House File 363 - Introduced



                                       HOUSE FILE       
                                       BY  DE BOEF and WATTS


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

                                      A BILL FOR

  1 An Act concerning rules relating to copayments and other
  2    information regarding services provided to medical assistance
  3    recipients.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  5 TLSB 2212YH 83
  6 pf/nh/8

PAG LIN



  1  1    Section 1.  ADMINISTRATIVE RULES == COPAYMENTS FOR CERTAIN
  1  2 SERVICES PROVIDED UNDER THE MEDICAL ASSISTANCE PROGRAM.  The
  1  3 department of human services shall adopt or amend rules under
  1  4 the medical assistance program to provide for all of the
  1  5 following:
  1  6    1.  A copayment charge shall not be applicable for a
  1  7 recipient of care as an inpatient at a hospital, nursing
  1  8 facility, state mental health institute, or other medical
  1  9 institution if the person is required, as a condition of
  1 10 receiving services in the hospital, facility, or institution,
  1 11 to spend for costs of necessary medical care all but a minimal
  1 12 amount of income for personal needs.
  1 13    2.  A copayment charge of five dollars shall be applicable
  1 14 for all covered services rendered in a hospital emergency room
  1 15 if the medical condition does not result in an inpatient
  1 16 admission to the hospital at the time of the emergency room
  1 17 visit or at a subsequent time.
  1 18    3.  The eligibility card of any recipient of medical
  1 19 assistance twenty-one years of age or older shall include a
  1 20 statement regarding the copayment charge for office visits and
  1 21 emergency room visits.
  1 22    4.  Any Medipass program card shall include a statement
  1 23 informing the recipient that the recipient must see the doctor
  1 24 whose name is printed on the card or receive a referral from
  1 25 such doctor in order to receive coverage for nonemergent
  1 26 medical services.
  1 27                           EXPLANATION
  1 28    This bill directs the department of human services to adopt
  1 29 or amend rules for the medical assistance program to provide
  1 30 for all of the following:
  1 31    1.  That a copayment charge shall not be applicable for a
  1 32 recipient of care as an inpatient at a hospital, nursing
  1 33 facility, state mental health institute, or other medical
  1 34 institution if the person is required, as a condition of
  1 35 receiving services in the hospital, facility, or institution,
  2  1 to spend for costs of necessary medical care all but a minimal
  2  2 amount of income for personal needs.  Current rules provide
  2  3 that a copayment does not apply to such care in such
  2  4 facilities, but does not specify that the copayment is only
  2  5 not applicable to care provided to an individual as an
  2  6 inpatient.
  2  7    2.  A copayment charge of $5 for all covered services
  2  8 rendered in a hospital emergency room if the medical condition
  2  9 does not result in an inpatient admission to the hospital at
  2 10 the time of the emergency room visit or at a subsequent time.
  2 11 Current rules provide that copayment charges are not
  2 12 applicable for emergency services.
  2 13    3.  The eligibility card of any recipient of medical
  2 14 assistance 21 years of age or older is to include a statement
  2 15 of the copayment charge for office visits and emergency room
  2 16 visits.
  2 17    4.  A Medipass program card is to include a statement
  2 18 informing the recipient that the recipient must see the doctor
  2 19 whose name is printed on the card or receive a referral from
  2 20 such doctor in order to receive coverage for nonemergent
  2 21 medical services.
  2 22 LSB 2212YH 83
  2 23 pf/nh/8