House File 2042 - Introduced



                                       HOUSE FILE       
                                       BY  CARROLL


    Passed House,  Date               Passed Senate, Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act relating to the medical assistance provider payment
  2    adjustments, providing for transfer, appropriation, and
  3    deposit of funds, providing an effective date, and providing
  4    for retroactive applicability.
  5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  6 TLSB 5644HH 81
  7 pf/je/5

PAG LIN



  1  1    Section 1.  Section 249J.23, subsection 1, Code Supplement
  1  2 2005, is amended to read as follows:
  1  3    1.  An account for health care transformation is created in
  1  4 the state treasury under the authority of the department.
  1  5 Moneys received through the physician payment adjustment as
  1  6 described in 2003 Iowa Acts, chapter 112, section 11,
  1  7 subsection 1, and through the adjustment to hospital payments
  1  8 to provide an increased base rate to offset the high costs
  1  9 incurred for providing services to medical assistance patients
  1 10 as described in 2004 Iowa Acts, chapter 1175, section 86,
  1 11 subsection 2, paragraph "b", from sources including but not
  1 12 limited to appropriations from the general fund of the state,
  1 13 grants, and contributions shall be deposited in the account.
  1 14 The account shall include a separate premiums subaccount.
  1 15 Revenue generated through payment of premiums by expansion
  1 16 population members as required pursuant to section 249J.8
  1 17 shall be deposited in the separate premiums subaccount within
  1 18 the account.
  1 19    Sec. 2.  2004 Iowa Acts, chapter 1175, section 86,
  1 20 subsection 2, paragraph b, unnumbered paragraph 2, and
  1 21 subparagraphs (1), (2), and (3), as amended by 2005 Iowa Acts,
  1 22 chapter 167, section 35, are amended to read as follows:
  1 23    (1)  If the The department of human services adjusts shall
  1 24 adjust hospital payments to provide an increased base rate to
  1 25 offset the high cost incurred for providing services to
  1 26 medical assistance patients on or prior to July 1 during the
  1 27 fiscal year ending June 30, 2005, a portion of the amount
  1 28 specified in this unnumbered paragraph equal to the increased
  1 29 Medicaid payment shall be transferred by the university of
  1 30 Iowa hospitals and clinics to the medical assistance fund of
  1 31 the department of human services.  Of the amount transferred,
  1 32 an amount equal to the federal share of the payments shall be
  1 33 transferred to the account for health care transformation
  1 34 created in section 249J.22.  The amount of the payment
  1 35 adjustment made pursuant to this subparagraph (1) shall be
  2  1 $25,267,017.
  2  2    (2)  Any incremental increase in the base rate made
  2  3 pursuant to subparagraph (1) shall not be used in determining
  2  4 the university of Iowa hospital hospitals and clinics
  2  5 disproportionate share rate or when determining the statewide
  2  6 average base rate for purposes of calculating indirect medical
  2  7 education rates.
  2  8    Sec. 3.  2003 Iowa Acts, chapter 112, section 11,
  2  9 subsection 1, as amended by 2005 Iowa Acts, chapter 167,
  2 10 section 36, is amended to read as follows:
  2 11    1.  For the fiscal years beginning July 1, 2003, and ending
  2 12 June 30, 2004, and beginning July 1, 2004, and ending June 30,
  2 13 2005, the department of human services shall institute a
  2 14 supplemental payment adjustment applicable to physician
  2 15 services provided to medical assistance recipients at publicly
  2 16 owned state=owned acute care teaching hospitals.  The
  2 17 adjustment shall generate supplemental payments to physicians
  2 18 which are equal to the difference between the physician's
  2 19 charge average reimbursement from nongovernmental payors and
  2 20 the physician's fee schedule under the medical assistance
  2 21 program.  To the extent of the supplemental payments, a
  2 22 qualifying hospital shall, after receipt of the payments,
  2 23 transfer to the department of human services an amount equal
  2 24 to the actual supplemental payments that were made in that
  2 25 month.  The department of human services shall deposit these
  2 26 payments in the department's medical assistance account.  The
  2 27 payment adjustment amount made pursuant to this subsection
  2 28 shall equal $34,423,090.  The department of human services
  2 29 shall amend the medical assistance state plan as necessary to
  2 30 implement this section.  The department may adopt emergency
  2 31 rules to implement this section.  The department of human
  2 32 services shall amend the medical assistance state plan to
