House File 649 S-3293 Amend House File 649, as amended, passed, and 1 reprinted by the House, as follows: 2 1. Page 1, line 19, by striking < 9,852,577 > and 3 inserting < 10,302,577 > 4 2. Page 1, after line 29 by inserting: 5 < 1A. The amount appropriated in this section 6 includes additional funding of $450,000 for delivery of 7 long-term care services to seniors with low or moderate 8 incomes. > 9 3. Page 2, line 35, by striking < 20,703,190 > and 10 inserting < 25,703,190 > 11 4. Page 3, by striking lines 2 through 11 and 12 inserting: 13 < a. (1) Of the funds appropriated in this 14 subsection, $5,453,830 shall be used for the tobacco 15 use prevention and control initiative, including 16 efforts at the state and local levels, as provided in 17 chapter 142A. 18 (2) Of the funds allocated in this paragraph 19 “a”, $453,830 shall be transferred to the alcoholic 20 beverages division of the department of commerce 21 for enforcement of tobacco laws, regulations, and 22 ordinances in accordance with 2011 Iowa Acts, House 23 File 467, as enacted. > 24 5. Page 6, line 16, by striking < 2,601,905 > and 25 inserting < 2,549,270 > 26 6. Page 6, line 17, by striking < 10.00 > and 27 inserting < 11.00 > 28 7. Page 6, line 25, by striking < 287,520 > and 29 inserting < 329,885 > 30 8. Page 6, line 30, after < children. > by inserting 31 < A portion of the funds allocated in this lettered 32 paragraph may be used for a full-time equivalent 33 position to coordinate the activities under this 34 paragraph. > 35 9. Page 7, by striking lines 8 through 14. 36 10. Page 7, line 19, by striking < 3,262,256 > and 37 inserting < 3,369,156 > 38 11. Page 7, line 20, by striking < 4.00 > and 39 inserting < 5.00 > 40 12. Page 7, line 21, by striking < 136,808 > and 41 inserting < 160,582 > 42 13. Page 7, line 25, by striking < 383,600 > and 43 inserting < 483,600 > 44 14. Page 8, line 6, by striking < 755,791 > and 45 inserting < 788,303 > 46 15. Page 8, line 8, by striking < 711,052 > and 47 inserting < 547,065 > 48 16. Page 8, line 12, by striking < 363,987 > and 49 inserting < 200,000 > 50 -1- HF649.2839 (1) 84 pf/jp 1/ 52 #1. #2. #3. #4. #5. #6. #7. #8. #9. #10. #11. #12. #13. #14. #15.
17. Page 8, line 18, by striking < 421,782 > and 1 inserting < 528,834 > 2 18. Page 8, line 20, after < disorders. > by 3 inserting < A portion of the funds allocated in this 4 paragraph may be used for one full-time equivalent 5 position for administration of the center. > 6 19. Page 8, line 28, by striking < 3,677,659 > and 7 inserting < 4,813,872 > 8 20. Page 9, line 33, by striking < Iowa-Nebraska > 9 and inserting < Iowa > 10 21. Page 10, line 1, by striking < 116,597 > and 11 inserting < 132,580 > 12 22. Page 10, after line 1 by inserting: 13 < (1A) For distribution to the Iowa family planning 14 network agencies for necessary infrastructure, 15 statewide coordination, provider recruitment, service 16 delivery, and provision of assistance to patients in 17 determining an appropriate medical home: 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 74,517 > 19 23. Page 10, line 5, by striking < 68,332 > and 20 inserting < 74,517 > 21 24. Page 10, line 9, by striking < 68,332 > and 22 inserting < 74,517 > 23 25. Page 10, line 14, by striking < 113,754 > and 24 inserting < 124,050 > 25 26. Page 10, line 19, by striking < 101,264 > and 26 inserting < 110,430 > 27 27. Page 10, line 23, by striking < 238,420 > and 28 inserting < 260,000 > 29 28. Page 10, line 27, by striking < 247,590 > and 30 inserting < 270,000 > 31 29. By striking page 10, line 32, through page 11, 32 line 5, and inserting: 33 < h. (1) Of the funds appropriated in this 34 subsection, $149,000 shall be used for continued 35 implementation of the recommendations of the direct 36 care worker task force established pursuant to 2005 37 Iowa Acts, chapter 88, based upon the report submitted 38 to the governor and the general assembly in December 39 2006. The department may use a portion of the funds 40 allocated in this lettered paragraph for an additional 41 position to assist in the continued implementation. 42 (2) It is the intent of the general assembly that 43 a board of direct care workers shall be established 44 within the department of public health by July 1, 2014, 45 contingent upon the availability of funds to establish 46 and maintain the board. 47 (3) The direct care worker advisory council 48 shall submit a final report no later than March 1, 49 2012, to the governor and the general assembly, in 50 -2- HF649.2839 (1) 84 pf/jp 2/ 52 #17. #18. #19. #20. #21. #22. #23. #24. #25. #26. #27. #28. #29.
accordance with 2010 Iowa Acts, chapter 1192, section 1 2, subsection 4, paragraph “h”, subparagraph (3). 2 (4) The department of public health shall report to 3 the persons designated in this Act for submission of 4 reports regarding use of the funds allocated in this 5 lettered paragraph, on or before January 15, 2012. 6 i. (1) Of the funds appropriated in this 7 subsection, $130,100 shall be used for allocation to an 8 independent statewide direct care worker association 9 for education, outreach, leadership development, 10 mentoring, and other initiatives intended to enhance 11 the recruitment and retention of direct care workers in 12 health care and long-term care settings. 13 (2) Of the funds appropriated in this subsection, 14 $45,173 shall be used to provide scholarships or 15 other forms of subsidization for direct care worker 16 educational conferences, training, or outreach 17 activities. > 18 30. Page 11, after line 13 by inserting: 19 < k. Of the funds appropriated in this subsection, 20 $50,000 shall be used for a matching dental education 21 loan repayment program to be allocated to a dental 22 nonprofit health service corporation to develop the 23 criteria and implement the loan repayment program. 24 l. Of the funds appropriated in this subsection, up 25 to $134,214 shall be used to support the department’s 26 activities relating to health and long-term care access 27 as specified pursuant to chapter 135, division XXIV. 28 m. Of the funds appropriated in this subsection, 29 $363,987 shall be used as state matching funds for the 30 health information network as enacted by this Act. 31 n. Of the funds appropriated in this subsection, 32 $25,000 shall be used for a pilot program established 33 as a collaborative effort between the department 34 of public health and the department of education 35 to provide vision screening to elementary school 36 children in one urban and one rural school district 37 in the state, on a voluntary basis, over a multiyear 38 period. The departments shall develop protocol for 39 participating schools including the grade level of the 40 children to be screened, the training and certification 41 necessary for individuals conducting the vision 42 screening, vision screening equipment requirements, and 43 documentation and tracking requirements. Following 44 the conclusion of the pilot program, the participating 45 schools shall report findings and recommendations 46 for statewide implementation of the vision screening 47 program to the departments. > 48 31. Page 11, line 19, by striking < 7,297,142 > and 49 inserting < 7,336,142 > 50 -3- HF649.2839 (1) 84 pf/jp 3/ 52 #30.
32. Page 11, line 22, by striking < 5,287,955 > and 1 inserting < 5,326,955 > 2 33. Page 12, line 7, by striking < 2,906,532 > and 3 inserting < 2,778,688 > 4 34. Page 12, after line 24 by inserting: 5 < d. Of the funds appropriated in this subsection, 6 $50,000 shall be used for education, testing, training, 7 and other costs to conform the requirements for 8 certification of emergency medical care providers with 9 national standards. > 10 35. Page 12, by striking lines 25 through 30. 11 36. Page 23, line 27, by striking < 897,237,190 > and 12 inserting < 878,216,915 > 13 37. Page 23, by striking lines 28 through 34 and 14 inserting: 15 < 1. Medically necessary abortions are those 16 performed under any of the following conditions: 17 a. The attending physician certifies that 18 continuing the pregnancy would endanger the life of the 19 pregnant woman. 20 b. The attending physician certifies that the 21 fetus is physically deformed, mentally deficient, or 22 afflicted with a congenital illness. 23 c. The pregnancy is the result of a rape which 24 is reported within 45 days of the incident to a law 25 enforcement agency or public or private health agency 26 which may include a family physician. 27 d. The pregnancy is the result of incest which 28 is reported within 150 days of the incident to a law 29 enforcement agency or public or private health agency 30 which may include a family physician. 31 e. Any spontaneous abortion, commonly known as a 32 miscarriage, if not all of the products of conception 33 are expelled. > 34 38. By striking page 28, line 17, through page 29, 35 line 8, and inserting: 36 < ___. a. The department may implement cost 37 containment strategies recommended by the governor, and 38 may adopt emergency rules for such implementation. 39 b. The department shall not implement the cost 40 containment strategy to require a primary care referral 41 for the provision of chiropractic services. 42 c. The department may increase the amounts 43 allocated for salaries, support, maintenance, and 44 miscellaneous purposes associated with the medical 45 assistance program, as necessary, to implement the cost 46 containment strategies. The department shall report 47 any such increase to the legislative services agency 48 and the department of management. 49 d. If the savings to the medical assistance 50 -4- HF649.2839 (1) 84 pf/jp 4/ 52 #32. #33. #34. #35. #36. #37. #38.
program exceed the cost, the department may transfer 1 any savings generated for the fiscal year due to 2 medical assistance program cost containment efforts 3 initiated pursuant to 2010 Iowa Acts, chapter 1031, 4 Executive Order No. 20, issued December 16, 2009, or 5 cost containment strategies initiated pursuant to 6 this subsection, to the appropriation made in this 7 division of this Act for medical contracts or general 8 administration to defray the increased contract costs 9 associated with implementing such efforts. 10 e. The department shall report the implementation 11 of any cost containment strategies under this 12 subsection to the individuals specified in this 13 division of this Act for submission of reports on a 14 quarterly basis. > 15 39. Page 29, after line 12 by inserting: 16 < ___. Of the funds appropriated in this section, 17 $6,100,000 shall be used to reduce the waiting lists 18 of the medical assistance home and community-based 19 services waivers, including the waiver for persons with 20 intellectual disabilities for which the nonfederal 21 share is paid as state case services and other support 22 pursuant to section 331.440. The department shall 23 distribute the funding allocated under this subsection 24 proportionately among all home and community-based 25 services waivers. 26 ___. a. The department may submit medical 27 assistance program state plan amendments to the centers 28 for Medicare and Medicaid services of the United 29 States department of health and human services, and may 30 adopt administrative rules pursuant to chapter 17A to 31 implement any of the following if the respective state 32 plan amendment is approved: 33 (1) Health homes pursuant to section 2703 of the 34 federal Patient Protection and Affordable Care Act, 35 Pub. L. No. 111-148. The department shall collaborate 36 with the medical home system advisory council created 37 pursuant to section 135.159 in developing such health 38 homes. 39 (2) Accountable care organization pilot programs, 40 if such programs are advantageous to the medical 41 assistance program. 42 b. Any health home or accountable care organization 43 pilot program implemented pursuant to this subsection 44 shall demonstrate value to the state with a 45 positive return on investment within two years of 46 implementation, and may utilize care coordination fees, 47 pay-for-performance fees, or shared saving strategies 48 if approved as part of the state plan amendment. > 49 40. Page 29, line 19, by striking < 5,773,844 > and 50 -5- HF649.2839 (1) 84 pf/jp 5/ 52 #39.
inserting < 9,893,844 > 1 41. Page 29, line 20, before < The > by inserting 2 < 1. > 3 42. Page 29, after line 24 by inserting: 4 < 2. Of the funds appropriated in this section, 5 $150,000 shall be used for implementation of a 6 uniform cost report to be used in the development 7 of specified Medicaid reimbursement rates over a 8 multiyear timeframe. The department of human services, 9 in collaboration with affected providers, shall 10 finalize a uniform cost report that includes provider 11 type-specific cost schedules by December 15, 2011. 12 The uniform cost report shall be applied to providers 13 of home and community-based services waiver services, 14 habilitation services, case management services 15 and community mental health centers, residential 16 care facilities, psychiatric medical institutions 17 for children, and intermediate care facilities 18 for the mentally retarded in the development of 19 Medicaid reimbursement rates. The department shall 20 collaborate with affected Medicaid providers to test 21 the effectiveness of the cost report and determine 22 the fiscal impact of implementing the uniform cost 23 report during the fiscal year beginning July 1, 2012. 24 A report of the findings and fiscal impact shall be 25 submitted to the governor and the general assembly by 26 December 31, 2013. The rates paid in the fiscal year 27 beginning July 1, 2014, shall be established using 28 uniform cost reports submitted in the fiscal year 29 beginning July 1, 2012. Implementation of the uniform 30 cost report shall be limited to the extent of the 31 funding available. 32 3. a. Of the funds appropriated in this section, 33 $100,000 shall be used for implementation of an 34 electronic medical record system, including system 35 purchase or development, for home and community-based 36 services providers and mental health services providers 37 that comply with the requirements of federal and state 38 laws and regulation by the fiscal year beginning July 39 1, 2013. 40 b. The department shall analyze the costs and 41 benefits of providing an electronic medical record and 42 billing system for home and community-based services 43 providers and mental health services providers that 44 comply with the requirements of federal and state laws 45 and regulation. The analysis shall include a review 46 of all of the following: including the capability for 47 an electronic medical record and billing system within 48 the procurement for the Medicaid management information 49 system, developing the system, and utilizing capacity 50 -6- HF649.2839 (1) 84 pf/jp 6/ 52 #41. #42.
