Senate File 2010 - Introduced SENATE FILE 2010 BY HATCH A BILL FOR An Act relating to home and community-based services under the 1 medical assistance program. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 5235XS (3) 84 pf/nh

S.F. 2010 Section 1. MEDICAL ASSISTANCE PROGRAM —— HOME AND 1 COMMUNITY-BASED SERVICES. 2 1. The department of human services shall submit an 3 application to the centers for Medicare and Medicaid services 4 of the United States department of health and human services 5 to participate in the medical assistance state balancing 6 incentive payments program created pursuant to section 10202 7 of the federal Patient Protection and Affordable Care Act of 8 2010, Pub. L. No. 111-148 (2010), as amended by the Health Care 9 and Education Reconciliation Act of 2010, Pub. L. No. 111-152. 10 If selected for participation in the grant program, the 11 department shall comply with the requirements of the program 12 including developing a no wrong door single entry point system; 13 providing a conflict-free case management system; providing 14 core standardized assessment instruments within six months of 15 submitting the application; and complying with data collection 16 requirements relating to services, quality, and outcomes. No 17 later than October 1, 2015, the department shall meet the 18 applicable target spending percentage required under the state 19 balancing incentive payments program to rebalance long-term 20 care spending under the medical assistance program between home 21 and community-based services and institution-based services. 22 Funding received under the federal grant shall be used for new 23 or expanded medical assistance program noninstitutionally based 24 long-term care services and supports. 25 2. Beginning July 1, 2012, home health care providers under 26 the medical assistance program shall be reimbursed based on the 27 Medicare low utilization payment adjustment methodology rather 28 than a cost-based methodology. 29 EXPLANATION 30 This bill relates to home and community-based services 31 under the medical assistance (Medicaid) program. The bill 32 directs the department of human services (DHS) to submit an 33 application to the centers for Medicare and Medicaid services 34 of the United States department of health and human services to 35 -1- LSB 5235XS (3) 84 pf/nh 1/ 2

S.F. 2010 participate in the medical assistance state balancing incentive 1 payments program created under the federal Patient Protection 2 and Affordable Care Act. If selected for participation in the 3 grant program, DHS is required to comply with the requirements 4 of the program including developing a no wrong door single 5 entry point system; providing a conflict-free case management 6 system; providing core standardized assessment instruments 7 within six months of submitting the application; and complying 8 with data collection requirements relating to services, 9 quality, and outcomes. Additionally, no later than October 1, 10 2015, DHS is required to meet the applicable target spending 11 percentage required under the state balancing incentive 12 payments program to rebalance long-term care spending under the 13 Medicaid program between home and community-based services and 14 institution-based services. Funding received under the federal 15 grant must be used for new or expanded medical assistance 16 program noninstitutionally based long-term care services and 17 supports. 18 The bill also requires that beginning July 1, 2012, home 19 health care providers under the medical assistance program 20 shall be reimbursed based on the Medicare low utilization 21 payment adjustment methodology rather than a cost-based 22 methodology. 23 -2- LSB 5235XS (3) 84 pf/nh 2/ 2