  2 33 eliminate this provision effective June 30, 2005.
  2 34    Sec. 4.  TRANSFER, APPROPRIATION, AND DEPOSIT OF FUNDS.
  2 35 Upon receipt of the supplemental payments described in
  3  1 sections 1 and 2 of this Act, the university of Iowa shall
  3  2 transfer to the general fund of the state, from whatever
  3  3 source available, an amount equal to the appropriations made
  3  4 pursuant to 2003 Iowa Acts, chapter 182, section 9, subsection
  3  5 2, paragraph "b", as modified by executive orders 31 and 36,
  3  6 and pursuant to 2004 Iowa Acts, chapter 1175, section 86,
  3  7 subsection 2, paragraph "b", except that the total amount
  3  8 transferred shall not exceed $54,639,129.  Of the amount
  3  9 transferred to the general fund of the state pursuant to this
  3 10 section, $21,186,597 is appropriated and shall be deposited in
  3 11 the medical assistance account of the department of human
  3 12 services and $33,452,532 is appropriated and shall be
  3 13 deposited in the account for health care transformation
  3 14 created in section 249J.23.
  3 15    Sec. 5.  ACTIVITIES SUBSEQUENT TO TRANSFER AND PAYMENTS.
  3 16 Subsequent to the transfer of funds by the university of Iowa
  3 17 to the general fund of the state pursuant to section 4 of this
  3 18 Act, the supplemental payments made to the university of Iowa
  3 19 hospitals and clinics and to the carver college of medicine
  3 20 faculty practice plan by the department of human services
  3 21 pursuant to sections 2 and 3 of this Act are irrevocable,
  3 22 notwithstanding any subsequent decision by the centers for
  3 23 Medicare and Medicaid services of the United States department
  3 24 of health and human services or any other state or federal
  3 25 agency.  The department of human services is solely
  3 26 responsible for any repayment or payment of any penalty or
  3 27 fine assessed by any state or federal agency on any party
  3 28 relative to the transactions pursuant to sections 2, 3, and 4
  3 29 of this Act.
  3 30    Sec. 6.  EFFECTIVE AND RETROACTIVE APPLICABILITY DATES.
  3 31    1.  This Act, being deemed of immediate importance, takes
  3 32 effect upon enactment.
  3 33    2.  The provision of this Act amending 2003 Iowa Acts,
  3 34 chapter 112, section 11, is retroactively applicable to May 2,
  3 35 2003.
  4  1    3.  The provision of this Act amending 2004 Iowa Acts,
  4  2 chapter 1175, section 86, is retroactively applicable to May
  4  3 17, 2004.
  4  4                           EXPLANATION
  4  5    This bill revises the mechanisms to provide funding for the
  4  6 purposes of the health care transformation account.  Instead
  4  7 of requiring the university of Iowa hospitals and clinics
  4  8 (UIHC) to transfer the amount of the increase resulting from
  4  9 hospital payment adjustments during fiscal year 2004=2005 and
  4 10 from supplemental payment adjustments for physician services
  4 11 provided to medical assistance patients during fiscal years
  4 12 2003=2004 and 2004=2005 back to the department of human
  4 13 services, the department of human services will pay the UIHC
  4 14 and the carver college of medicine faculty practice plan a
  4 15 specific amount for each payment adjustment, which the UIHC
  4 16 and the carver college of medicine faculty practice plan will
  4 17 retain.  Once the payment adjustment amounts are paid, the
  4 18 university of Iowa will transfer an amount equal to the
  4 19 amounts appropriated from the general fund of the state to the
  4 20 UIHC for the indigent care program for FY 2003=2004 and FY
  4 21 2004=2005, from whatever source available, not to exceed a
  4 22 total of $54,639,129, to the general fund of the state, and
  4 23 this amount is then appropriated and is divided into specified
  4 24 amounts for deposit into the medical assistance account of the
  4 25 department of human services and into the account for health
  4 26 care transformation.
  4 27    The bill also provides that once the transfer of funds by
  4 28 the university of Iowa to the general fund of the state is
  4 29 made, the supplemental payments made to the university of Iowa
  4 30 hospitals and clinics and the carver college of medicine
  4 31 faculty practice plan by the department of human services are
  4 32 irrevocable, notwithstanding any subsequent decision by state
  4 33 or federal agencies, and the department of human services is
  4 34 solely responsible for any repayment or payment of any penalty
  4 35 or fine assessed by any state or federal agency on any party
  5  1 relative to those transactions.
  5  2    The bill takes effect upon enactment and portions of the
  5  3 bill are retroactively applicable.
  5  4 LSB 5644HH 81
  5  5 pf:rj/je/5.1