within the health information network established by 1 the department of public health as enacted in this 2 Act. If the analysis demonstrates that a program 3 may be implemented in a cost-effective manner and 4 within available funds, the department may take steps 5 to implement such a system. The department shall 6 report the results of the analysis, activities, and 7 recommendations to the persons designated in this 8 division of this Act for submission of reports by 9 December 15, 2011. 10 c. Notwithstanding section 8.33, funds allocated in 11 this subsection that remain unencumbered or unobligated 12 at the close of the fiscal year shall not revert but 13 shall remain available in succeeding fiscal years to be 14 used for the purposes designated. 15 4. Of the amount appropriated in this section, 16 $3,500,000 shall be used for technology upgrades 17 necessary to support Medicaid claims and other health 18 operations, worldwide federal Health Insurance 19 Portability and Accountability Act of 1996 (HIPAA) 20 claims, transactions, and coding requirements, and 21 the Iowa automated benefits calculation system. 22 Notwithstanding section 8.33, funds allocated in this 23 subsection that remain unencumbered or unobligated at 24 the close of the fiscal year shall not revert but shall 25 remain available in succeeding fiscal years to be used 26 for the purposes designated. 27 5. Of the funds appropriated in this section, 28 $100,000 shall be used for an accountable care 29 organization pilot project as specified in the division 30 of this Act relating to prior appropriations and 31 related changes. 32 6. Of the funds appropriated in this section, 33 $200,000 shall be used for the development of a 34 provider payment system plan to provide recommendations 35 to reform the health care provider payment system as an 36 effective way to promote coordination of care, lower 37 costs, and improve quality as specified in the division 38 of this Act relating to cost containment. 39 7. Of the funds appropriated in this section, 40 $20,000 shall be used for the development of a plan 41 to establish an all-payer claims database to provide 42 for the collection and analysis of claims data from 43 multiple payers of health care as specified in the 44 division of this Act relating to cost containment. 45 8. The department shall amend the state Medicaid 46 health information technology plan to include costs 47 related to the one-time development costs of the health 48 information network as enacted in this Act. 49 9. Of the amount appropriated in this section, up 50 -7- HF649.2839 (1) 84 pf/jp 7/ 52
to $250,000 may be transferred to the appropriation for 1 general administration in this division of this Act to 2 be used for additional full-time equivalent positions 3 in the development of key health initiatives such as 4 cost containment, development and oversight of managed 5 care programs, and development of health strategies 6 targeted toward improved quality and reduced costs in 7 the Medicaid program. 8 10. Of the funds appropriated in this section, 9 $50,000 shall be used for home and community-based 10 services waiver quality assurance programs, including 11 the review and streamlining of processes and policies 12 related to oversight and quality management to meet 13 state and federal requirements. The department shall 14 submit a report to the persons designated by this 15 division of this Act for submission of reports by 16 December 15, 2011, regarding the modifications to the 17 quality assurance programs. > 18 43. Page 30, line 22, by striking < There > and 19 inserting < 1. There > 20 44. Page 30, line 32, by striking < 32,927,152 > and 21 inserting < 33,056,102 > 22 45. Page 30, after line 32 by inserting: 23 < 2. Of the funds appropriated in this section, 24 $128,950 is allocated for continuation of the contract 25 for advertising and outreach with the department of 26 public health. > 27 46. Page 31, line 4, by striking < 51,237,662 > and 28 inserting < 55,265,509 > 29 47. Page 31, line 5, by striking < 49,868,235 > and 30 inserting < 51,896,082 > 31 48. Page 31, by striking lines 25 through 30 and 32 inserting < system in accordance with section 237A.30. > 33 49. Page 33, after line 32 by inserting: 34 < 4. For the fiscal year beginning July 1, 2011, 35 notwithstanding section 232.52, subsection 2, and 36 section 907.3A, subsection 1, the court shall not order 37 the placement of a child at the Iowa juvenile home 38 or the state training school under section 232.52, if 39 that placement is not in accordance with the population 40 guidelines for the respective juvenile institution 41 established pursuant to section 233A.1 or 233B.1. > 42 50. Page 34, line 5, by striking < 82,020,163 > and 43 inserting < 83,420,163 > 44 51. Page 35, line 29, by striking < 7,170,116 > and 45 inserting < 7,670,116 > 46 52. Page 37, line 32, by striking < 4,522,602 > and 47 inserting < 6,022,602 > 48 53. Page 39, after line 35 by inserting: 49 < ___. Of the funds appropriated in this section, 50 -8- HF649.2839 (1) 84 pf/jp 8/ 52 #43. #44. #45. #46. #47. #48. #49. #50. #51. #52. #53.
$300,000 shall be used for continuation of the central 1 Iowa system of care program grant through June 30, 2 2012. > 3 54. Page 40, line 8, by striking < 34,897,591 > and 4 inserting < 34,466,591 > 5 55. Page 41, line 8, by striking < department of 6 human services > and inserting < division of criminal and 7 juvenile justice planning of the department of human 8 rights > 9 56. Page 41, by striking lines 14 and 15 and 10 inserting < submission of reports and to the department 11 of human services by > 12 57. Page 47, after line 35 by inserting: 13 < Notwithstanding section 8.33, moneys appropriated 14 in this section that remain unencumbered or unobligated 15 at the close of the fiscal year shall not revert but 16 shall remain available for expenditure for the purposes 17 designated until the close of the succeeding fiscal 18 year. > 19 58. Page 48, line 10, by striking < 285.00 > and 20 inserting < 290.00 > 21 59. Page 48, by striking lines 17 through 25 and 22 inserting: 23 < 3. Of the funds appropriated in this section, 24 $132,300 shall be used to contract with a statewide 25 association representing community providers of mental 26 health, mental retardation and brain injury services 27 programs to provide technical assistance, support, and 28 consultation to providers of habilitation services and 29 home and community-based waiver services for adults 30 with disabilities under the medical assistance program. 31 Notwithstanding section 8.47 or any other provision of 32 law to the contrary, the department may utilize a sole 33 source approach to contract with the association. 34 4. Of the funds appropriated in this section, 35 $176,400 shall be used to contract with an appropriate 36 entity to expand the provision of nationally accredited 37 and recognized internet-based training to include 38 mental health and disability services providers. 39 Notwithstanding section 8.47 or any other provision of 40 law to the contrary, the department may utilize a sole 41 site source approach to enter into such contract. > 42 60. Page 48, before line 30 by inserting: 43 < ___. Notwithstanding section 8.33, moneys 44 appropriated in this section that remain unencumbered 45 or unobligated at the close of the fiscal year shall 46 not revert but shall remain available for expenditure 47 for the purposes designated until the close of the 48 succeeding fiscal year. > 49 61. Page 49, line 7, by striking < 225,502,551 > and 50 -9- HF649.2839 (1) 84 pf/jp 9/ 52 #54. #55. #56. #57. #58. #59. #60.
inserting < 235,493,065 > 1 62. Page 50, line 6, after < lower. > by inserting 2 < The reimbursement specified under this paragraph shall 3 be adjusted in accordance with chapter 249N, as enacted 4 in this Act. > 5 63. Page 50, line 19, after < 2011 > by inserting 6 < , except that the portion of the fund attributable 7 to graduate medical education shall be reduced in 8 an amount that reflects the elimination of graduate 9 medical education payments made to out-of-state 10 hospitals. > 11 64. Page 51, line 10, by striking < For > and 12 inserting < (1) For > 13 65. Page 51, by striking lines 14 through 16 and 14 inserting: < medical assistance. 15 (2) For nonstate-owned psychiatric medical 16 institutions for children, reimbursement rates shall 17 remain at the rates in effect on June 30, 2011, except 18 that the reimbursement rates shall be adjusted to 19 include all ancillary costs and any other changes 20 required for federal compliance. To the extent 21 possible, such adjustments shall be budget neutral 22 to the institutions. The nonstate-owned psychiatric 23 medical institutions for children shall contract with 24 other health care providers as necessary to ensure 25 that prescription drug and other ancillary medical 26 services are provided to a child while residing 27 in the institution. The department shall commence 28 implementation activities for this subparagraph on 29 the effective date of this subparagraph in order to 30 facilitate implementation beginning July 1, 2011. > 31 66. Page 56, line 32, by striking < The > and 32 inserting < 1. The > 33 67. Page 57, after line 1 by inserting: 34 < 2. The provision under the section of the division 35 of this Act providing for reimbursement of medical 36 assistance, state supplementary assistance, and social 37 service providers by the department of human services 38 relating to reimbursement of nonstate-owned psychiatric 39 medical institutions for children. > 40 68. Page 57, line 4, after < ACCOUNT, > by inserting 41 < NONPARTICIPATING PROVIDER REIMBURSEMENT FUND, > 42 69. Page 57, by striking line 7 and inserting: 43 < HOSPITAL HEALTH CARE ACCESS TRUST FUND, AND PHARMACY 44 ASSESSMENT TRUST FUND > 45 70. By striking page 57, line 35, through page 46 58, line 7, and inserting < necessary abortions. For 47 the purpose of this subsection, an abortion is the 48 purposeful interruption of pregnancy with the intention 49 other than to produce a live-born infant or to remove a 50 -10- HF649.2839 (1) 84 pf/jp 10/ 52 #62. #63. #64. #65. #66. #67. #68. #69.
dead fetus, and a medically necessary abortion is one 1 performed under one of the following conditions: 2 (1) The attending physician certifies that 3 continuing the pregnancy would endanger the life of the 4 pregnant woman. 5 (2) The attending physician certifies that the 6 fetus is physically deformed, mentally deficient, or 7 afflicted with a congenital illness. 8 (3) The pregnancy is the result of a rape which 9 is reported within 45 days of the incident to a law 10 enforcement agency or public or private health agency 11 which may include a family physician. 12 (4) The pregnancy is the result of incest which 13 is reported within 150 days of the incident to a law 14 enforcement agency or public or private health agency 15 which may include a family physician. 16 (5) The abortion is a spontaneous abortion, 17 commonly known as a miscarriage, wherein not all of the 18 products of conception are expelled. > 19 71. Page 58, line 27, by striking < 54,226,279 > and 20 inserting < 44,226,279 > 21 72. Page 59, line 8, by striking < 14,000,000 > and 22 inserting < 16,277,753 > 23 73. Page 59, line 26, by striking < 51,500,000 > and 24 inserting < 65,000,000 > 25 74. Page 59, line 32, by striking < 48,500,000 > and 26 inserting < 60,000,000 > 27 75. Page 59, line 35, by striking < 48,500,00 > and 28 inserting < 60,000,000 > 29 76. Page 60, line 1, by striking < 48,500,000 > and 30 inserting < 60,000,000 > 31 77. Page 60, line 5, by striking < 48,500,000 > and 32 inserting < 60,000,000 > 33 78. Page 60, line 7, after < allocated. > by 34 inserting < Pursuant to paragraph “b”, of the amount 35 appropriated in this subsection, not more than 36 $4,000,000 shall be distributed for prescription drugs 37 and podiatry services. > 38 79. Page 60, after line 7 by inserting: 39 < b. Notwithstanding any provision of law to the 40 contrary, the hospital identified in this subsection, 41 shall be reimbursed for outpatient prescription drugs 42 and podiatry services provided to members of the 43 expansion population pursuant to all applicable medical 44 assistance program rules, in an amount not to exceed 45 $4,000,000. > 46 80. Page 60, line 8, by striking < b. > and inserting 47 < c. > 48 81. Page 60, line 9, by striking < 6 > and inserting 49 < 4 > 50 -11- HF649.2839 (1) 84 pf/jp 11/ 52 #71. #72. #73. #74. #75. #76. #77. #78. #79. #80.
82. Page 60, line 26, after < subsection. > by 1 inserting < Of the collections in excess of the 2 $19,000,000 received by the acute care teaching 3 hospital under this subparagraph (1), $2,000,000 shall 4 be distributed by the acute care teaching hospital to 5 the treasurer of state for deposit in the IowaCare 6 account in the month of January 2012, following the 7 July 1 through December 31, 2011, period. > 8 83. Page 60, line 35, after < subsection. > by 9 inserting < Of the collections in excess of the 10 $19,000,000 received by the acute care teaching 11 hospital under this subparagraph (2), $2,000,000 shall 12 be distributed by the acute care teaching hospital to 13 the treasurer of state for deposit in the IowaCare 14 account in the month of July 2012, following the 15 January 1 through June 30, 2012, period. > 16 84. Page 61, line 10, by striking < 6,000,000 > and 17 inserting < 3,472,176 > 18 85. Page 61, line 11, by striking < Notwithstanding > 19 and inserting < a. Notwithstanding > 20 86. Page 61, after line 17 by inserting: 21 < b. The department shall consult with providers 22 of primary care services in established regional 23 provider network areas to determine if the option 24 of establishing an alternative provider location is 25 feasible. The department may implement a pilot program 26 establishing an alternative provider location in an 27 established regional provider network area experiencing 28 capacity issues, if the department determines that this 29 option would most appropriately address such capacity 30 issues and provide better access to care for expansion 31 population members in the area. Any such pilot 32 program shall be implemented within funds available 33 under the existing appropriation and any alternative 34 provider location shall be subject to the requirements 35 applicable to an expansion population provider pursuant 36 to chapter 249J. > 37 87. Page 61, by striking lines 18 through 25 and 38 inserting: 39 < 6. There is appropriated from the IowaCare account 40 created in section 249J.24 to the department of human 41 services for the fiscal year beginning July 1, 2011, 42 and ending June 30, 2012, the following amount, or 43 so much thereof as is necessary to be used for the 44 purposes designated: 45 For a care coordination pool to pay the expansion 46 population providers consisting of the university of 47 Iowa hospitals and clinics, the publicly owned acute 48 care teaching hospital as specified in section 249J.7, 49 and nonparticipating providers as specified in section 50 -12- HF649.2839 (1) 84 pf/jp 12/ 52 #82. #83. #84. #85. #86. #87.
