Senate File 165 - Introduced
SENATE FILE
BY DANIELSON
Passed Senate, Date Passed House, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to creation of a program to address waste, fraud,
2 and abuse in the Medicaid program.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
4 TLSB 2261SS 82
5 pf/je/5
PAG LIN
1 1 Section 1. NEW SECTION. 249A.36 MEDICAL ASSISTANCE
1 2 INTEGRITY PROGRAM.
1 3 1. The organization in the state that administers the
1 4 senior Medicare patrol project through a grant from the
1 5 administration on aging of the United States department of
1 6 health and human services, shall expand the project to include
1 7 a medical assistance integrity program.
1 8 2. A statewide medical assistance integrity partnership
1 9 shall act as an advisory group to the program. The medical
1 10 assistance integrity partnership shall include members
1 11 representing the department, the medical assistance fraud
1 12 unit, and consumer advocacy groups for the elderly and adult
1 13 persons with disabilities.
1 14 3. The program, in consultation with the medical
1 15 assistance integrity partnership, shall do all of the
1 16 following:
1 17 a. Design and disseminate innovative and effective medical
1 18 assistance integrity outreach and training materials and
1 19 implement a statewide mass media campaign that focuses on
1 20 strengthening the integrity of the medical assistance program
1 21 through targeted education, resulting in increased awareness
1 22 and action regarding detection and reporting of medical
1 23 assistance program fraud, waste, and abuse. Special efforts
1 24 shall be directed toward increasing awareness and action
1 25 regarding detection and reporting of medical assistance
1 26 program fraud, waste, and abuse among cultural and ethnic
1 27 minorities, rural populations, persons with disabilities, and
1 28 the homebound.
1 29 b. Increase the ability of recipients and health care
1 30 providers to act as responsible consumers and providers of
1 31 health care.
1 32 c. Work with the public and policy makers to better
1 33 understand the importance of empowering recipients with the
1 34 ability to act as responsible consumers of health care.
1 35 d. Empower providers, case managers, and other
2 1 collaborative partners to detect and report medical assistance
2 2 program fraud, waste, and abuse.
2 3 e. Launch a statewide positive media campaign to increase
2 4 awareness that recipients are willing to provide and capable
2 5 of providing oversight for the medical assistance program.
2 6 f. Provide for national applicability of the program by
2 7 making all materials developed by the program, along with a
2 8 complete report on the accomplishments of and lessons learned
2 9 from the program, available to the national consumer
2 10 protection technical resource center of the administration on
2 11 aging of the United States department of health and human
2 12 services.
2 13 4. In administering the program, the organization shall do
2 14 all of the following:
2 15 a. Utilize resources such as the national consumer
2 16 protection technical resource center of the administration on
2 17 aging of the United States department of health and human
2 18 services for the senior Medicare patrol project.
2 19 b. Expand the senior Medicare patrol project toll=free
2 20 concerns line to provide for intake from medical assistance
2 21 program recipients and providers in order to address concerns,
2 22 provide advocacy, and make necessary referrals.
2 23 c. Expand the senior Medicare patrol project internet
2 24 website to include medical assistance program=specific
2 25 information.
2 26 d. Measure program outcomes on a semiannual basis.
2 27 EXPLANATION
2 28 This bill provides for the expansion of the senior Medicare
2 29 patrol project by its administering organization in the state
2 30 to include a medical assistance integrity program. The bill
2 31 provides that a statewide medical assistance integrity
2 32 partnership, comprised of members representing the department,
2 33 the medical assistance fraud unit, and consumer advocacy
2 34 groups for the elderly and adult persons with disabilities
2 35 will act as an advisory group to the program.
3 1 The program is to do all of the following, in consultation
3 2 with the medical assistance integrity partnership: design and
3 3 disseminate innovative and effective medical assistance
3 4 integrity outreach and training materials and implement a
3 5 statewide mass media campaign regarding the detection and
3 6 reporting of medical assistance program fraud, waste, and
3 7 abuse; increase the ability of medical assistance recipients
3 8 and health care providers to act as responsible consumers and
3 9 providers of health care; work with the public and policy
3 10 makers to better understand the importance of empowering
3 11 medical assistance recipients with the ability to act as
3 12 responsible consumers of health care; empower health care
3 13 providers, case managers, and other collaborative partners to
3 14 detect and report medical assistance program fraud, waste, and
3 15 abuse; launch a statewide positive media campaign to increase
3 16 awareness that medical assistance program recipients are
3 17 willing to provide and capable of providing oversight for the
3 18 medical assistance program; provide for national applicability
3 19 of the program by making all materials developed by the
3 20 program, along with a complete report on the accomplishments
3 21 of and lessons learned from the program, available to the
3 22 national consumer protection technical resource center.
3 23 The program is to be administered by utilizing existing
3 24 resources such as the national consumer protection technical
3 25 resource center for the senior Medicare patrol project,
3 26 expanding the senior Medicare patrol project toll=free
3 27 concerns line, expanding the senior Medicare patrol project
3 28 internet website to include medical assistance
3 29 program=specific information, and measuring program outcomes
3 30 on a semiannual basis.
3 31 LSB 2261SS 82
3 32 pf:rj/je/5