<?xml version="1.0" encoding="UTF-8"?><slim:Document xmlns:slim="urn:legix:slim" xmlns:xhtml="http://www.w3.org/1999/xhtml" xmlns:atipl="http://www.arbortext.com/namespace/PageLayout" class="codeChapter" id="chp249O" name="249O"><slim:About class="header"><slim:Property type="string" name="taskInfo">1035:6514EA0C-B4F9-4DB9-A752-66ED24C28843</slim:Property><slim:Property type="string" name="checkinTime">08/01/2025 11:46</slim:Property><slim:Property type="string" name="version">3</slim:Property></slim:About><slim:TOC><slim:Item idref="sec249O.1" title="249O.1   Definitions."/><slim:Item idref="sec249O.2" title="249O.2   Hospital directed payment program."/></slim:TOC><slim:Body><slim:Level class="codeChapter" id="chp249O"><slim:Heading class="heading"><xhtml:span class="identifier">249O</xhtml:span><xhtml:span class="headnote">HOSPITAL DIRECTED PAYMENT PROGRAM</xhtml:span></slim:Heading><slim:Section class="codeSection" id="sec249O.1"><xhtml:div class="heading"><xhtml:span class="identifier">249O.1</xhtml:span><xhtml:span class="headnote">Definitions.</xhtml:span></xhtml:div><xhtml:p class="para">As used in <xhtml:span class="iowaCodeRef">this chapter</xhtml:span>, unless the context otherwise requires:</xhtml:p><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Centers for Medicare and Medicaid services”</xhtml:span> means the centers for Medicare and Medicaid services of the United States department of health and human services.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Department”</xhtml:span> means the department of health and human services.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">3</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Hospital”</xhtml:span> means a nonstate-owned hospital licensed by the state.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">4</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“Hospital directed payment program”</xhtml:span> means a program that provides a state directed payment to a hospital for inpatient and outpatient hospital services.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">5</xhtml:span></xhtml:div><xhtml:p class="para"><xhtml:span class="term">“State directed payment”</xhtml:span> means the same as defined in <xhtml:span class="CFRRef">42 C.F.R. §438.2</xhtml:span>.</xhtml:p></xhtml:div><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:span class="iowaActsRef">2025 Acts, ch 169, §40</xhtml:span></xhtml:div></xhtml:div><xhtml:div class="footnotes"><xhtml:div class="footnote">NEW section</xhtml:div></xhtml:div></slim:Section><slim:Section class="codeSection" id="sec249O.2"><xhtml:div class="heading"><xhtml:span class="identifier">249O.2</xhtml:span><xhtml:span class="headnote">Hospital directed payment program.</xhtml:span></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">1</xhtml:span></xhtml:div><xhtml:p class="para">Prior to the department administering a hospital directed payment program under <xhtml:span class="iowaCodeRef">this chapter</xhtml:span> for any specific fiscal year, the department shall submit any authorizing documentation necessary to the centers for Medicare and Medicaid services for approval. Upon receipt of approval from the centers for Medicare and Medicaid services, the department shall administer the hospital directed payment program during the specified fiscal year.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">2</xhtml:span></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">a</xhtml:span></xhtml:div><xhtml:p class="para">For the sole purpose of the hospital directed payment program, the department may impose an assessment on a hospital. The total amount of assessments collected by the department shall not exceed the amount necessary to fully fund the nonfederal share of the maximum state directed payment allowed under federal regulations.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">b</xhtml:span></xhtml:div><xhtml:p class="para">The department shall establish requirements for timely payment of an assessment, and any penalties for late payment or nonpayment of an assessment. Any assessment imposed under <xhtml:span class="iowaCodeRef">this section</xhtml:span> shall constitute a debt due the state and may be collected by civil action under any method provided by law.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">c</xhtml:span></xhtml:div><xhtml:p class="para">The department and a third-party administrator contracted with the department may collectively assess and collect an administrative fee of no more than four percent of the amount of each assessment imposed.</xhtml:p></xhtml:div></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">3</xhtml:span></xhtml:div><xhtml:p class="para">Any assessments and penalties collected under <xhtml:span class="iowaCodeRef">this section</xhtml:span> shall be used for the purposes of the hospital directed payment program.</xhtml:p></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">4</xhtml:span></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">a</xhtml:span></xhtml:div><xhtml:p class="para">The hospital directed payment program shall not be administered, an assessment shall not be imposed, and a hospital shall not be required to pay an assessment if federal financial participation is not available, or if the hospital directed payment program and imposition of an assessment are not approved by the centers for Medicare and Medicaid services.</xhtml:p></xhtml:div><xhtml:div class="letteredPara"><xhtml:div class="heading"><xhtml:span class="identifier">b</xhtml:span></xhtml:div><xhtml:p class="para">If federal law or policy significantly impacts the hospital directed payment program as determined by the department, the department, in collaboration with stakeholders, may terminate the hospital directed payment program.</xhtml:p></xhtml:div></xhtml:div><xhtml:div class="subsection"><xhtml:div class="heading"><xhtml:span class="identifier">5</xhtml:span></xhtml:div><xhtml:p class="para">The department shall adopt rules pursuant to <xhtml:span class="iowaCodeRef">chapter 17A</xhtml:span> as necessary to administer <xhtml:span class="iowaCodeRef">this chapter</xhtml:span>.</xhtml:p></xhtml:div><xhtml:div class="history"><xhtml:div class="historyItem"><xhtml:span class="iowaActsRef">2025 Acts, ch 169, §41</xhtml:span></xhtml:div></xhtml:div><xhtml:div class="footnotes"><xhtml:div class="footnote">NEW section</xhtml:div></xhtml:div></slim:Section></slim:Level></slim:Body></slim:Document>