249J.24A that are current medical assistance program 1 providers, for services covered by the full benefit 2 medical assistance program but not under the IowaCare 3 program pursuant to section 249J.6, that are provided 4 to expansion population members: 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,500,000 6 a. Notwithstanding section 249J.6, the amount 7 appropriated in this subsection is intended to provide 8 payment for medically necessary services provided 9 to expansion population members for continuation of 10 care provided by the university of Iowa hospitals and 11 clinics or the publicly owned acute care teaching 12 hospital as specified in section 249J.7. Payment 13 may only be made for services that are not otherwise 14 covered under section 249J.6, and which are follow-up 15 services to covered services provided by the hospitals 16 specified in this paragraph “a”. 17 b. The funds appropriated in this subsection are 18 intended to provide limited payment for continuity 19 of care services for an expansion population member, 20 and are intended to cover the costs of services 21 to expansion population members, regardless of 22 the member’s county of residence or medical home 23 assignment, if the care is related to specialty or 24 hospital services provided by the hospitals specified 25 in paragraph “a”. 26 c. The funds appropriated in this subsection are 27 not intended to provide for expanded coverage under 28 the IowaCare program, and shall not be used to cover 29 emergency transportation services. 30 d. The department shall adopt administrative 31 rules pursuant to chapter 17A to establish a prior 32 authorization process and to identify covered services 33 for reimbursement under this subsection. If the entire 34 amount appropriated under this subsection is expended, 35 the responsibility for coordinating noncovered care 36 needs of expansion population members shall revert to 37 the medical home to which the expansion population 38 member is assigned. 39 7. There is appropriated from the IowaCare account 40 created in section 249J.24 to the department of human 41 services for the fiscal year beginning July 1, 2011, 42 and ending June 30, 2012, the following amount or 43 so much thereof as is necessary to be used for the 44 purposes designated: 45 For a laboratory test and radiology pool for 46 services authorized by a federally qualified health 47 center designated by the department as part of the 48 IowaCare regional provider network that does not have 49 the capability to provide these services on site: 50 -13- HF649.2839 (1) 84 pf/jp 13/ 52
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 500,000 1 Notwithstanding sections 249J.6 and 249J.7, the 2 amount appropriated in this subsection is intended 3 to provide reimbursement for services provided to 4 expansion population members that have previously 5 been paid for through expenditure by designated 6 regional provider network providers of their own 7 funds, not to expand coverage under the IowaCare 8 program or to expand the expansion population 9 provider network. The department shall designate the 10 laboratory and radiology provider associated with 11 each designated regional provider network provider 12 that may receive reimbursement. The department shall 13 adopt administrative rules pursuant to chapter 17A 14 to establish a prior authorization process and to 15 identify covered services for reimbursement under this 16 subsection. All other medical assistance program 17 payment policies and rules for laboratory and radiology 18 services shall apply to services provided under this 19 subsection. If the entire amount appropriated under 20 this subsection is expended, laboratory tests and 21 radiology services ordered by a designated regional 22 provider network provider shall be the financial 23 responsibility of the regional provider network 24 provider. Any funds remaining at the end of the 25 fiscal year shall be used to pay any unpaid claims by 26 university of Iowa physicians, nurse practitioners, and 27 physician assistants. > 28 88. Page 61, before line 26 by inserting: 29 < Sec. ___. APPROPRIATIONS FROM NONPARTICIPATING 30 PROVIDER REIMBURSEMENT FUND —— DEPARTMENT OF HUMAN 31 SERVICES. Notwithstanding any provision to the 32 contrary, and subject to the availability of funds, 33 there is appropriated from the nonparticipating 34 provider reimbursement fund created in section 249J.24A 35 to the department of human services for the fiscal year 36 beginning July 1, 2011, and ending June 30, 2012, the 37 following amount or so much thereof as is necessary for 38 the purposes designated: 39 To reimburse nonparticipating providers in 40 accordance with section 249J.24A: 41 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2,000,000 > 42 89. By striking page 61, line 34, through page 62, 43 line 1. 44 90. Page 62, by striking lines 33 through 35 and 45 inserting: 46 < 10. For transfer to the department of public 47 health to be used for the costs of medical home 48 system advisory council established pursuant to 49 section 135.159, including for the incorporation of 50 -14- HF649.2839 (1) 84 pf/jp 14/ 52 #88. #89. #90.
the work and duties of the prevention and chronic 1 care management advisory council pursuant to section 2 135.161, as amended by this Act: 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 233,357 > 4 91. Page 64, line 3, by striking < To > and inserting 5 < 1. To > 6 92. Page 64, line 6, by striking < 29,000,000 > and 7 inserting < 60,496,712 > 8 93. Page 64, after line 6 by inserting: 9 < 2. To increase the monthly upper cost limit 10 for services under the medical assistance home and 11 community-based services waiver for the elderly: 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,000,000 > 13 94. Page 64, after line 22 by inserting: 14 < Sec. ___. PHARMACY ASSESSMENT TRUST FUND —— 15 DEPARTMENT OF HUMAN SERVICES. Notwithstanding 16 any provision to the contrary and subject to the 17 availability of funds, there is appropriated from the 18 pharmacy assessment trust fund created in section 19 249N.4, as enacted in this Act, to the department of 20 human services for the fiscal year beginning July 1, 21 2011, and ending June 30, 2012, the following amounts, 22 or so much thereof as is necessary, for the purposes 23 designated: 24 To supplement the appropriation made in this Act 25 from the general fund of the state to the department of 26 human services for medical assistance: 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 17,377,252 > 28 95. Page 65, after line 2 by inserting: 29 < Sec. ___. CONTINUATION OF WORKGROUP BY JUDICIAL 30 BRANCH AND DEPARTMENT OF HUMAN SERVICES. The judicial 31 branch and department of human services shall continue 32 the workgroup implemented pursuant to 2010 Iowa Acts, 33 chapter 1192, section 24, subsection 2, to improve 34 the processes for involuntary commitment for chronic 35 substance abuse under chapter 125 and serious mental 36 illness under chapter 229. The recommendations issued 37 by the workgroup shall address alternatives and options 38 to the current provision of transportation by the 39 county sheriff; to the role, supervision, and funding 40 of mental health patient advocates; and for civil 41 commitment prescreening. Additional stakeholders 42 shall be added as necessary to facilitate the workgroup 43 efforts. The workgroup shall complete deliberations 44 and submit a final report providing findings and 45 recommendations on or before December 15, 2011. > 46 96. By striking page 70, line 22, through page 72, 47 line 17. 48 97. Page 72, line 33, after < Grenada, > by inserting 49 < Lebanon, > 50 -15- HF649.2839 (1) 84 pf/jp 15/ 52 #91. #92. #93. #94. #95. #96.
98. Page 73, line 28, after < 72, > by inserting 1 < shall not revert but shall remain available in 2 succeeding fiscal years to be used for the purposes 3 designated until expended and any other > 4 99. Page 74, by striking lines 19 through 27 and 5 inserting: 6 < Sec. ___. 2009 Iowa Acts, chapter 183, section 62, 7 subsection 4, is amended to read as follows: 8 4. The financial assistance shall be for any of the 9 following purposes: 10 a. For making temporary payments to qualifying 11 families whose members are recently unemployed and 12 seeking work to use in meeting immediate family needs. 13 b. For providing sliding scale subsidies for 14 qualifying families for child care provided to the 15 families’ infants and toddlers by providers who 16 are accredited by the national association for the 17 education of young children or the national association 18 for family child care, or who have a rating at level 3 19 2 or higher under the child care quality rating system 20 implemented pursuant to section 237A.30. 21 c. For expanding training and other support for 22 infant care providers in the community and this state. 23 d. For ensuring child care environments are healthy 24 and safe. 25 e. For promoting positive relationships between 26 parents and providers in their mutual efforts to care 27 for very young children. 28 f. For ensuring that parents have the information 29 and resources needed to choose quality child care. > 30 100. By striking page 74, line 28, through page 75, 31 line 7. 32 101. Page 76, after line 31 by inserting: 33 < CHILD WELFARE TRAINING ACADEMY 34 Sec. ___. 2010 Iowa Acts, chapter 1192, section 19, 35 subsection 22, is amended to read as follows: 36 22. Of the funds appropriated in this section, 37 at least $47,158 shall be used for the child welfare 38 training academy. Notwithstanding section 8.33, moneys 39 allocated in this subsection that remain unencumbered 40 or unobligated at the close of the fiscal year shall 41 not revert but shall remain available for expenditure 42 for the purposes designated until the close of the 43 succeeding fiscal year. > 44 102. Page 76, line 32, after < TRANSFER > by 45 inserting < AND NONREVERSION > 46 103. Page 76, line 34, by striking < subsection > and 47 inserting < subsections > 48 104. Page 77, after line 4 by inserting: 49 < NEW SUBSECTION . 5. Notwithstanding section 50 -16- HF649.2839 (1) 84 pf/jp 16/ 52 #98. #99. #100. #101. #102. #103. #104.
8.33, moneys appropriated in this section that remain 1 unencumbered or unobligated at the close of the fiscal 2 year shall not revert but shall remain available for 3 expenditure for the purposes designated until the close 4 of the succeeding fiscal year. > 5 105. Page 77, after line 4 by inserting: 6 < DEPARTMENT OF HUMAN SERVICES —— FIELD OPERATIONS 7 Sec. ___. 2010 Iowa Acts, chapter 1192, section 8 29, is amended by adding the following new unnumbered 9 paragraph: 10 NEW UNNUMBERED PARAGRAPH . Notwithstanding section 11 8.33, moneys appropriated in this section that remain 12 unencumbered or unobligated at the close of the fiscal 13 year shall not revert but shall remain available for 14 expenditure for the purposes designated until the close 15 of the succeeding fiscal year. 16 DEPARTMENT OF HUMAN SERVICES —— GENERAL ADMINISTRATION 17 Sec. ___. 2010 Iowa Acts, chapter 1192, section 30, 18 is amended by adding the following new subsection: 19 NEW SUBSECTION . 5. Notwithstanding section 8.33, 20 moneys appropriated in this section and the designated 21 allocations that remain unencumbered or unobligated 22 at the close of the fiscal year shall not revert but 23 shall remain available for expenditure for the purposes 24 designated until the close of the succeeding fiscal 25 year. > 26 106. Page 77, before line 30 by inserting: 27 < QUALITY ASSURANCE TRUST FUND —— DEPARTMENT OF HUMAN 28 SERVICES > 29 107. Page 79, after line 3 by inserting: 30 < STATE INSTITUTION —— APPROPRIATION TRANSFERS 31 Sec. ___. DEPARTMENT OF HUMAN SERVICES. There 32 is transferred between the following designated 33 appropriations made to the department of human services 34 for the fiscal year beginning July 1, 2010, and ending 35 June 30, 2011, not more than the following amounts: 36 1. From the appropriation made for purposes of the 37 state resource center at Glenwood in 2010 Iowa Acts, 38 chapter 1192, section 25, subsection 1, paragraph “a”, 39 to the appropriation made for purposes of the Iowa 40 juvenile home at Toledo in 2010 Iowa Acts, chapter 41 1192, section 17, subsection 1: 42 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 400,000 43 2. From the appropriation made for purposes of the 44 state resource center at Woodward in 2010 Iowa Acts, 45 chapter 1192, section 25, subsection 1, paragraph “b”, 46 to the appropriation made for purposes of the state 47 mental health institute at Independence in 2010 Iowa 48 Acts, chapter 1192, section 24, subsection 1, paragraph 49 “c”: 50 -17- HF649.2839 (1) 84 pf/jp 17/ 52 #105. #106. #107.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 400,000 > 1 108. Page 79, by striking lines 4 through 14. 2 109. Page 81, after line 2 by inserting: 3 < Sec. ___. RETROACTIVE APPLICABILITY. The section 4 of this division of this Act making transfers between 5 appropriations made to the department of human services 6 for state institutions in 2010 Iowa Acts, chapter 1192, 7 applies retroactively to January 1, 2011. > 8 110. Page 82, after line 3 by inserting: 9 < Sec. ___. Section 29C.20B, Code 2011, is amended 10 to read as follows: 11 29C.20B Disaster case management. 12 1. The rebuild Iowa office homeland security 13 and emergency management division shall work with 14 the department of human services and nonprofit, 15 voluntary, and faith-based organizations active 16 in disaster recovery and response in coordination 17 with the homeland security and emergency management 18 division the department of human services to establish 19 a statewide system of disaster case management to be 20 activated following the governor’s proclamation of 21 a disaster emergency or the declaration of a major 22 disaster by the president of the United States for 23 individual assistance purposes. Under the system, the 24 department of human services homeland security and 25 emergency management division shall coordinate case 26 management services locally through local committees 27 as established in each local emergency management 28 commission’s emergency plan. Beginning July 1, 29 2011, the department of human services shall assume 30 the duties of the rebuild Iowa office under this 31 subsection . 32 2. The department of human services homeland 33 security and emergency management division , in 34 conjunction with the rebuild Iowa office, the homeland 35 security and emergency management division department 36 of human services , and an Iowa representative to 37 the national voluntary organizations active in 38 disaster, shall adopt rules pursuant to chapter 17A to 39 create coordination mechanisms and standards for the 40 establishment and implementation of a statewide system 41 of disaster case management which shall include at 42 least all of the following: 43 a. Disaster case management standards. 44 b. Disaster case management policies. 45 c. Reporting requirements. 46 d. Eligibility criteria. 47 e. Coordination mechanisms necessary to carry out 48 the services provided. 49 f. Develop formal working relationships with 50 -18- HF649.2839 (1) 84 pf/jp 18/ 52 #108. #109. #110.
agencies and create interagency agreements for 1 those considered to provide disaster case management 2 services. 3 g. Coordination of all available services for 4 individuals from multiple agencies. > 5 111. Page 82, after line 3 by inserting: 6 < Sec. ___. Section 135.106, Code 2011, is amended 7 by adding the following new subsection: 8 NEW SUBSECTION . 4. It is the intent of the general 9 assembly that priority for home visitation funding be 10 given to approaches using evidence-based or promising 11 models for home visitation. > 12 112. Page 82, after line 3 by inserting: 13 < Sec. ___. Section 135H.6, subsection 8, Code 2011, 14 is amended to read as follows: 15 8. The department of human services may give 16 approval to conversion of beds approved under 17 subsection 6 , to beds which are specialized to provide 18 substance abuse treatment. However, the total number 19 of beds approved under subsection 6 and this subsection 20 shall not exceed four hundred thirty. Conversion of 21 beds under this subsection shall not require a revision 22 of the certificate of need issued for the psychiatric 23 institution making the conversion. Beds for children 24 who do not reside in this state and whose service costs 25 are not paid by public funds in this state are not 26 subject to the limitations on the number of beds and 27 certificate of need requirements otherwise applicable 28 under this section. > 29 113. Page 82, after line 31 by inserting: 30 < Sec. ___. Section 154A.24, subsection 3, paragraph 31 s, Code 2011, is amended by striking the paragraph. > 32 114. Page 82, after line 31 by inserting: 33 < Sec. ___. NEW SECTION . 155A.43 Pharmaceutical 34 collection and disposal program —— annual allocation. 35 Of the fees collected pursuant to sections 124.301 36 and 147.80 and chapter 155A by the board of pharmacy, 37 and retained by the board pursuant to section 147.82, 38 not more than one hundred twenty-five thousand 39 dollars, may be allocated annually by the board for 40 administering the pharmaceutical collection and 41 disposal program originally established pursuant to 42 2009 Iowa Acts, chapter 175, section 9. The program 43 shall provide for the management and disposal of 44 unused, excess, and expired pharmaceuticals. The 45 board of pharmacy may cooperate with the Iowa pharmacy 46 association and may consult with the department and 47 sanitary landfill operators in administering the 48 program. > 49 115. Page 83, after line 9 by inserting: 50 -19- HF649.2839 (1) 84 pf/jp 19/ 52 #111. #112. #113. #114. #115.
