S-3384

   Amend House File 653, as amended, passed, and reprinted by the House, as follows:
   1.  Page 151, after line 20 by inserting: 
<DIVISION ___
MEDICAID MANAGED CARE —— PROGRAM EVALUATION

   Sec. ___.  MEDICAID MANAGED CARE —— PROGRAM EVALUATION.
   1.  In addition to being consistent with options under federal law and regulations, and contingent upon receipt of approval from the office of the governor of reimbursement for each abortion performed under the Medicaid program, the medical assistance appropriation for the fiscal year beginning July 1, 2017, in this 2017 Act, shall also be contingent upon completion of the Medicaid managed care program evaluation as specified in this section.
   2.  a.  The department of human services shall utilize the medical assistance advisory council to receive input from the membership of the council, the university of Iowa public policy center, and representatives of other entities and consumers with interest or expertise relevant to the Medicaid program, to review Medicaid managed care and, at a minimum, accomplish all of the following:
   (1)  Evaluate the effects on the Medicaid long-term services and supports population in receiving Medicaid services through capitated Medicaid managed care and determine the feasibility of transitioning the long-term services and supports population to a fee-for-service or other payment model that best meets the needs of the population. The objectives of the evaluation shall include a determination of the best service delivery system and reimbursement methodology to ensure sufficient access by members to providers and services, to provide adequate reimbursement to providers of services and supports, to improve the health of the population, to improve member experience of care and ensure positive outcomes, and to reduce costs through these improvements.
   (2)  In addition to the evaluation of the effects on the Medicaid long-term services and supports population, evaluate the effects of capitated Medicaid managed care on the remaining Medicaid populations and determine the best service delivery system and reimbursement methodology to ensure sufficient access of members to providers and services, provide adequate reimbursement to providers of services and supports, to encourage the delivery of high quality services, and to ensure positive outcomes for each population. 
   (3)  Review the impact of capitated Medicaid managed care provider reimbursement methodologies and rates on provider sustainability and member access, and make recommendations regarding rate and payment methodologies to ensure provider sustainability and adequate access to providers.
   (4)  Review and determine measures to institute consistency and uniformity across processes and procedures utilized by Medicaid managed care organizations to increase efficiencies and reduce duplication and delay.
   (5)  Review data needs to determine additional Medicaid managed care contractor data reporting requirements to ensure member access to medically necessary services and achievement of overall positive health outcomes. 
   b.  The department shall submit a report, summarizing the evaluation and including findings and recommendations, to the governor and the general assembly by December 15, 2017. 
   3.  The department of human services shall require the completion of an initial external quality review of the Medicaid managed care program by January 1, 2018, and, as part of the ongoing quality assurance activities of the Iowa Medicaid program, shall continue to contract with the university of Iowa public policy center to perform an evaluation of Medicaid managed care by January 1, 2018.>
   2.  By renumbering as necessary.

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AMANDA RAGAN

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LIZ MATHIS