House File 2347 - Introduced
HOUSE FILE
BY COMMITTEE ON HUMAN RESOURCES
(SUCCESSOR TO HF 2042)
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 5644HV 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 $20,216,039.
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 2 and 3 of this Act, the university of Iowa shall
3 2 transfer to the general fund of the state, from whatever
3 3 source available, $54,639,129, which is an amount equal to the
3 4 appropriations made pursuant to 2003 Iowa Acts, chapter 182,
3 5 section 9, subsection 2, paragraph "b", as modified by
3 6 executive orders 31 and 36, and pursuant to 2004 Iowa Acts,
3 7 chapter 1175, section 86, subsection 2, paragraph "b". Of the
3 8 amount transferred to the general fund of the state pursuant
3 9 to this section, $19,350,061 is appropriated and shall be
3 10 deposited in the medical assistance account of the department
3 11 of human services and $35,289,068 is appropriated and shall be
3 12 deposited in the account for health care transformation
3 13 created in section 249J.23.
3 14 Sec. 5. APPROPRIATION == HEALTH CARE TRANSFORMATION
3 15 ACCOUNT. There is appropriated from the account for health
3 16 care transformation created in section 249J.23, to the
3 17 university of Iowa hospitals and clinics for the fiscal year
3 18 beginning July 1, 2005, and ending June 30, 2006, the
3 19 following amount, or so much thereof as is necessary, for the
3 20 purposes designated:
3 21 For provision of services pursuant to and for costs
3 22 associated with chapter 249J:
3 23 .................................................. $ 2,000,000
3 24 Notwithstanding section 8.33, moneys appropriated in this
3 25 section that remain unencumbered or unobligated at the close
3 26 of the fiscal year shall not revert, but shall remain
3 27 available for expenditure for the purposes designated until
3 28 the close of the succeeding fiscal year.
3 29 Sec. 6. ACTIVITIES SUBSEQUENT TO TRANSFER AND PAYMENTS.
3 30 Subsequent to the transfer of funds by the university of Iowa
3 31 to the general fund of the state pursuant to section 4 of this
3 32 Act, the supplemental payments made to the university of Iowa
3 33 hospitals and clinics and to the carver college of medicine
3 34 faculty practice plan by the department of human services
3 35 pursuant to sections 2 and 3 of this Act are irrevocable,
4 1 notwithstanding any subsequent decision by the centers for
4 2 Medicare and Medicaid services of the United States department
4 3 of health and human services or any other state or federal
4 4 agency. The department of human services is solely
4 5 responsible for any repayment or payment of any penalty or
4 6 fine assessed by any state or federal agency on any party
4 7 relative to the transactions pursuant to sections 2, 3, and 4
4 8 of this Act.
4 9 Sec. 7. EFFECTIVE AND RETROACTIVE APPLICABILITY DATES.
4 10 1. This Act, being deemed of immediate importance, takes
4 11 effect upon enactment.
4 12 2. The provision of this Act amending 2003 Iowa Acts,
4 13 chapter 112, section 11, is retroactively applicable to May 2,
4 14 2003.
4 15 3. The provision of this Act amending 2004 Iowa Acts,
4 16 chapter 1175, section 86, is retroactively applicable to May
4 17 17, 2004.
4 18 EXPLANATION
4 19 This bill revises the mechanisms to provide funding for the
4 20 purposes of the health care transformation account. Instead
4 21 of requiring the university of Iowa hospitals and clinics
4 22 (UIHC) to transfer the amount of the increase resulting from
4 23 hospital payment adjustments during fiscal year 2004=2005 and
4 24 from supplemental payment adjustments for physician services
4 25 provided to medical assistance patients during fiscal years
4 26 2003=2004 and 2004=2005 back to the department of human
4 27 services, the department of human services will pay the UIHC
4 28 and the carver college of medicine faculty practice plan a
4 29 specific amount for each payment adjustment, which the UIHC
4 30 and the carver college of medicine faculty practice plan will
4 31 retain. Once the payment adjustment amounts are received, the
4 32 university of Iowa will transfer to the general fund of the
4 33 state, $54,639,129, from whatever sources available, which is
4 34 an amount equal to the amounts appropriated from the general
4 35 fund of the state to the UIHC for the indigent care program
5 1 for FY 2003=2004 and FY 2004=2005. This amount is then
5 2 appropriated and is divided into specified amounts for deposit
5 3 into the medical assistance account of the department of human
5 4 services and into the account for health care transformation.
5 5 The bill also provides that once the transfer of funds by
5 6 the university of Iowa to the general fund of the state is
5 7 made, the supplemental payments made to the university of Iowa
5 8 hospitals and clinics and the carver college of medicine
5 9 faculty practice plan by the department of human services are
5 10 irrevocable, notwithstanding any subsequent decision by state
5 11 or federal agencies, and the department of human services is
5 12 solely responsible for any repayment or payment of any penalty
5 13 or fine assessed by any state or federal agency on any party
5 14 relative to those transactions.
5 15 The bill also makes an appropriation from the account for
5 16 health care transformation to the University of Iowa hospitals
5 17 and clinics of $2 million for FY 2005=2006.
5 18 The bill takes effect upon enactment and portions of the
5 19 bill are retroactively applicable.
5 20 LSB 5644HV 81
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