< Sec. ___. Section 235B.19, Code 2011, is amended 1 by adding the following new subsection: 2 NEW SUBSECTION . 2A. a. The department shall 3 serve a copy of the petition and any order authorizing 4 protective services, if issued, on the dependent adult 5 and on persons who are competent adults and reasonably 6 ascertainable at the time the petition is filed in 7 accordance with the following priority: 8 (1) An attorney in fact named by the dependent 9 adult in a durable power of attorney for health care 10 pursuant to chapter 144B. 11 (2) The dependent adult’s spouse. 12 (3) The dependent adult’s children. 13 (4) The dependent adult’s grandchildren. 14 (5) The dependent adult’s siblings. 15 (6) The dependent adult’s aunts and uncles. 16 (7) The dependent adult’s nieces and nephews. 17 (8) The dependent adult’s cousins. 18 b. When the department has served a person in one 19 of the categories specified in paragraph “a” , the 20 department shall not be required to serve a person in 21 any other category. 22 c. The department shall serve the dependent adult’s 23 copy of the petition and order personally upon the 24 dependent adult. Service of the petition and all other 25 orders and notices shall be in a sealed envelope with 26 the proper postage on the envelope, addressed to the 27 person being served at the person’s last known post 28 office address, and deposited in a mail receptacle 29 provided by the United States postal service. The 30 department shall serve such copies of emergency orders 31 authorizing protective services and notices within 32 three days after filing the petition and receiving such 33 orders. 34 d. The department and all persons served by the 35 department with notices under this subsection shall 36 be prohibited from all of the following without prior 37 court approval after the department’s petition has been 38 filed: 39 (1) Selling, removing, or otherwise disposing of 40 the dependent adult’s personal property. 41 (2) Withdrawing funds from any bank, savings and 42 loan association, credit union, or other financial 43 institution, or from an account containing securities 44 in which the dependent adult has an interest. > 45 116. Page 83, after line 9 by inserting: 46 < Sec. ___. Section 237A.1, subsection 3, paragraph 47 n, Code 2011, is amended to read as follows: 48 n. A program offered to a child whose parent, 49 guardian, or custodian is engaged solely in a 50 -20- HF649.2839 (1) 84 pf/jp 20/ 52 #116.
recreational or social activity, remains immediately 1 available and accessible on the physical premises on 2 which the child’s care is provided, and does not engage 3 in employment while the care is provided. However, 4 if the recreational or social activity is provided in 5 a fitness center or on the premises of a nonprofit 6 organization the parent, guardian, or custodian of the 7 child may be employed to teach or lead the activity. > 8 117. Page 83, after line 9 by inserting: 9 < Sec. ___. Section 249A.4B, subsection 2, paragraph 10 a, subparagraph (18), Code 2011, is amended to read as 11 follows: 12 (18) The Iowa/Nebraska Iowa primary care 13 association. > 14 118. Page 83, by striking lines 10 through 19. 15 119. Page 83, after line 21 by inserting: 16 < DIVISION ___ 17 IOWA FALSE CLAIMS ACT 18 Sec. ___. Section 685.1, subsection 11, Code 2011, 19 is amended to read as follows: 20 11. “Original source” means an individual who has 21 direct and independent prior to a public disclosure 22 under section 685.3, subsection 5, paragraph “c” , has 23 voluntarily disclosed to the state the information on 24 which the allegations or transactions in a claim are 25 based; or who has knowledge of the information on which 26 the allegations are based that is independent of and 27 materially adds to the publicly disclosed allegations 28 or transactions, and has voluntarily provided the 29 information to the state before filing an action under 30 section 685.3 which is based on the information this 31 chapter . 32 Sec. ___. Section 685.1, Code 2011, is amended by 33 adding the following new subsection: 34 NEW SUBSECTION . 15. “State” means the state of 35 Iowa. 36 Sec. ___. Section 685.2, subsection 1, unnumbered 37 paragraph 1, Code 2011, is amended to read as follows: 38 A person who commits any of the following acts is 39 jointly and severally liable to the state for a civil 40 penalty of not less than five thousand dollars and 41 not more than ten thousand dollars the civil penalty 42 allowed under the federal False Claims Act, as codified 43 in 31 U.S.C. § 3729 et seq., as may be adjusted in 44 accordance with the inflation adjustment procedures 45 prescribed in the federal Civil Penalties Inflation 46 Adjustment Act of 1990, Pub. L. No. 101-410, for each 47 false or fraudulent claim , plus three times the amount 48 of damages which the state sustains because of the act 49 of that person : 50 -21- HF649.2839 (1) 84 pf/jp 21/ 52 #117. #118. #119.
Sec. ___. Section 685.3, subsection 5, paragraph 1 c, Code 2011, is amended by striking the paragraph and 2 inserting in lieu thereof the following: 3 c. A court shall dismiss an action or claim 4 under this section, unless opposed by the state, if 5 substantially the same allegations or transactions as 6 alleged in the action or claim were publicly disclosed 7 in a state criminal, civil, or administrative hearing 8 in which the state or an agent of the state is a 9 party; in a state legislative, state auditor, or other 10 state report, hearing, audit, or investigation; or 11 by the news media, unless the action is brought by 12 the attorney general or the qui tam plaintiff is an 13 original source of the information. 14 Sec. ___. Section 685.3, subsection 6, Code 2011, 15 is amended to read as follows: 16 6. a. Any employee, contractor, or agent who 17 shall be entitled to all relief necessary to make 18 that employee, contractor, or agent whole, if that 19 employee, contractor, or agent is discharged, demoted, 20 suspended, threatened, harassed, or in any other manner 21 discriminated against in the terms and conditions of 22 employment because of lawful acts performed done by 23 the employee, contractor, or agent on behalf of the 24 employee, contractor, or agent or associated others in 25 furtherance of an action under this section or other 26 efforts to stop a violation one or more violations of 27 this chapter , shall be entitled to all relief necessary 28 to make the employee, contractor, or agent whole . Such 29 relief 30 b. Relief under paragraph “a” shall include 31 reinstatement with the same seniority status such 32 that employee, contractor, or agent would have had 33 but for the discrimination, two times the amount of 34 back pay, interest on the back pay, and compensation 35 for any special damages sustained as a result of 36 the discrimination, including litigation costs and 37 reasonable attorney fees. An employee, contractor, or 38 agent may bring an action under this subsection may be 39 brought in the appropriate district court of the state 40 for the relief provided in this subsection . 41 c. A civil action under this subsection shall not 42 be brought more than three years after the date when 43 the retaliation occurred. 44 DIVISION ___ 45 IOWACARE PROGRAM 46 Sec. ___. Section 249J.6, subsection 2, paragraph 47 b, Code 2011, is amended to read as follows: 48 b. Refusal of an expansion population member to 49 participate in a comprehensive medical examination 50 -22- HF649.2839 (1) 84 pf/jp 22/ 52
or any health risk assessment implemented by the 1 department shall not be a basis for ineligibility 2 for or disenrollment from the expansion population. 3 Refusal of an expansion population member to 4 participate in a comprehensive medical examination or 5 other preventative health service shall not negatively 6 affect the calculation of performance payments for an 7 expansion population network provider medical home. 8 Sec. ___. Section 249J.6, subsection 3, Code 2011, 9 is amended to read as follows: 10 3. Expansion population members , including members 11 assigned to an expansion population network provider 12 medical home, shall be provided access to an IowaCare 13 nurse helpline, accessible twenty-four hours per day, 14 seven days per week, to assist expansion population 15 members in making appropriate choices about the use of 16 emergency room and other health care services. 17 Sec. ___. Section 249J.7, subsection 1, paragraph 18 c, Code 2011, is amended to read as follows: 19 c. (1) Tertiary care shall only be provided to 20 eligible expansion population members residing in any 21 county in the state at the university of Iowa hospitals 22 and clinics. 23 (2) Secondary care shall be provided by the 24 publicly owned acute care teaching hospital located 25 in a county with a population over three hundred 26 fifty thousand and the university of Iowa hospitals 27 and clinics, based on county of residence, only to 28 the extent specified in the phase-in of the regional 29 provider network designated by the department. 30 Sec. ___. Section 249J.24A, subsection 1, Code 31 2011, is amended to read as follows: 32 1. A nonparticipating provider may be reimbursed 33 for covered expansion population services provided to 34 an expansion population member by a nonparticipating 35 provider if the nonparticipating provider contacts the 36 appropriate participating provider prior to providing 37 covered services to verify consensus regarding one of 38 the following courses of action if any of the following 39 conditions is met : 40 a. If the nonparticipating provider and the 41 participating provider agree that the medical status 42 of the expansion population member indicates it 43 is medically possible to postpone provision of 44 services, the nonparticipating provider shall direct 45 the expansion population member to the appropriate 46 participating provider for services. 47 b. a. If the nonparticipating provider and the 48 participating provider agree determines that the 49 medical status of the expansion population member 50 -23- HF649.2839 (1) 84 pf/jp 23/ 52
indicates it is not medically possible advisable to 1 postpone provision of services, the nonparticipating 2 provider shall provide medically necessary services. 3 c. b. If the nonparticipating provider and the 4 participating provider agree that transfer of the 5 expansion population member is not possible due to lack 6 of available inpatient capacity, the nonparticipating 7 provider shall provide medically necessary services. 8 d. c. If the medical status of the expansion 9 population member indicates a medical emergency and the 10 nonparticipating provider is not able to contact the 11 appropriate participating provider prior to providing 12 medically necessary services, the nonparticipating 13 provider shall document the medical emergency 14 and inform the appropriate participating provider 15 immediately after the member has been stabilized of any 16 covered services provided. 17 Sec. ___. Section 249J.24A, subsection 2, paragraph 18 a, Code 2011, is amended to read as follows: 19 a. If the nonparticipating provider meets 20 the requirements specified in subsection 1 , the 21 nonparticipating provider shall be reimbursed for 22 covered expansion population services , limited to 23 emergency and other inpatient hospital services 24 provided to the expansion population member up to the 25 point of transfer to another provider, discharge, 26 or transfer to another level of care, through the 27 nonparticipating provider reimbursement fund in 28 accordance with rules adopted by the department of 29 human services. However, any funds received from 30 participating providers, appropriated to participating 31 providers, or deposited in the IowaCare account 32 pursuant to section 249J.24 , shall not be transferred 33 or appropriated to the nonparticipating provider 34 reimbursement fund or otherwise used to reimburse 35 nonparticipating providers. 36 DIVISION ___ 37 VOLUNTEER HEALTH CARE PROVIDER PROGRAM 38 Sec. ___. Section 135.24, subsection 2, paragraphs 39 b and c, Code 2011, are amended to read as follows: 40 b. Procedures for registration of hospitals, free 41 clinics, field dental clinics, and specialty health 42 care provider offices. 43 c. Criteria for and identification of hospitals, 44 clinics, free clinics, field dental clinics, specialty 45 health care provider offices, or other health care 46 facilities, health care referral programs, or 47 charitable organizations, eligible to participate in 48 the provision of free medical, dental, chiropractic, 49 pharmaceutical, nursing, optometric, psychological, 50 -24- HF649.2839 (1) 84 pf/jp 24/ 52
social work, behavioral science, podiatric, physical 1 therapy, occupational therapy, respiratory therapy, or 2 emergency medical care services through the volunteer 3 health care provider program. A hospital, a clinic, a 4 free clinic, a field dental clinic, a specialty health 5 care provider office, a health care facility, a health 6 care referral program, a charitable organization, or 7 a health care provider participating in the program 8 shall not bill or charge a patient for any health care 9 provider service provided under the volunteer health 10 care provider program. 11 Sec. ___. Section 135.24, Code 2011, is amended by 12 adding the following new subsection: 13 NEW SUBSECTION . 6A. A hospital providing free care 14 under this section shall be considered a state agency 15 solely for the purposes of this section and chapter 669 16 and shall be afforded protection under chapter 669 as a 17 state agency for all claims arising from the provision 18 of free care by a health care provider registered under 19 subsection 3 who is providing services at the hospital 20 in accordance with this section, if the hospital has 21 registered with the department pursuant to subsection 22 1. 23 Sec. ___. Section 135.24, subsection 7, Code 2011, 24 is amended by adding the following new paragraph: 25 NEW PARAGRAPH . 0e. “Hospital” means hospital as 26 defined in section 135B.1. 27 DIVISION ___ 28 HEALTH CARE COST CONTAINMENT 29 Sec. ___. ALL-PAYER CLAIMS DATABASE PLAN. The 30 department of human services shall develop a plan to 31 establish an all-payer claims database to provide 32 for the collection and analysis of claims data from 33 multiple payers of health care. The plan shall 34 establish the goals of the database which may include 35 but are not limited to determining health care 36 utilization patterns and rates; identifying gaps in 37 prevention and health promotion services; evaluating 38 access to care; assisting with benefit design and 39 planning; analyzing statewide and local health care 40 expenditures by provider, employer, and geography; 41 informing the development of payment systems for 42 providers; and establishing clinical guidelines related 43 to quality, safety, and continuity of care. The plan 44 shall identify a standard means of data collection, 45 statutory changes necessary to the collection and 46 use of the data, and the types of claims for which 47 collection of data is required which may include 48 but are not limited to eligibility data; provider 49 information; medical data; private and public medical, 50 -25- HF649.2839 (1) 84 pf/jp 25/ 52
pharmacy, and dental claims data; and other appropriate 1 data. The plan shall also include an implementation 2 and maintenance schedule including a proposed budget 3 and funding plan and vision for the future. 4 Sec. ___. PROVIDER PAYMENT SYSTEM PLAN —— PILOT 5 PROJECT. The department of human services shall 6 develop a provider payment system plan to provide 7 recommendations to reform the health care provider 8 payment system as an effective way to promote 9 coordination of care, lower costs, and improve quality. 10 The plan shall provide analysis and recommendations 11 regarding but not limited to accountable care 12 organizations, a global payment system, or an episode 13 of care payment system. 14 Sec. ___. EFFECTIVE UPON ENACTMENT. This division 15 of this Act, being deemed of immediate importance, 16 takes effect upon enactment. > 17 120. Page 83, after line 21 by inserting: 18 < DIVISION ___ 19 NURSING FACILITY QUALITY ASSURANCE ASSESSMENT PROGRAM 20 Sec. ___. Section 249L.2, Code 2011, is amended by 21 adding the following new subsection: 22 NEW SUBSECTION . 8A. “Patient service revenue” means 23 the total Medicaid, Medicare, and private pay revenues 24 as they correlate with the Medicaid cost reports. 25 Sec. ___. Section 249L.3, subsection 1, paragraph 26 d, Code 2011, is amended to read as follows: 27 d. The aggregate quality assurance assessments 28 imposed under this chapter shall not exceed the lower 29 of three five percent of the aggregate non-Medicare 30 patient service revenues of a nursing facility or the 31 maximum amount that may be assessed pursuant to the 32 indirect guarantee threshold as established pursuant to 33 42 C.F.R. § 433.68(f)(3)(i), and shall be stated on a 34 per-patient-day basis. 35 Sec. ___. Section 249L.4, subsection 2, Code 2011, 36 is amended to read as follows: 37 2. a. Moneys in the trust fund shall be used, 38 subject to their appropriation by the general assembly, 39 by the department only for reimbursement of services 40 for which federal financial participation under the 41 medical assistance program is available to match state 42 funds. 43 b. Any moneys appropriated from the trust fund for 44 reimbursement of nursing facilities, in addition to 45 the quality assurance assessment pass-through and the 46 quality assurance assessment rate add-on which shall be 47 used as specified in subsection 5 , paragraph “b” , shall 48 be used in a manner such that no less than thirty-five 49 percent of the amount received by a nursing facility 50 -26- HF649.2839 (1) 84 pf/jp 26/ 52 #120.
