HF 101 (LSB 1253HH (1) 85)

HOUSE FILE 101

BY  HEATON

A BILL FOR

An Act relating to cost report and rate setting procedures for home and community-based services providers under the Medicaid program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  MEDICAID COST REPORT AND RATE SETTING PROCEDURES —— HOME AND COMMUNITY-BASED SERVICES PROVIDERS —— RULES.  The department of human services shall adopt rules pursuant to chapter 17A to provide the following with regard to resolution of cost reports and rate setting for home and community-based services providers under the Medicaid program:
   1.  A request by the department for additional information from a provider following submission of the provider’s cost report shall not affect the total number of days specified in the provider contract for resolution of cost reports. Upon receipt of the additional information, the department shall restart the resolution period beginning with the day after the number of days elapsed prior to the request for additional information, and shall resolve the cost report within the time that remains in the resolution period specified in the provider contract.
   2.  Notwithstanding resolution of a provider’s cost report, a provider’s new rate shall be effective the day after the day that constitutes the end of the time period specified for resolution of cost reports in the provider contract.
EXPLANATION
   This bill relates to cost report and rate setting provisions for Medicaid program home and community-based services providers. The bill directs the department of human services (DHS) to adopt administrative rules to provide that once a provider’s cost report is submitted, a request for additional information by DHS shall not affect the time frame specified in the provider’s contract for resolution of cost reports. Additionally, the rules are to provide that upon receipt of the additional information by DHS, DHS is required to restart the resolution period the day after the number of days elapsed prior to the request for additional information, and resolve the cost report within the time that remains in the resolution period specified in the provider contract.
   With regard to rate setting, the bill directs DHS that notwithstanding resolution of a provider’s cost report, a provider’s new rate is effective the day after the day that constitutes the end of the time period specified in the provider’s contract for resolution of cost reports.