider under the full benefit
     2 20 medical assistance program, subject to the
     2 21 availability of funds in the nonparticipating provider
     2 22 reimbursement fund and subject to the appropriation of
     2 23 moneys in the fund to the department.
     2 24    d.  The department shall reimburse the
     2 25 nonparticipating provider only if the recipient of the
     2 26 services is an expansion population member with active
     2 27 eligibility status at the time the services are
     2 28 provided.
     2 29    3.  a.  A nonparticipating provider reimbursement
     2 30 fund is created in the state treasury under the
     2 31 authority of the department.  Moneys designated for
     2 32 deposit in the fund that are received from sources
     2 33 including but not limited to appropriations from the
     2 34 general fund of the state, grants, and contributions,
     2 35 shall be deposited in the fund.
     2 36    b.  Moneys in the fund shall be separate from the
     2 37 general fund of the state and shall not be considered
     2 38 part of the general fund of the state.  The moneys
     2 39 deposited in the fund are not subject to section 8.33
     2 40 and shall not be transferred, used, obligated,
     2 41 appropriated, or otherwise encumbered, except to
     2 42 provide for the purposes specified in this section.
     2 43 Notwithstanding section 12C.7, subsection 2, interest
     2 44 or earnings on moneys deposited in the fund shall be
     2 45 credited to the fund.
     2 46    c.  Moneys deposited in the fund shall be used only
     2 47 to reimburse nonparticipating providers who provide
     2 48 covered services to expansion population members if no
     2 49 other third party is liable for reimbursement and as
     2 50 specified in subsections 1 and 2.
     3  1    d.  The department shall attempt to maximize
     3  2 receipt of federal matching funds under the medical
     3  3 assistance program for covered services provided under
     3  4 this section if such attempt does not directly or
     3  5 indirectly limit the federal funds available to
     3  6 participating providers.
     3  7    4.  For the purposes of this section,
     3  8 "nonparticipating provider" means a hospital licensed
     3  9 pursuant to chapter 135B that is not a member of the
     3 10 expansion population provider network as specified in
     3 11 section 249J.7.
     3 12    Sec. 2.  CONTINGENT IMPLEMENTATION.
     3 13 Notwithstanding the requirement of this Act directing
     3 14 the department of human services to include provisions
     3 15 for reimbursement of covered services provided to an
     3 16 expansion population member by a nonparticipating
     3 17 provider under any medical assistance program waiver
     3 18 relating to the continuation of the IowaCare program,
     3 19 if the department of human services in consultation
     3 20 with the governor determines that such requirement
     3 21 would adversely affect continuation of the IowaCare
     3 22 waiver, the department shall not include such
     3 23 provisions in the IowaCare waiver and this Act shall
     3 24 not be implemented.>
     3 25 #2.  Title page, by striking line 2 and inserting
     3 26 the following:  <for covered services provided to
     3 27 IowaCare program members, creating a reimbursement
     3 28 fund, and providing for contingent implementation.>
     3 29
     3 30
     3 31                               
     3 32 AMANDA RAGAN
     3 33 HF 580.502 83
     3 34 pf/nh/22993

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