House File 773 - Introduced HOUSE FILE BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO HSB 259) Passed House, Date Passed Senate, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act relating to criteria under the medical assistance program 2 for admission to a psychiatric medical institution for 3 children. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 1568HV 83 6 jp/rj/8 PAG LIN 1 1 Section 1. Section 135H.3, Code 2009, is amended by adding 1 2 the following new unnumbered paragraph: 1 3 NEW UNNUMBERED PARAGRAPH. If a child is diagnosed with a 1 4 biologically based mental illness as defined in section 1 5 514C.22 and meets the medical assistance program criteria for 1 6 admission to a psychiatric medical institution for children, 1 7 the child shall be deemed to meet the acuity criteria for 1 8 inpatient benefits under a group policy, contract, or plan 1 9 providing for third=party payment or prepayment of health, 1 10 medical, and surgical coverage benefits issued by a carrier, 1 11 as defined in section 513B.2, or by an organized delivery 1 12 system authorized under 1993 Iowa Acts, chapter 158, that is 1 13 subject to section 514C.22. Such benefits shall not be 1 14 excluded or denied as care that is substantially custodial in 1 15 nature under section 514C.22, subsection 8, paragraph "b". 1 16 EXPLANATION 1 17 This bill relates to the criteria under the medical 1 18 assistance (Medicaid) program for a child's admission to a 1 19 psychiatric medical institution for children (PMIC). The bill 1 20 amends Code section 135H.3, relating to the nature of care in 1 21 a PMIC. The amendment provides that if a child requires 1 22 treatment for a biologically based mental illness and meets 1 23 the Medicaid program criteria for PMIC admission, the child 1 24 also meets the acuity criteria for inpatient benefits under 1 25 various types of health care coverage. The term "biologically 1 26 based mental illness" means the same as defined in Code 1 27 section 514C.22, relating to health and accident insurance 1 28 coverages for such illnesses. The bill specifies that the 1 29 inpatient benefits cannot be excluded or denied under that 1 30 Code section as care that is substantially custodial in 1 31 nature. 1 32 LSB 1568HV 83 1 33 jp/rj/8