Senate Amendment 5164


PAG LIN

     1  1    Amend Senate File 2356 as follows:
     1  2 #1.  Page 3, by striking lines 16 through 19 and
     1  3 inserting:
     1  4    <a.  (1)  The individual is not eligible for health
     1  5 care coverage under any other public program, with the
     1  6 exception of coverage through the Iowa comprehensive
     1  7 health insurance association pursuant to chapter 514E.
     1  8    (2)  The individual is not eligible for health care
     1  9 coverage through group or individual health insurance.
     1 10    (3)  Health care coverage offered to the individual
     1 11 through group or individual health insurance is not
     1 12 affordable as specified in section 217A.7.>
     1 13 #2.  Page 3, by striking lines 25 through 28 and
     1 14 inserting <which the individual is eligible or the
     1 15 individual has not had individual health insurance
     1 16 coverage in the last six months.>
     1 17 #3.  Page 4, by striking line 27.
     1 18 #4.  Page 5, line 8, after <135.153> by inserting
     1 19 <that meet the requirements for medical homes developed
     1 20 pursuant to this section>
     1 21 #5.  Page 5, line 21, after <shall> by inserting
     1 22 <develop a methodology to>
     1 23 #6.  Page 5, line 31, after <5.> by inserting
     1 24 <IowaCare plus member services provided to members by
     1 25 providers included in the regional provider network
     1 26 shall be payable at the full benefit recipient rates.>
     1 27 #7.  Page 5, line 34, by striking <1.>
     1 28 #8.  Page 6, line 8, after <"c".> by inserting
     1 29 <Premiums collected pursuant to this section shall be
     1 30 deposited in the IowaCare plus trust fund created in
     1 31 section 217A.8.>
     1 32 #9.  Page 6, after line 8 by inserting:
     1 33    <2.  Each IowaCare plus member may be eligible
     1 34 for premium assistance as specified by rule of the
     1 35 department.>
     1 36 #10.  Page 6, by striking lines 9 through 21 and
     1 37 inserting:
     1 38    <Sec. ___.  NEW SECTION.  217A.7A  Coverage
     1 39 options == eligible individuals.
     1 40    1.  If an eligible individual is eligible for
     1 41 premium assistance under section 217A.7, the department
     1 42 shall require, that prior to provision of coverage
     1 43 through the IowaCare plus program, the eligible
     1 44 individual provides proof that the eligible individual
     1 45 is unable to obtain individual or group coverage
     1 46 that is affordable as specified in section 217A.7 as
     1 47 follows:
     1 48    a.  In the individual market, even if the program
     1 49 pays the individual share of the annual premium up
     1 50 to the amount that the program would subsidize the
     2  1 eligible individual through the program.
     2  2    b.  If the individual has access to health care
     2  3 coverage through the individual's employer, for which
     2  4 coverage the employer pays at least fifty percent of
     2  5 the annual premium cost, even if the program pays the
     2  6 employee share of the annual premium up to the amount
     2  7 the program would subsidize the individual through the
     2  8 program.
     2  9    2.  If an eligible individual provides proof that
     2 10 the eligible individual is unable to obtain individual
     2 11 or group coverage as specified in subsection 1, the
     2 12 eligible individual may obtain coverage under the
     2 13 program.
     2 14    3.  The department shall adopt rules to implement
     2 15 this section, including the documentation necessary for
     2 16 an eligible individual to provide proof of inability
     2 17 to obtain coverage.>
     2 18 #11.  Page 7, line 10, after <of> by inserting
     2 19 <federal>
     2 20 #12.  Page 7, by striking lines 12 through 14.
     2 21 #13.  Page 7, line 31, after <centers> and inserting
     2 22 <or federally qualified health center look=alikes in
     2 23 the state>
     2 24 #14.  Page 8, after line 15 by inserting:
     2 25    <(5)  Notwithstanding any provision to the contrary,
     2 26 the department shall develop a methodology to reimburse
     2 27 regional provider network participating providers
     2 28 designated under this subsection.>
     2 29 #15.  Page 8, by striking lines 24 through 26 and
     2 30 inserting <appropriated on an annual basis, the
     2 31 hospital and the university of Iowa hospitals and
     2 32 clinics shall remain the only expansion population
     2 33 providers for the residents of such county.>
     2 34 #16.  Page 8, by striking lines 27 through 30 and
     2 35 inserting:
     2 36    <2.  Expansion population services provided to
     2 37 expansion population members by providers included in
     2 38 the expansion population provider network the publicly
     2 39 owned acute care teaching hospital located in a county
     2 40 with a population over three hundred fifty thousand and
     2 41 the university of Iowa hospitals and clinics shall be
     2 42 payable at the full benefit recipient rates.>
     2 43 #17.  By striking page 9, line 14, through page 10,
     2 44 line 1, and inserting:
     2 45    <6.  The department shall utilize certified public
     2 46 expenditures at the university of Iowa hospitals and
     2 47 clinics to maximize the availability of state funding
     2 48 to provide necessary access to both local primary
     2 49 and specialty physician care to expansion population
     2 50 members.  The resulting savings to the state shall be
     3  1 utilized to reimburse physician services provided to
     3  2 expansion population members at the university of Iowa
     3  3 college of medicine, to reimburse providers designated
     3  4 to participate in the regional provider network for
     3  5 services provided to expansion population members,
     3  6 and for deposit in the nonparticipating provider
     3  7 reimbursement fund created in section 249J.24A to be
     3  8 used in accordance with the purposes and requirements
     3  9 of the fund.>
     3 10 #18.  Page 10, after line 4 by inserting:
     3 11    <Sec. ___.  Section 249J.24A, Code Supplement 2009,
     3 12 is amended by adding the following new subsection:
     3 13    NEW SUBSECTION.  5.  Notwithstanding any provision
     3 14 to the contrary, moneys in the fund may also be used
     3 15 in accordance with the methodology developed by the
     3 16 department for reimbursement of nonparticipating
     3 17 providers in the IowaCare plus program's regional
     3 18 provider network established pursuant to section
     3 19 217A.6.  However, prioritization in allocation
     3 20 of moneys within the fund shall be to provide
     3 21 reimbursement to nonparticipating providers as defined
     3 22 in this section.>
     3 23 #19.  By renumbering as necessary.


                                        
          JACK HATCH


                                        
          RICH OLIVE
          SF2356.1645 (3) 83
          pf/rj

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