is used for increases in compensation and costs 1 of employment for direct care workers, and no less 2 than sixty percent of the total is used to increase 3 compensation and costs of employment for all nursing 4 facility staff. For the purposes of use of such 5 funds, “direct care worker” , “nursing facility staff” , 6 “increases in compensation” , and “costs of employment” 7 mean as defined or specified in this chapter . 8 c. One million dollars of the moneys in the trust 9 fund shall be used to increase the monthly upper cost 10 limit for services under the medical assistance home 11 and community-based services waiver for the elderly. 12 Sec. ___. Section 249L.4, subsection 5, paragraph 13 a, subparagraph (2), Code 2011, is amended to read as 14 follows: 15 (2) A quality assurance assessment rate 16 add-on. This rate add-on shall be calculated on a 17 per-patient-day basis for medically indigent residents. 18 The amount paid to a nursing facility as a quality 19 assurance assessment rate add-on shall be ten not 20 exceed fifteen dollars per patient day. 21 Sec. ___. DIRECTIVE TO DEPARTMENT OF HUMAN 22 SERVICES. Upon enactment of this division of this Act, 23 the department of human services shall request any 24 medical assistance state plan amendment necessary to 25 implement the revisions to the nursing facility quality 26 assurance assessment program specified in this division 27 of this Act from the centers for Medicare and Medicaid 28 services of the United States department of health and 29 human services. 30 Sec. ___. CONTINGENCY PROVISION. The revised 31 quality assurance assessment specified in this Act 32 shall accrue beginning July 1, 2011. However, accrued 33 quality assurance assessments shall not be collected 34 prior to completion of both of the following: 35 1. The approval of the medical assistance state 36 plan amendment necessary to implement the revisions 37 specified in this division of this Act by the centers 38 for Medicare and Medicaid services of the United States 39 department of health and human services. 40 2. An appropriation enacted by the general assembly 41 to implement the revised nursing facility provider 42 reimbursements as provided in this Act. 43 Sec. ___. EFFECTIVE UPON ENACTMENT AND 44 APPLICABILITY. This division of this Act, being deemed 45 of immediate importance, takes effect upon enactment. 46 However, the department of human services shall only 47 implement this division of this Act if the department 48 receives approval of the state plan amendment necessary 49 to implement the revisions to the nursing facility 50 -27- HF649.2839 (1) 84 pf/jp 27/ 52
quality assurance assessment program as specified in 1 this division of this Act. > 2 121. Page 83, after line 21 by inserting: 3 < DIVISION ___ 4 PHARMACY ASSESSMENT 5 Sec. ___. NEW SECTION . 249N.1 Title. 6 This chapter shall be known and may be cited as the 7 “Pharmacy Assessment Program” . 8 Sec. ___. NEW SECTION . 249N.2 Definitions. 9 As used in this chapter, unless the context 10 otherwise requires: 11 1. “Department” means the department of human 12 services. 13 2. “Pharmacy” means pharmacy as defined in section 14 155A.3. 15 Sec. ___. NEW SECTION . 249N.3 Pharmacy assessment 16 program. 17 1. Beginning July 1, 2011, or the implementation 18 date of the pharmacy assessment program as determined 19 by receipt of approval from the centers for Medicare 20 and Medicaid services of the United States department 21 of health and human services, whichever is later, a 22 pharmacy in this state shall be assessed a fee based 23 on a methodology determined by the department in 24 consultation with pharmacy representatives. Pharmacies 25 domiciled or headquartered outside the state that are 26 engaged in prescription drug sales that are delivered 27 directly to patients within the state via common 28 carrier, mail, or a carrier service are not subject to 29 the provisions of this chapter. 30 2. The aggregate assessment imposed under this 31 section shall not exceed the maximum amount that may be 32 assessed pursuant to the indirect guarantee threshold 33 as established pursuant to 42 C.F.R. § 433.68(f)(3)(i), 34 and shall be stated on a per prescription basis. 35 3. The assessment shall be paid by each pharmacy to 36 the department on a quarterly basis. The department 37 shall prepare and distribute a form upon which 38 pharmacies shall calculate and report the assessment. 39 A pharmacy shall submit the completed form with the 40 assessment amount no later than the last day of the 41 month following the end of each calendar quarter. The 42 department may deduct the monthly amount from medical 43 assistance payments to a pharmacy. The amount deducted 44 from the payments shall not exceed the total amount of 45 the assessment due. 46 4. A pharmacy shall retain and preserve for a 47 period of three years such books and records as may be 48 necessary to determine the amount of the assessment 49 for which the pharmacy is liable under this chapter. 50 -28- HF649.2839 (1) 84 pf/jp 28/ 52 #121.
The department may inspect and copy the books and 1 records of a pharmacy for the purpose of auditing 2 the calculation of the assessment. All information 3 obtained by the department under this subsection is 4 confidential and does not constitute a public record. 5 5. The department shall collect the assessment 6 imposed and shall deposit all revenues collected in 7 the pharmacy assessment trust fund created in section 8 249N.4. 9 6. a. A pharmacy that fails to pay the assessment 10 within the time frame specified in this section 11 shall pay, in addition to the outstanding assessment, 12 a penalty of one and five-tenths percent of the 13 assessment amount owed for each month or portion of 14 each month that the payment is overdue. 15 b. If the assessment has not been received by the 16 department by seven days after the last day of the 17 month in which the payment is due, the department shall 18 withhold an amount equal to the assessment and penalty 19 owed from any payment due such pharmacy under the 20 medical assistance program. 21 c. The assessment imposed under this section 22 constitutes a debt due the state and may be collected 23 by civil action, including but not limited to the 24 filing of tax liens, and any other method provided for 25 by law. 26 d. Any penalty collected pursuant to this 27 subsection shall be credited to the pharmacy assessment 28 trust fund. 29 7. a. If pharmacies are not reimbursed at the 30 reimbursement rates established pursuant to this 31 chapter, the department shall terminate the imposition 32 of the assessment under this section no later than 33 ninety days from the date such reimbursement takes 34 effect. 35 b. If federal financial participation to match the 36 assessments made under this section becomes unavailable 37 under federal law, the department shall terminate the 38 imposition of the assessments beginning on the date the 39 federal statutory, regulatory, or interpretive change 40 takes effect. 41 Sec. ___. NEW SECTION . 249N.4 Pharmacy assessment 42 trust fund. 43 1. A pharmacy assessment trust fund is created 44 in the state treasury under the authority of the 45 department. Moneys received through the collection of 46 the pharmacy assessment imposed under this chapter and 47 any other moneys specified for deposit in the trust 48 fund shall be deposited in the trust fund. 49 2. Moneys in the trust fund shall be used, subject 50 -29- HF649.2839 (1) 84 pf/jp 29/ 52
to their appropriation by the general assembly, by 1 the department only for reimbursement of services for 2 which federal financial participation under the medical 3 assistance program is available to match state funds. 4 3. Beginning July 1, 2011, or the implementation 5 date of the pharmacy assessment program as determined 6 by receipt of approval from the centers for Medicare 7 and Medicaid services of the United States department 8 of health and human services, whichever is later, 9 moneys that are appropriated from the trust fund for 10 reimbursement to pharmacies shall be used to provide 11 the following pharmacy reimbursement adjustment 12 increases within the parameters specified: 13 a. Enhanced generic prescription drug dispensing 14 fee. The department shall reimburse pharmacy 15 dispensing fees using a rate of four dollars and 16 thirty-four cents per prescription plus the enhanced 17 generic prescription drug dispensing fee per generic 18 prescription. 19 b. Enhanced brand name prescription drug dispensing 20 fee. The department shall reimburse pharmacy 21 dispensing fees using a rate of four dollars and 22 thirty-four cents per prescription plus the enhanced 23 brand name prescription drug dispensing fee per brand 24 name prescription. 25 4. Appropriations from the trust fund shall be 26 based on the following: 27 a. For the fiscal year beginning July 1, 2011, 28 fifty-one percent of the moneys in the trust fund shall 29 be appropriated for reimbursement to pharmacies. 30 b. For the fiscal year beginning July 1, 2012, 31 seventy-five percent of the moneys in the trust fund 32 shall be appropriated for reimbursement to pharmacies. 33 5. Any payments made to pharmacies under this 34 section shall result in budget neutrality to the 35 general fund of the state. 36 6. The trust fund shall be separate from the 37 general fund of the state and shall not be considered 38 part of the general fund of the state. The moneys 39 in the trust fund shall not be considered revenue of 40 the state, but rather shall be funds of the pharmacy 41 assessment program. The moneys deposited in the 42 trust fund are not subject to section 8.33 and shall 43 not be transferred, used, obligated, appropriated, 44 or otherwise encumbered, except to provide for the 45 purposes of this chapter. Notwithstanding section 46 12C.7, subsection 2, interest or earnings on moneys 47 deposited in the trust fund shall be credited to the 48 trust fund. 49 7. The department shall adopt rules pursuant 50 -30- HF649.2839 (1) 84 pf/jp 30/ 52
to chapter 17A to administer the trust fund and 1 reimbursements made from the trust fund. 2 8. The department shall report annually to the 3 general assembly regarding the use of moneys deposited 4 in the trust fund and appropriated to the department. 5 Sec. ___. NEW SECTION . 249N.5 REPEAL. 6 This chapter is repealed June 30, 2013. 7 Sec. ___. DIRECTIVE TO DEPARTMENT OF HUMAN 8 SERVICES. Upon enactment of this division of this Act, 9 the department of human services shall request any 10 medical assistance state plan amendment necessary to 11 implement this division of this Act from the centers 12 for Medicare and Medicaid services of the United States 13 department of health and human services. 14 Sec. ___. CONTINGENCY PROVISIONS. 15 1. The pharmacy assessment imposed pursuant to this 16 division of this Act shall not be imposed retroactively 17 prior to July 1, 2011. 18 2. The pharmacy assessment shall not be collected 19 until the department of human services has received 20 approval of the assessment from the centers for 21 Medicare and Medicaid services of the United States 22 department of health and human services. 23 Sec. ___. EFFECTIVE UPON ENACTMENT AND 24 APPLICABILITY. This division of this Act, being deemed 25 of immediate importance, takes effect upon enactment. 26 However, the department of human services shall only 27 implement this division of this Act if the department 28 receives federal approval of the requests relating to 29 the medical assistance state plan amendment necessary 30 to implement this division of this Act. > 31 122. Page 83, after line 21 by inserting: 32 < DIVISION ___ 33 BISPHENOL A PROHIBITION 34 Sec. ___. NEW SECTION . 135.181 Bisphenol A 35 prohibition. 36 1. As used in this section, unless the context 37 otherwise requires: 38 a. “Infant pacifier” means a device designed to be 39 bitten or sucked by an infant for the sole purpose of 40 soothing or providing comfort to the infant, including 41 soothing discomfort caused by teething. 42 b. “Reusable beverage container” means a baby bottle 43 or spill-proof container primarily intended by the 44 manufacturer for use by a child three years of age or 45 younger. 46 1A. For purposes of this section, “reusable beverage 47 container” includes disposable baby bottle liners 48 designed to hold liquids in a baby bottle. 49 2. Beginning January 1, 2013, a person shall 50 -31- HF649.2839 (1) 84 pf/jp 31/ 52 #122.
