House File 2518 H-8036 Amend House File 2518 as follows: 1 1. Page 1, by striking lines 16 through 28 and inserting: 2 < NEW SUBSECTION . 15. a. Conduct an annual review of 3 provider reimbursement rates for medical and health services 4 provided under this chapter that are reimbursed by a statewide 5 fee schedule and that are not periodically updated or rebased 6 pursuant to federal or state law or rule. The department shall 7 compare each provider reimbursement rate in the following 8 manner: 9 (1) For all medical and health services other than dental 10 services, to reimbursement rates under the federal Medicare 11 program. 12 (2) For dental services, to reimbursement rates for 13 Medicaid programs in states contiguous to Iowa. 14 b. On or before January 15 of each calendar year, the 15 department shall submit to the general assembly a report 16 summarizing the department’s review under paragraph “a” . > 17 2. By striking page 1, line 35, through page 2, line 21, and 18 inserting: 19 < 2. On or before July 1 of each fiscal year, providers 20 shall submit actual cost of service and supply data to the 21 department. Upon request by the department, a provider shall 22 submit to reasonable review of the actual cost of service and 23 supply data submitted. 24 3. a. Upon the required submission of annual cost reports 25 by providers and implementation by the department of a waiver 26 fee schedule, the department, with input from the public, 27 consumers, providers, and other stakeholders, shall develop a 28 proposed cost-based reimbursement system and related changes to 29 department policies and procedures for all services rendered 30 under a waiver during the period of review specified by 31 the department. The cost-based reimbursement system shall 32 be developed using information provided to the department 33 including but not limited to all of the following: 34 (1) Provider cost data. 35 -1- HF 2518.2869 (1) 91 ak/ko 1/ 2 #1. #2.
(2) Provider claims data. 1 (3) Consumer needs assessment data. 2 (4) Other relevant regional and national data. 3 b. The department shall, with input from providers and 4 other relevant stakeholders, develop a uniform and streamlined 5 provider cost reporting mechanism for home and community-based 6 services. 7 4. At least once every four years, the department shall 8 establish a new base period to be used in calculating proposed 9 rate models and related changes to department policies and 10 procedures. On or before October 1 of each year that a new base 11 period is established, the department shall submit a report 12 to the general assembly that includes proposed rate models, 13 the projected fiscal impact of implementing the proposed rate 14 models, including documentation supporting the actuarial 15 soundness of the proposed rate models, and the proposed changes 16 to department policies and procedures. > 17 3. Title page, by striking lines 1 through 4 and inserting 18 < An Act relating to the department of health and human services 19 and reporting requirements for shelter care, residential 20 treatment, and Medicaid provider reimbursement rates, and 21 establishing provider reimbursement rates for Medicaid home and 22 community-based waiver services. > 23 4. By renumbering as necessary. 24 ______________________________ A. MEYER of Webster -2- HF 2518.2869 (1) 91 ak/ko 2/ 2 #3. #4.