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