not manufacture, sell, or distribute in commerce in 1 this state any infant pacifier or reusable beverage 2 container containing bisphenol A. A manufacturer or 3 wholesaler who sells or offers for sale in this state a 4 reusable beverage container that is intended for retail 5 sale shall do all of the following: 6 a. Ensure that the container is conspicuously 7 labeled as not containing bisphenol A. 8 b. Provide the retailer with affirmation that the 9 container does not contain bisphenol A. 10 3. A manufacturer shall use the least toxic 11 alternative when replacing bisphenol A in accordance 12 with this section. 13 4. In complying with this section, a manufacturer 14 shall not replace bisphenol A with a substance rated 15 by the United States environmental protection agency 16 as a class A, B, or C carcinogen or a substance listed 17 on the agency’s list of chemicals evaluated for 18 carcinogenic potential as known or likely carcinogens, 19 known to be human carcinogens, or likely to be human 20 carcinogens. 21 5. In complying with this section, a manufacturer 22 shall not replace bisphenol A with a reproductive 23 toxicant that has been identified by the United States 24 environmental protection agency as causing birth 25 defects, reproductive harm, or developmental harm. 26 6. A person who violates this section is subject 27 to a civil penalty of five hundred dollars for each 28 violation. 29 Sec. ___. EFFECTIVE DATE. This division of this 30 Act takes effect January 1, 2013. > 31 123. Page 83, after line 21 by inserting: 32 < DIVISION ___ 33 HEALTH INFORMATION TECHNOLOGY 34 Sec. ___. NEW SECTION . 135D.1 Findings and intent. 35 1. The general assembly finds all of the following: 36 a. Technology used to support health-related 37 functions is widely known as health information 38 technology. Electronic health records are used to 39 collect and store relevant patient health information. 40 Electronic health records serve as a means of bringing 41 evidence-based knowledge resources and patient 42 information to the point of care to support better 43 decision making and more efficient care processes. 44 b. Health information technology allows for 45 comprehensive management of health information and its 46 secure electronic exchange between providers, public 47 health agencies, payers, and consumers. Broad use of 48 health information technology should improve health 49 care quality and the overall health of the population, 50 -32- HF649.2839 (1) 84 pf/jp 32/ 52 #123.
increase efficiencies in administrative health care, 1 reduce unnecessary health care costs, and help prevent 2 medical errors. 3 c. Health information technology provides a 4 mechanism to transform the delivery of health and 5 medical care in Iowa and across the nation. 6 2. It is the intent of the general assembly to 7 use health information technology as a catalyst 8 to achieve a healthier Iowa through the electronic 9 sharing of health information. A health information 10 network involves sharing health information across the 11 boundaries of individual practice and institutional 12 health settings and with consumers. The result is a 13 public good that will contribute to improved clinical 14 outcomes and patient safety, population health, access 15 to and quality of health care, and efficiency in health 16 care delivery. 17 3. It is the intent of the general assembly that 18 the health information network shall not constitute a 19 health benefit exchange or a health insurance exchange. 20 Sec. ___. NEW SECTION . 135D.2 Definitions. 21 For the purposes of this chapter, unless the context 22 otherwise requires: 23 1. “Authorized” means having met the requirements 24 as a participant for access to the health information 25 network. 26 2. “Board” means the board of directors of Iowa 27 e-health. 28 3. “Consumers” means people who acquire and use 29 goods and services for personal need. 30 4. “Continuity of care document” means a summary 31 of a patient’s health information for each visit to a 32 provider to be delivered through the health information 33 network. 34 5. “Department” means the department of public 35 health. 36 6. “Deputy director” means the deputy director of 37 public health. 38 7. “Director” means the director of public health. 39 8. “Exchange” means the authorized electronic 40 sharing of health information between providers, 41 payers, consumers, public health agencies, the 42 department, and other authorized participants utilizing 43 the health information network and health information 44 network services. 45 9. “Executive director” means the executive director 46 of the office of health information technology. 47 10. “Health information” means any information, 48 in any form or medium, that is created, transmitted, 49 or received by a provider, payer, consumer, public 50 -33- HF649.2839 (1) 84 pf/jp 33/ 52
health agency, the department, or other authorized 1 participant, which relates to the past, present, 2 or future physical or mental health or condition of 3 an individual; the provision of health care to an 4 individual; or the past, present, or future payment for 5 the provision of health care to an individual. 6 11. “Health information network” means the exclusive 7 statewide electronic health information network. 8 12. “Health information network services” means 9 the exchanging of health information via the health 10 information network; education and outreach to 11 support connection and access to and use of the health 12 information network; and all other activities related 13 to the electronic exchange of health information. 14 13. “Health Insurance Portability and Accountability 15 Act” means the federal Health Insurance Portability 16 and Accountability Act of 1996, Pub. L. No. 104-191, 17 including amendments thereto and regulations 18 promulgated thereunder. 19 14. “Infrastructure” means technology including 20 architecture, hardware, software, networks, terminology 21 and standards, and policies and procedures governing 22 the electronic exchange of health information. 23 15. “Iowa e-health” means the collaboration 24 between the department and other public and private 25 stakeholders to establish, operate, and sustain an 26 exclusive statewide health information network. 27 16. “Iowa Medicaid enterprise” means Iowa medicaid 28 enterprise as defined in section 249J.3. 29 17. “Local board of health” means a city, county, or 30 district board of health. 31 18. “Office” means the office of health information 32 technology within the department. 33 19. “Participant” means an authorized provider, 34 payer, patient, public health agency, the department, 35 or other authorized person that has voluntarily agreed 36 to authorize, submit, access, and disclose health 37 information through the health information network in 38 accordance with this chapter and all applicable laws, 39 rules, agreements, policies, and procedures. 40 20. “Participation and data sharing agreement” means 41 the agreement outlining the terms of access and use for 42 participation in the health information network. 43 21. “Patient” means a person who has received or is 44 receiving health services from a provider. 45 22. “Payer” means a person who makes payments 46 for health services, including but not limited to an 47 insurance company, self-insured employer, government 48 program, individual, or other purchaser that makes such 49 payments. 50 -34- HF649.2839 (1) 84 pf/jp 34/ 52
23. “Protected health information” means 1 individually identifiable patient information, 2 including demographic information, related to the past, 3 present, or future health or condition of a person; 4 the provision of health care to a person; or the past, 5 present, or future payment for such health care; which 6 is created, transmitted, or received by a participant. 7 “Protected health information” does not include 8 education and other records that are covered under the 9 federal Family Educational Rights and Privacy Act of 10 1974, as codified at 20 U.S.C. 1232g, as amended; or 11 any employment records maintained by a covered entity, 12 as defined under the Health Insurance Portability and 13 Accountability Act, in its role as an employer. 14 24. “Provider” means a hospital, physician clinic, 15 pharmacy, laboratory, health service provider, or 16 other person that is licensed, certified, or otherwise 17 authorized or permitted by law to administer health 18 care in the ordinary course of business or in the 19 practice of a profession, or any other person or 20 organization that furnishes, bills, or is paid for 21 health care in the normal course of business. 22 25. “Public health agency” means an entity that is 23 governed by or contractually responsible to a local 24 board of health or the department to provide services 25 focused on the health status of population groups and 26 their environments. 27 26. “Purchaser” means any individual, employer, 28 or organization that purchases health insurance or 29 services and includes intermediaries. 30 27. “Vendor” means a person or organization that 31 provides or proposes to provide goods or services to 32 the department pursuant to a contract, but does not 33 include an employee of the state, a retailer, or a 34 state agency or instrumentality. 35 Sec. ___. NEW SECTION . 135D.3 Iowa e-health 36 established —— guiding principles, goals, domains. 37 1. Iowa e-health is established as a 38 public-private, multi-stakeholder collaborative. 39 The purpose of Iowa e-health is to develop, administer, 40 and sustain the health information network to improve 41 the quality, safety, and efficiency of health care 42 available to Iowans. 43 2. Iowa e-health shall manage and operate 44 the health information network. Nothing in 45 this chapter shall be interpreted to impede or 46 preclude the formation and operation of regional, 47 population-specific, or local health information 48 networks or their participation in the health 49 information network. 50 -35- HF649.2839 (1) 84 pf/jp 35/ 52
3. Iowa e-health shall facilitate the exchange 1 of health information for prevention and treatment 2 purposes to help providers make the best health care 3 decisions for patients and to provide patients with 4 continuity of care regardless of the provider the 5 patient visits. 6 4. The guiding principles of Iowa e-health include 7 all of the following: 8 a. To engage in a collaborative, public-private, 9 multi-stakeholder effort including providers, payers, 10 purchasers, governmental entities, educational 11 institutions, and consumers. 12 b. To create a sustainable health information 13 network which makes information available when and 14 where it is needed. 15 c. To ensure the health information network 16 incorporates provider priorities and appropriate 17 participant education. 18 d. To instill confidence in consumers that their 19 health information is secure, private, and accessed 20 appropriately. 21 e. To build on smart practices and align with 22 federal standards to ensure interoperability within and 23 beyond the state. 24 5. The goals of Iowa e-health include all of the 25 following: 26 a. To build awareness and trust of health 27 information technology through communication and 28 outreach to providers and consumers. 29 b. To safeguard privacy and security of health 30 information shared electronically between participants 31 through the health information network so that the 32 health information is secure, private, and accessed 33 only by authorized individuals and entities. 34 c. To promote statewide deployment and use of 35 electronic health records. 36 d. To enable the electronic exchange of health 37 information. 38 e. To advance coordination of activities across 39 state and federal governments. 40 f. To establish a governance model for the health 41 information network. 42 g. To establish sustainable business and technical 43 operations for the health information exchange. 44 h. To secure financial resources to develop and 45 sustain the health information network. 46 i. To monitor and evaluate health information 47 technology progress and outcomes. 48 6. Iowa e-health shall include the following five 49 domains: 50 -36- HF649.2839 (1) 84 pf/jp 36/ 52
a. Governance. Iowa e-health shall be governed 1 by a board of directors whose members represent 2 stakeholders such as provider organizations and 3 associations, providers, payers, purchasers, 4 governmental entities, business, and consumers. Iowa 5 e-health shall be supported by the department’s office 6 of health information technology. The board shall 7 set direction, goals, and policies for Iowa e-health 8 and provide oversight of the business and technical 9 operations of the health information network and health 10 information network services. 11 b. Business and technical operations. The office of 12 health information technology shall perform day-to-day 13 operations to support and advance Iowa e-health, the 14 health information network, and health information 15 network services. 16 c. Finance. Iowa e-health shall identify and 17 manage financial resources to achieve short-term and 18 long-term sustainability of the health information 19 network. The health information network shall be 20 financed by participants based on a business model and 21 financial sustainability plan approved by the board 22 no later than December 31, 2011, and submitted to the 23 governor and the general assembly. The model and plan 24 may contemplate participant fees based on value-based 25 principles. Fees shall not be assessed to participants 26 prior to approval by the board and an enactment of the 27 general assembly establishing such fees. 28 d. Technical infrastructure. Iowa e-health shall 29 implement and manage the core infrastructure and 30 standards to enable the safe and secure delivery of 31 health information to providers and consumers through 32 the health information network. 33 e. Legal and policy. Iowa e-health shall establish 34 privacy and security policies and guidelines, and 35 participation and data sharing agreements, to protect 36 consumers and enforce rules for utilization of the 37 health information network. 38 Sec. ___. NEW SECTION . 135D.4 Governance —— board 39 of directors —— advisory council. 40 1. Iowa e-health shall be governed by a board of 41 directors. Board members shall be residents of the 42 state of Iowa. The membership of the board shall 43 comply with sections 69.16 and 69.16A. 44 2. The board of directors shall be comprised of the 45 following members: 46 a. The board shall include all of the following as 47 voting members: 48 (1) Two members who represent the Iowa 49 collaborative safety net provider network created in 50 -37- HF649.2839 (1) 84 pf/jp 37/ 52
section 135.153, designated by the network. 1 (2) Four members who represent hospitals, two of 2 whom are designated by the two largest health care 3 systems in the state, one of whom is designated by the 4 university of Iowa hospitals and clinics, and one of 5 whom is designated by the Iowa hospital association to 6 represent critical access hospitals. 7 (3) Two members who represent two different private 8 health insurance carriers, designated by the federation 9 of Iowa insurers, one of which has the largest health 10 market share in Iowa. 11 (4) One member who is a licensed physician, 12 designated by the Iowa medical society. 13 (5) One member representing the department who is 14 designated by the department. 15 (6) One member representing the Iowa Medicaid 16 enterprise who is the Iowa Medicaid director, or the 17 director’s designee. 18 b. The board shall include as ex officio, 19 nonvoting members four members of the general 20 assembly, one appointed by the speaker of the house of 21 representatives, one appointed by the minority leader 22 of the house of representatives, one appointed by the 23 majority leader of the senate, and one appointed by the 24 minority leader of the senate. 25 3. A person shall not serve on the board in any 26 capacity if the person is required to register as a 27 lobbyist under section 68B.36 because of the person’s 28 activities for compensation on behalf of a profession 29 or an entity that is engaged in providing health care, 30 reviewing or analyzing health care, paying for health 31 care services or procedures, or providing health 32 information technology or health information network 33 services. 34 4. a. Board members shall serve four-year terms 35 but shall not serve more than two consecutive four-year 36 terms. However, the board members who represent state 37 agencies are not subject to term limits. 38 b. At the end of any term, a member of the 39 board may continue to serve until the appointing or 40 designating authority names a successor. 41 c. A vacancy on the board shall be filled for the 42 remainder of the term in the manner of the original 43 appointment. A vacancy in the membership of the board 44 shall not impair the right of the remaining members to 45 exercise all the powers and perform all the duties of 46 the board. 47 d. A board member may be removed by the board for 48 cause including but not limited to malfeasance in 49 office, failure to attend board meetings, misconduct, 50 -38- HF649.2839 (1) 84 pf/jp 38/ 52
