SENATE FILE 2010

BY  HATCH

A BILL FOR

An Act relating to home and community-based services under the medical assistance program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  MEDICAL ASSISTANCE PROGRAM —— HOME AND COMMUNITY-BASED SERVICES.
   1.  The department of human services shall submit an application to the centers for Medicare and Medicaid services of the United States department of health and human services to participate in the medical assistance state balancing incentive payments program created pursuant to section 10202 of the federal Patient Protection and Affordable Care Act of 2010, Pub. L. No. 111-148 (2010), as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152. If selected for participation in the grant program, the department shall comply with the requirements of the program including developing a no wrong door single entry point system; providing a conflict-free case management system; providing core standardized assessment instruments within six months of submitting the application; and complying with data collection requirements relating to services, quality, and outcomes. No later than October 1, 2015, the department shall meet the applicable target spending percentage required under the state balancing incentive payments program to rebalance long-term care spending under the medical assistance program between home and community-based services and institution-based services. Funding received under the federal grant shall be used for new or expanded medical assistance program noninstitutionally based long-term care services and supports. 
   2.  Beginning July 1, 2012, home health care providers under the medical assistance program shall be reimbursed based on the Medicare low utilization payment adjustment methodology rather than a cost-based methodology.
EXPLANATION
   This bill relates to home and community-based services under the medical assistance (Medicaid) program. The bill directs the department of human services (DHS) to submit an application to the centers for Medicare and Medicaid services of the United States department of health and human services to participate in the medical assistance state balancing incentive payments program created under the federal Patient Protection and Affordable Care Act. If selected for participation in the grant program, DHS is required to comply with the requirements of the program including developing a no wrong door single entry point system; providing a conflict-free case management system; providing core standardized assessment instruments within six months of submitting the application; and complying with data collection requirements relating to services, quality, and outcomes. Additionally, no later than October 1, 2015, DHS is required to meet the applicable target spending percentage required under the state balancing incentive payments program to rebalance long-term care spending under the Medicaid program between home and community-based services and institution-based services. Funding received under the federal grant must be used for new or expanded medical assistance program noninstitutionally based long-term care services and supports.
   The bill also requires that beginning July 1, 2012, home health care providers under the medical assistance program shall be reimbursed based on the Medicare low utilization payment adjustment methodology rather than a cost-based methodology.