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