or violation of ethical rules and standards. 1 Nonattendance of the board members appointed by the 2 governor shall be governed by the provisions of section 3 69.15. A board member may be removed by a vote of the 4 board if, based on the criteria provided in section 5 69.15, subsection 1, paragraphs “a” and “b” , the board 6 member would be deemed to have submitted a resignation 7 from the board. 8 e. The board members shall elect a chairperson from 9 their membership. The department’s designee shall 10 serve as vice chairperson. 11 5. Meetings of the board shall be governed by the 12 provisions of chapter 21. 13 a. The board shall meet upon the call of the 14 chairperson or the vice chairperson. Notice of the 15 time and place of each board meeting shall be given 16 to each member. The board shall keep accurate and 17 complete records of all of its meetings. 18 b. A simple majority of the members shall 19 constitute a quorum to enable the transaction of any 20 business and for the exercise of any power or function 21 of the board. Action may be taken and motions and 22 resolutions adopted by the affirmative vote of a 23 majority of the members attending the meeting whether 24 in person, by telephone, web conference, or other 25 means. A board member shall not vote by proxy or 26 through a delegate. 27 c. Public members of the board shall receive 28 reimbursement for actual expenses incurred while 29 serving in their official capacity, only if they are 30 not eligible for reimbursement by the organization that 31 they represent. A person who serves as a member of 32 the board shall not by reason of such membership be 33 entitled to membership in the Iowa public employees’ 34 retirement system or service credit for any public 35 retirement system. 36 6. The board may exercise its powers, duties, 37 and functions as provided in this chapter and as 38 prescribed by law. The director and the board shall 39 ensure that matters under the purview of the board 40 are carried out in a manner that does not violate or 41 risk violation of applicable state or federal laws or 42 regulations, and that supports overriding public policy 43 and public safety concerns, fiscal compliance, and 44 compliance with the office of the national coordinator 45 for health information technology state health 46 information exchange cooperative agreement program or 47 any other cooperative agreement programs or grants 48 supporting Iowa e-health. The board shall do all of 49 the following: 50 -39- HF649.2839 (1) 84 pf/jp 39/ 52
a. Participate in the selection of the executive 1 director and assist in the development of performance 2 standards and evaluations of the executive director. 3 b. Establish priorities among health information 4 network services based on the needs of the population 5 of this state. 6 c. Oversee the handling and accounting of assets 7 and moneys received for or generated by the health 8 information network. 9 d. Establish committees and workgroups as needed. 10 e. Review and approve or disapprove all of the 11 following, as proposed by the department: 12 (1) Strategic, operational, and financial 13 sustainability plans for Iowa e-health, the health 14 information network, and health information network 15 services. 16 (2) Standards, requirements, policies, and 17 procedures for access, use, secondary use, and privacy 18 and security of health information network through the 19 health information exchange, consistent with applicable 20 federal and state standards and laws. 21 (3) Policies and procedures for administering the 22 infrastructure, technology, and associated professional 23 services necessary for the business and technical 24 operation of the health information network and health 25 information network services. 26 (4) Policies and procedures for evaluation of the 27 health information network and health information 28 network services. 29 (5) Mechanisms for periodic review and update of 30 policies and procedures. 31 (6) An annual budget and fiscal report for the 32 operations of the health information network and an 33 annual report for Iowa e-health and health information 34 network services. 35 (7) Major purchases of goods and services. 36 f. Adopt administrative rules pursuant to chapter 37 17A to implement this chapter and relating to the 38 management and operation of the health information 39 network and health information network services. 40 g. Adopt rules for monitoring access to and use 41 of the health information network and enforcement 42 of health information network rules, standards, 43 requirements, policies, and procedures. The board 44 may suspend, limit, or terminate a participant’s 45 utilization of the health information network for 46 violation of such rules, standards, requirements, 47 policies, or procedures, and shall establish, by rule, 48 a process for notification, right to respond, and 49 appeal relative to such violations. 50 -40- HF649.2839 (1) 84 pf/jp 40/ 52
h. Have all remedies allowed by law to address any 1 violation of the terms of the participation and data 2 sharing agreement. 3 i. Perform any and all other activities in 4 furtherance of its purpose. 5 7. a. A board member is subject to chapter 68B, 6 the rules adopted by the Iowa ethics and campaign 7 disclosure board, and the ethics rules and requirements 8 that apply to the executive branch of state government. 9 b. A board member shall not participate in any 10 matter before the board in which the board member 11 has a direct or indirect interest in an undertaking 12 that places the board member’s personal or business 13 interests in conflict with those of Iowa e-health, 14 including but not limited to an interest in a 15 procurement contract, or that may create the appearance 16 of impropriety. 17 8. Advisory council. 18 a. An advisory council to the board is established 19 to provide an additional mechanism for obtaining 20 broader stakeholder advice and input regarding health 21 information technology, the health information network, 22 and health information network services. 23 b. The advisory council shall be comprised of the 24 following members who shall serve two-year staggered 25 terms: 26 (1) The following members designated as specified: 27 (a) One member who is a licensed practicing nurse 28 in an office or clinic setting, designated by the Iowa 29 nurses association. 30 (b) One member representing licensed pharmacists, 31 designated by the Iowa pharmacy association. 32 (c) One member representing the Iowa healthcare 33 collaborative, designated by the collaborative. 34 (d) One member representing substance abuse 35 programs, designated by the Iowa behavioral health 36 association. 37 (e) One member representing community mental 38 health centers, designated by the Iowa association of 39 community providers. 40 (f) One member representing long-term care 41 providers, designated by the Iowa health care 42 association/Iowa center for assisted living and the 43 Iowa association of homes and services for the aging. 44 (g) One member representing licensed physicians, 45 designated by the Iowa academy of family physicians. 46 (h) One member representing chiropractors, 47 designated by the Iowa chiropractic society. 48 (i) One member who is a practicing physician in 49 an office or clinic setting, designated by the Iowa 50 -41- HF649.2839 (1) 84 pf/jp 41/ 52
osteopathic medical association. 1 (j) One member representing business interests, 2 designated by the Iowa association of business and 3 industry. 4 (2) The following members appointed by the board: 5 (a) One member representing the state board of 6 health. 7 (b) One member representing academics. 8 (c) One member representing the Iowa Medicare 9 quality improvement organization. 10 (d) One member who is the state chief information 11 officer. 12 (e) One member representing the private 13 telecommunications industry. 14 (f) One member representing Des Moines university. 15 (g) One member representing home health care 16 providers. 17 (h) One member representing the department of 18 veterans affairs. 19 c. The board may change the membership and the 20 composition of the advisory council, by rule, to 21 accommodate changes in stakeholder interests and the 22 evolution of health information technology, the health 23 information network, and health information network 24 services. An advisory council member may be removed by 25 a vote of the board if, based on the criteria provided 26 in section 69.15, subsection 1, paragraphs “a” and “b” , 27 the advisory council member would be deemed to have 28 submitted a resignation from the advisory council. 29 Sec. ___. NEW SECTION . 135D.5 Business and 30 technical operations —— office of health information 31 technology. 32 1. The office of health information technology 33 is established within the department and shall be 34 responsible for the day-to-day business and operations 35 of Iowa e-health, the health information network, and 36 health information network services. The office shall 37 be under the direction of the director and under the 38 supervision of the deputy director. 39 2. a. The department shall employ an executive 40 director to manage the office and the executive 41 director shall report to the deputy director. 42 b. The executive director shall manage the planning 43 and implementation of Iowa e-health, the health 44 information network, and health information network 45 services, and shall provide high-level coordination 46 across public and private sector stakeholders. 47 c. The executive director shall serve as Iowa’s 48 health information technology coordinator and primary 49 point of contact for the office of the national 50 -42- HF649.2839 (1) 84 pf/jp 42/ 52
coordinator for health information technology, 1 other federal and state agencies involved in health 2 information technology, and state health information 3 technology coordinators from other states. 4 3. a. The executive director and all other 5 employees of the office shall be employees of the 6 state, classified and compensated in accordance with 7 chapter 8A, subchapter IV, and chapter 20. 8 b. Subject to approval of the board, the director 9 shall have the sole power to determine the number of 10 full-time and part-time equivalent positions necessary 11 to carry out the provisions of this chapter. 12 c. An employee of the office shall not have a 13 financial interest in any vendor doing business or 14 proposing to do business with Iowa e-health. 15 4. The department shall do all of the following: 16 a. Develop, implement, and enforce the following, 17 as approved by the board: 18 (1) Strategic, operational, and financial 19 sustainability plans for the health information 20 network, Iowa e-health, and health information network 21 services. 22 (2) Standards, requirements, policies, and 23 procedures for access, use, secondary use, and privacy 24 and security of health information exchanged through 25 the health information network, consistent with 26 applicable federal and state standards and laws. 27 (3) Policies and procedures for monitoring 28 participant usage of the health information network 29 and health information network services; enforcing 30 noncompliance with health information network 31 standards, requirements, policies, rules, and 32 procedures. 33 (4) Policies and procedures for administering 34 the infrastructure, technology, and associated 35 professional services required for operation of the 36 health information network and health information 37 network services. 38 (5) Policies and procedures for evaluation of the 39 health information network and health information 40 network services. 41 (6) A mechanism for periodic review and update of 42 policies and procedures. 43 (7) An annual budget and fiscal report for the 44 business and technical operations of the health 45 information network and an annual report for Iowa 46 e-health, the health information network, and health 47 information network services. The department shall 48 submit all such reports to the general assembly. 49 b. Convene and facilitate board, advisory council, 50 -43- HF649.2839 (1) 84 pf/jp 43/ 52
workgroup, committee, and other stakeholder meetings. 1 c. Provide technical and operational assistance for 2 planning and implementing Iowa e-health activities, 3 the health information network, and health information 4 network services. 5 d. Provide human resource, budgeting, project and 6 activity coordination, and related management functions 7 to Iowa e-health, the health information network, and 8 health information network services. 9 e. Develop educational materials and educate the 10 general public on the benefits of electronic health 11 records, the health information network, and the 12 safeguards available to prevent unauthorized disclosure 13 of health information. 14 f. Enter into participation and data sharing 15 agreements with participants of the health information 16 network. 17 g. Record receipts and approval of payments, and 18 file required financial reports. 19 h. Apply for, acquire by gift or purchase, and 20 hold, dispense, or dispose of funds and real or 21 personal property from any person, governmental entity, 22 or organization in the exercise of its powers and 23 performance of its duties in accordance with this 24 chapter. 25 i. Administer grant funds in accordance with the 26 terms of the grant and all applicable state and federal 27 laws, rules, and regulations. 28 j. Select and contract with vendors in compliance 29 with applicable state and federal procurement laws and 30 regulations. 31 k. Coordinate with other health information 32 technology and health information network programs and 33 activities. 34 l. Work to align interstate and intrastate 35 interoperability and standards in accordance with 36 national health information exchange standards. 37 m. Execute all instruments necessary or incidental 38 to the performance of its duties and the execution of 39 its powers. 40 Sec. ___. NEW SECTION . 135D.6 Iowa e-health 41 finance fund. 42 1. The Iowa e-health finance fund is created as 43 a separate fund within the state treasury under the 44 control of the board. Revenues, donations, gifts, 45 interest, or other moneys received or generated 46 relative to the operation and administration of the 47 health information network and health information 48 network services, shall be deposited in the fund. 49 2. Moneys in the fund shall be expended by 50 -44- HF649.2839 (1) 84 pf/jp 44/ 52
the department only on activities and operations 1 suitable to the performance of the department’s 2 duties on behalf of the board and Iowa e-health as 3 specified in this chapter, subject to board approval. 4 Disbursements may be made from the fund for purposes 5 related to the administration, management, operations, 6 functions, activities, and sustainability of the health 7 information network and health information network 8 services. 9 3. Notwithstanding section 12C.7, subsection 2, 10 earnings or interest on moneys deposited in the fund 11 shall be credited to the fund. Notwithstanding section 12 8.33, any unexpended balance in the fund at the end 13 of each fiscal year shall be retained in the fund and 14 shall not be transferred to the general fund of the 15 state. 16 4. The moneys in the fund shall be subject to 17 financial and compliance audits by the auditor of 18 state. 19 5. The general assembly may appropriate moneys 20 in the fund to the department on behalf of Iowa 21 e-health for the health information network and health 22 information network services. 23 Sec. ___. NEW SECTION . 135D.7 Technical 24 infrastructure. 25 1. The health information network shall provide 26 a mechanism to facilitate and support the secure 27 electronic exchange of health information between 28 participants. The health information network shall 29 not function as a central repository of all health 30 information. 31 2. The health information network shall provide a 32 mechanism for participants without an electronic health 33 record system to access health information from the 34 health information network. 35 3. The technical infrastructure of the health 36 information network shall be designed to facilitate 37 the secure electronic exchange of health information 38 using functions including but not limited to all of the 39 following: 40 a. A master patient index, in the absence of a 41 single, standardized patient identifier, to exchange 42 secure health information among participants. 43 b. A record locator service to locate and exchange 44 secure health information among participants. 45 c. Authorization, authentication, access, and 46 auditing processes for security controls to protect 47 the privacy of consumers and participants and the 48 confidentiality of health information by limiting 49 access to the health information network and health 50 -45- HF649.2839 (1) 84 pf/jp 45/ 52
