House File 623 - Introduced HOUSE FILE 623 BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO HF 106) A BILL FOR An Act relating to the treatment of medical assistance 1 eligibility for individuals committed to certain public 2 institutions, and including effective date provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1770HV (2) 84 pf/nh

H.F. 623 Section 1. NEW SECTION . 249A.38 Inmates of public 1 institutions —— suspension or termination of medical assistance. 2 1. The following conditions shall apply to an individual who 3 is an inmate of a public institution as defined in 42 C.F.R. 4 § 435.1010, who is enrolled in the medical assistance program 5 at the time of commitment to the public institution, and who 6 is eligible for medical assistance by reason of disability or 7 being sixty-five years of age or older: 8 a. The department shall suspend the individual’s 9 eligibility for up to the initial twelve months of the period 10 of commitment. The department shall delay the suspension 11 of eligibility for a period of up to the first thirty days 12 of commitment if such delay is approved by the centers for 13 Medicare and Medicaid services of the United States department 14 of health and human services. If such delay is not approved, 15 the department shall suspend eligibility during the entirety 16 of the initial twelve months of the period of commitment. 17 Claims submitted on behalf of the individual under the medical 18 assistance program for covered services provided during the 19 delay period shall only be reimbursed if federal financial 20 participation is applicable to such claims. 21 b. The department shall terminate the individual’s 22 eligibility following the initial twelve months of the period 23 of commitment. 24 2. a. A public institution shall provide the department and 25 the social security administration with a monthly report of the 26 individuals who are committed to the public institution and of 27 the individuals who are discharged from the public institution. 28 b. The department shall provide a public institution with 29 the forms necessary to be used by the individual in expediting 30 restoration of the individual’s medical assistance benefits 31 upon discharge from the public institution. 32 3. This section applies to individuals as specified in 33 subsection 1 on or after January 1, 2012. 34 4. The department may adopt rules pursuant to chapter 17A to 35 -1- LSB 1770HV (2) 84 pf/nh 1/ 3

H.F. 623 implement this section. 1 Sec. 2. IMPLEMENTATION. 2 1. The department of human services shall request any 3 waiver or approval necessary from the centers for Medicare and 4 Medicaid services of the United States department of health 5 and human services to provide for the delay in suspension of 6 eligibility as provided in this Act. The department shall 7 implement the delay period to the maximum extent of the federal 8 approval. 9 2. The department of human services shall do all of the 10 following: 11 a. Develop a process for suspension of medical assistance 12 eligibility for individuals as specified in this Act. 13 b. By July 1, 2013, submit recommendations to the general 14 assembly for changes in state law and the redesign of the 15 eligibility information management system in order to maximize 16 and facilitate restoration of medical assistance benefits 17 to inmates of public institutions upon discharge. The 18 recommendations shall incorporate medical assistance program 19 eligibility changes necessitated by the federal Patient 20 Protection and Affordable Care Act, Pub. L. No. 111-148. 21 c. Incorporate provisions for suspension and termination 22 of medical assistance eligibility for inmates of public 23 institutions within any future redesign of the medical 24 assistance program eligibility information management system. 25 Sec. 3. EFFECTIVE UPON ENACTMENT. This Act, being deemed of 26 immediate importance, takes effect upon enactment. 27 EXPLANATION 28 This bill provides for the suspension of medical assistance 29 (Medicaid) benefits of a person who is eligible for Medicaid 30 by reason of disability or being 65 years of age or older, 31 and who received Medicaid benefits immediately prior to the 32 individual’s commitment to a public institution. The duration 33 of the suspension would be for the initial 12-month period of 34 commitment, after which such benefits would be terminated. 35 -2- LSB 1770HV (2) 84 pf/nh 2/ 3

H.F. 623 The bill also provides that if federal approval is received, 1 DHS would delay the suspension for up to the first 30 days of 2 the period of commitment, and that payment of claims under 3 the medical assistance program for the individual during the 4 30-day delay would not be reimbursed if federal financial 5 participation was not applicable to the claim. 6 The bill requires a public institution to provide the 7 department of human services (DHS) and the social security 8 administration with a monthly report of individuals who are 9 committed to or who are discharged from the public institution. 10 DHS is required to provide the public institution with the 11 forms necessary to be used by the individual to expedite 12 restoration of Medicaid benefits upon discharge. 13 The bill applies to individuals on or after January 1, 2012. 14 The bill directs DHS to request a federal waiver or approval 15 for the 30-day delay in the suspension; directs DHS to develop 16 a process for the suspension; directs DHS by July 1, 2013, to 17 submit recommendations to the general assembly for changes 18 in state law and the redesign of the eligibility information 19 management system to maximize and facilitate restoration of 20 Medicaid benefits for inmates of public institutions upon 21 discharge, incorporating the eligibility changes under the 22 federal Patient Protection and Affordable Care Act; and directs 23 DHS to incorporate the suspension and termination provisions in 24 any redesign of the eligibility information management system. 25 The bill takes effect upon enactment. 26 -3- LSB 1770HV (2) 84 pf/nh 3/ 3