House File 82 - Introduced HOUSE FILE 82 BY DE BOEF , LOFGREN , CHAMBERS , HUSEMAN , IVERSON , FORRISTALL , RAYHONS , DRAKE , GARRETT , WORTHAN , PAUSTIAN , FRY , SANDS , DOLECHECK , BALTIMORE , SWEENEY , HAGER , SHAW , PEARSON , ALONS , MASSIE , and HELLAND A BILL FOR An Act concerning rules relating to copayments and other 1 information regarding services provided to medical 2 assistance recipients. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1405YH (4) 84 pf/nh

H.F. 82 Section 1. ADMINISTRATIVE RULES —— COPAYMENTS FOR CERTAIN 1 SERVICES PROVIDED UNDER THE MEDICAL ASSISTANCE PROGRAM. The 2 department of human services shall adopt or amend rules under 3 the medical assistance program to provide for all of the 4 following: 5 1. A copayment charge shall not be applicable for a 6 recipient of care as an inpatient at a hospital, nursing 7 facility, state mental health institute, or other medical 8 institution if the person is required, as a condition of 9 receiving services in the hospital, facility, or institution, 10 to spend for costs of necessary medical care all but a minimal 11 amount of income for personal needs. 12 2. A copayment charge of five dollars shall be applicable 13 for all covered services rendered in a hospital emergency 14 room if the medical condition does not result in an inpatient 15 admission to the hospital at the time of the emergency room 16 visit or at a subsequent time. 17 3. The eligibility card of any recipient of medical 18 assistance twenty-one years of age or older shall include a 19 statement regarding the copayment charge for office visits and 20 emergency room visits. 21 4. Any Medipass program card shall include a statement 22 informing the recipient that the recipient must see the doctor 23 whose name is printed on the card or receive a referral from 24 such doctor in order to receive coverage for nonemergent 25 medical services. 26 EXPLANATION 27 This bill directs the department of human services to adopt 28 or amend rules for the medical assistance program to provide 29 for all of the following: 30 1. That a copayment charge shall not be applicable for 31 a recipient of care as an inpatient at a hospital, nursing 32 facility, state mental health institute, or other medical 33 institution if the person is required, as a condition of 34 receiving services in the hospital, facility, or institution, 35 -1- LSB 1405YH (4) 84 pf/nh 1/ 2

H.F. 82 to spend for costs of necessary medical care all but a 1 minimal amount of income for personal needs. Current rules 2 provide that a copayment does not apply to such care in such 3 facilities, but does not specify that the copayment is only not 4 applicable to care provided to an individual as an inpatient. 5 2. A copayment charge of $5 for all covered services 6 rendered in a hospital emergency room if the medical condition 7 does not result in an inpatient admission to the hospital at 8 the time of the emergency room visit or at a subsequent time. 9 Current rules provide that copayment charges are not applicable 10 for emergency services. 11 3. The eligibility card of any recipient of medical 12 assistance 21 years of age or older is to include a statement 13 of the copayment charge for office visits and emergency room 14 visits. 15 4. A Medipass program card is to include a statement 16 informing the recipient that the recipient must see the doctor 17 whose name is printed on the card or receive a referral from 18 such doctor in order to receive coverage for nonemergent 19 medical services. 20 -2- LSB 1405YH (4) 84 pf/nh 2/ 2