information to participants whose identity has been 1 authenticated, and whose access to health information 2 is limited by their role and recorded through an audit 3 trail. 4 d. Electronic transmission procedures and software 5 necessary to facilitate the electronic exchange of 6 various types of health information through the health 7 information network. 8 e. Telecommunications through coordination of 9 public and private networks to provide the backbone 10 infrastructure to connect participants exchanging 11 health information. The networks may include but 12 are not limited to the state-owned communications 13 network, other fiber optic networks, and private 14 telecommunications service providers. 15 4. The state shall own or possess the rights 16 to use all processes and software developed, and 17 hardware installed, leased, designed, or purchased 18 for the health information network, and shall permit 19 participants to use the health information network 20 and health information network services in accordance 21 with the standards, policies, procedures, rules, and 22 regulations approved by the board, and the terms of the 23 participation and data sharing agreement. 24 Sec. ___. NEW SECTION . 135D.8 Legal and policy. 25 1. Upon approval from the board, the office 26 of health information technology shall establish 27 appropriate security standards, policies, and 28 procedures to protect the transmission and receipt of 29 individually identifiable health information exchanged 30 through the health information network. The security 31 standards, policies, and procedures shall, at a 32 minimum, comply with the Health Insurance Portability 33 and Accountability Act security rule pursuant to 45 34 C.F.R. pt. 164, subpt. C, and shall reflect all of the 35 following: 36 a. Include authorization controls, including the 37 responsibility to authorize, maintain, and terminate a 38 participant’s use of the health information network. 39 b. Require authentication controls to verify the 40 identity and role of the participant using the health 41 information network. 42 c. Include role-based access controls to restrict 43 functionality and information available through the 44 health information network. 45 d. Include a secure and traceable electronic audit 46 system to document and monitor the sender and the 47 recipient of health information exchanged through the 48 health information network. 49 e. Require standard participation and data sharing 50 -46- HF649.2839 (1) 84 pf/jp 46/ 52
agreements which define the minimum privacy and 1 security obligations of all participants using the 2 health information network and health information 3 network services. 4 f. Include controls over access to and the 5 collection, organization, and maintenance of records 6 and data for purposes of research or population health 7 that protect the confidentiality of consumers who are 8 the subject of the health information. 9 2. a. A patient shall have the opportunity to 10 decline exchange of their health information through 11 the health information network. The board shall 12 provide by rule the means and process by which patients 13 may decline participation. A patient shall not be 14 denied care or treatment for declining to exchange 15 their health information, in whole or in part, through 16 the health information network. The means and process 17 utilized under the rules shall minimize the burden on 18 patients and providers. 19 b. Unless otherwise authorized by law or rule, 20 a patient’s decision to decline participation means 21 that none of the patient’s health information shall be 22 exchanged through the health information network. If a 23 patient does not decline participation, the patient’s 24 health information may be exchanged through the health 25 information network except as follows: 26 (1) If health information associated with a patient 27 visit with a provider is protected by state law that is 28 more restrictive than the Health Insurance Portability 29 and Accountability Act, a patient shall have the right 30 to decline sharing of health information through the 31 health information network from such visit as provided 32 by rule. 33 (2) With the consent of the patient, a provider 34 may limit health information associated with a patient 35 visit from being shared through the health information 36 network if such limitation is reasonably determined 37 by the provider, in consultation with the patient, to 38 be in the best interest of the patient as provided by 39 rule. 40 c. A patient who declines participation in the 41 health information network may later decide to 42 have health information shared through the health 43 information network. A patient who is participating 44 in the health information network may later decline 45 participation in the health information network. 46 3. The office shall develop and distribute 47 educational tools and information for consumers, 48 patients, and providers to inform them about the health 49 information network, including but not limited to the 50 -47- HF649.2839 (1) 84 pf/jp 47/ 52
safeguards available to prevent unauthorized disclosure 1 of health information and a patient’s right to decline 2 participation in the health information network. 3 4. a. A participant shall not release or use 4 protected health information exchanged through the 5 health information network for purposes unrelated 6 to prevention, treatment, payment, or health care 7 operations unless otherwise authorized or required by 8 law. Participants shall limit the use and disclosure 9 of protected health information to the minimum amount 10 required to accomplish the intended purpose of the use 11 or request, in compliance with the Health Insurance 12 Portability and Accountability Act and other applicable 13 federal law. Use or distribution of the information 14 for a marketing purpose, as defined by the Health 15 Insurance Portability and Accountability Act, is 16 strictly prohibited. 17 b. The department, the office, and all persons 18 using the health information network shall be 19 individually responsible for following breach 20 notification policies as provided by the Health 21 Insurance Portability and Accountability Act. 22 c. A participant shall not be compelled by 23 subpoena, court order, or other process of law 24 to access health information through the health 25 information network in order to gather records or 26 information not created by the participant. 27 5. a. If a patient has declined participation in 28 the health information network, the patient’s health 29 information may be released to a provider through the 30 health information network if all of the following 31 circumstances exist: 32 (1) The patient is unable to provide consent due to 33 incapacitation. 34 (2) The requesting provider believes, in good 35 faith, that the information is necessary to prevent 36 imminent serious injury to the patient. Imminent 37 serious injury includes but it not limited to death, 38 injury or disease that creates a substantial risk of 39 death, or injury or disease that causes protracted loss 40 or impairment of any organ or body system. 41 (3) Such information cannot otherwise be readily 42 obtained. 43 b. The department shall provide by rule for the 44 reporting of emergency access and use by a provider. 45 6. All participants exchanging health information 46 and data through the health information network 47 shall grant to participants of the health information 48 network a nonexclusive license to retrieve and use that 49 information or data in accordance with applicable state 50 -48- HF649.2839 (1) 84 pf/jp 48/ 52
and federal laws, and the policies, procedures, and 1 rules established by the board. 2 7. The department shall establish by rule the 3 procedures for a patient who is the subject of health 4 information to do all of the following: 5 a. Receive notice of a violation of the 6 confidentiality provisions required under this chapter. 7 b. Upon request to the department, view an audit 8 report created under this chapter for the purpose of 9 monitoring access to the patient’s records. 10 8. a. A provider who relies reasonably and in 11 good faith upon any health information provided 12 through the health information network in treatment 13 of a patient shall be immune from criminal or civil 14 liability arising from any damages caused by such 15 reasonable, good faith reliance. Such immunity shall 16 not apply to acts or omissions constituting negligence, 17 recklessness, or intentional misconduct. 18 b. A participant that has disclosed health 19 information through the health information network 20 in compliance with applicable law and the standards, 21 requirements, policies, procedures, and agreements of 22 the health information network shall not be subject to 23 criminal or civil liability for the use or disclosure 24 of the health information by another participant. 25 9. a. Notwithstanding chapter 22, the following 26 records shall be kept confidential, unless otherwise 27 ordered by a court or consented to by the patient or by 28 a person duly authorized to release such information: 29 (1) The protected health information contained in, 30 stored in, submitted to, transferred or exchanged by, 31 or released from the health information network. 32 (2) Any protected health information in the 33 possession of Iowa e-health or the department due to 34 its administration of the health information network. 35 b. Unless otherwise provided in this chapter, when 36 using the health information network for the purpose of 37 patient treatment, a provider is exempt from any other 38 state law that is more restrictive than the Health 39 Insurance Portability and Accountability Act that would 40 otherwise prevent or hinder the exchange of patient 41 information by the patient’s providers. 42 Sec. ___. NEW SECTION . 135D.9 Iowa e-health —— 43 health information network services. 44 Iowa e-health shall facilitate services through 45 the health information network or through other 46 marketplace mechanisms to improve the quality, safety, 47 and efficiency of health care available to consumers. 48 These services shall include but are not limited to all 49 of the following: 50 -49- HF649.2839 (1) 84 pf/jp 49/ 52
1. Patient summary records such as continuity of 1 care documents. 2 2. A provider directory and provider messaging. 3 3. Clinical orders and results. 4 4. Public health reporting such as electronic 5 reporting to the statewide immunization registry and 6 reportable diseases. 7 5. Medication history. 8 Sec. ___. NEW SECTION . 135D.10 Governance review 9 and transition. 10 1. a. The Iowa e-health governance structure 11 shall continue during the first two years of the term 12 of the state health information exchange cooperative 13 agreement with the office of the national coordinator 14 for health information technology to address the 15 development of policies and procedures; dissemination 16 of interoperability standards; the initiation, testing, 17 and operation of the health information network 18 infrastructure; and the evolution of health information 19 network services to improve patient care for the 20 population. 21 b. Following the end of the first two years of the 22 term of the cooperative agreement, the board and the 23 department shall review the Iowa e-health governance 24 structure, operations of the health information 25 network, and the business and sustainability plan to 26 determine if the existing Iowa e-health governance 27 structure should continue or should be replaced by any 28 of the following: 29 (1) A public authority or similar body with broad 30 stakeholder representation on its governing board. 31 (2) A not-for-profit entity with broad stakeholder 32 representation on its governing board. 33 2. If the board and department determine that the 34 governance structure should be replaced, Iowa e-health 35 shall develop a transition plan to transfer the 36 responsibilities for the domains specified in section 37 135D.3. 38 Sec. ___. Section 136.3, subsection 14, Code 2011, 39 is amended to read as follows: 40 14. Perform those duties authorized pursuant to 41 sections 135.156 , 135.159 , and 135.161 , and other 42 provisions of law. 43 Sec. ___. Section 249J.14, subsection 2, paragraphs 44 a and b, Code 2011, are amended to read as follows: 45 a. Design and implement a program for distribution 46 and monitoring of provider incentive payments, 47 including development of a definition of “meaningful 48 use” for purposes of promoting the use of electronic 49 medical recordkeeping by providers. The department 50 -50- HF649.2839 (1) 84 pf/jp 50/ 52
shall develop this program in collaboration with the 1 department of public health and the electronic health 2 information advisory council and executive committee 3 board of directors and the advisory council to the 4 board of Iowa e-health created pursuant to section 5 135.156 135D.4 . 6 b. Develop the medical assistance health 7 information technology plan as required by the centers 8 for Medicare and Medicaid services of the United 9 States department of health and human services. The 10 plan shall provide detailed implementation plans for 11 the medical assistance program for promotion of the 12 adoption and meaningful use of health information 13 technology by medical assistance providers and the 14 Iowa Medicaid enterprise. The plan shall include the 15 integration of health information technology and the 16 health information exchange network with the medical 17 assistance management information system. The plan 18 shall be developed in collaboration with the department 19 of public health and the electronic health information 20 advisory council and executive committee board of 21 directors and the advisory council to the board of Iowa 22 e-health created pursuant to section 135.156 135D.4 . 23 Sec. ___. INITIAL APPOINTMENTS —— BOARD. 24 1. The initial appointments of board member 25 positions described in section 135D.4, as enacted by 26 this division of this Act, shall have staggered terms 27 as follows: 28 a. The board members appointed by the governor 29 shall have initial terms of two years, after which the 30 members shall serve four-year terms, subject to the 31 following: 32 (1) The terms shall begin and end as provided in 33 section 69.19. 34 (2) Any board member appointed by the governor when 35 the senate is not in session shall serve only until 36 the end of the next regular session of the general 37 assembly, unless and until confirmed by the senate. 38 b. The board member designated by the Iowa medical 39 society shall have an initial term of two years, after 40 which the member shall serve a four-year term. 41 c. The board members designated by the university 42 of Iowa hospitals and clinics and the Iowa hospital 43 association shall have initial terms of four years, 44 after which the members shall serve four-year terms. 45 d. The board members designated by the federation 46 of Iowa insurers shall serve initial terms of six 47 years, after which the members shall serve four-year 48 terms. 49 2. With the exception of board members who are 50 -51- HF649.2839 (1) 84 pf/jp 51/ 52
representative of state agencies and not subject 1 to term limits as provided in section 135D.4, board 2 members may serve an additional four-year term, 3 with the exception of those board members initially 4 serving a two-year term, who may serve two consecutive 5 four-year terms following the initial two-year term. 6 Sec. ___. REPEAL. Sections 135.154, 135.155, and 7 135.156, Code 2011, are repealed. 8 Sec. ___. TRANSITION PROVISIONS. Notwithstanding 9 any other provision of this division of this Act, 10 the department of public health, and the executive 11 committee and the advisory council created pursuant to 12 section 135.156, shall continue to exercise the powers 13 and duties specified under that section until such time 14 as all board members have been appointed as provided 15 in section 135D.4, as enacted by this division of this 16 Act. 17 Sec. ___. EFFECTIVE DATE. The sections of this 18 division of this Act repealing sections 135.154, 19 135.155, and 135.156, and amending sections 136.3 and 20 249J.14, take effect on the date all board members are 21 appointed as provided in section 135D.4, as enacted by 22 this division of this Act. The department of public 23 health shall notify the Code editor of such date. 24 Sec. ___. EFFECTIVE UPON ENACTMENT. Except as 25 otherwise provided in this division of this Act, 26 this division of this Act, being deemed of immediate 27 importance, takes effect upon enactment. > 28 124. By striking page 83, line 22, through page 29 150, line 23. 30 125. Title page, line 3, after < appropriations > by 31 inserting < , providing penalties, > 32 126. By renumbering as necessary. 33 ______________________________ COMMITTEE ON APPROPRIATIONS ROBERT E. DVORSKY, CHAIRPERSON -52- HF649.2839 (1) 84 pf/jp 52/ 52 #124. #125. #126.