House File 2120 - Introduced HOUSE FILE 2120 BY MASCHER , RUFF , HUNTER , STAED , JACOBY , KEARNS , STUTSMAN , LENSING , DUNKEL , ABDUL-SAMAD , COHOON , T. TAYLOR , HALL , MEYER , ISENHART , WOLFE , OURTH , BEARINGER , and OLDSON A BILL FOR An Act relating to the submission of a Medicaid state plan 1 amendment for the provision of home and community-based 2 services to elders. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 5142HH (4) 85 pf/nh
H.F. 2120 Section 1. MEDICAID —— SECTION 1915(i) STATE PLAN 1 AMENDMENT —— HOME AND COMMUNITY-BASED SERVICES FOR ELDERS. The 2 department of human services shall convene a workgroup of 3 stakeholders with interest or expertise in issues relating 4 to elders to develop a section 1915(i) medical assistance 5 program state plan amendment in accordance with section 6 2402 of the federal Patient Protection and Affordable Care 7 Act to cover home and community-based services for eligible 8 elders 65 years of age or older. The workgroup shall make 9 recommendations on or before September 1, 2014, relating to 10 financial eligibility; benefits, including whether individuals 11 receiving 1915(i) services should be eligible for full Medicaid 12 benefits; available services; and the needs-based level of 13 care criteria for determination of eligibility under the state 14 plan amendment. The recommendations of the workgroup shall be 15 incorporated into a 1915(i) state plan amendment and submitted 16 by the department of human services to the centers for Medicare 17 and Medicaid services of the United States department of health 18 and human services for approval. 19 EXPLANATION 20 The inclusion of this explanation does not constitute agreement with 21 the explanation’s substance by the members of the general assembly. 22 This bill directs the department of human services (DHS) 23 to convene a workgroup of stakeholders with interest or 24 expertise in issues relating to elders to develop a section 25 1915(i) Medicaid state plan amendment to provide home and 26 community-based services (HCBS) to eligible elders. The 27 workgroup is directed to make recommendations on or before 28 September 1, 2014, relating to financial eligibility; benefits, 29 including whether individuals receiving 1915(i) services should 30 be eligible for full Medicaid benefits; available services; and 31 the needs-based level of care criteria for determination of 32 eligibility under the state plan amendment. The bill directs 33 DHS to incorporate the recommendations of the workgroup into 34 a state plan amendment to be submitted to the centers for 35 -1- LSB 5142HH (4) 85 pf/nh 1/ 2
H.F. 2120 Medicare and Medicaid services of the United States department 1 of health and human services for approval. 2 The 1915(i) state plan amendment option under the federal 3 Patient Protection and Affordable Care Act (ACA) allows states 4 to provide HCBS to eligible individuals without requiring 5 the individuals to meet the institutional level of care 6 criteria. Rather, an individual must meet a needs-based 7 criteria specified by the state that is less restrictive 8 than the state’s institutional level of care criteria. The 9 ACA provision also allows states to expand the scope of 10 allowable services; allows states to provide a specific set 11 of HCBS benefits to a targeted population group; allows the 12 use of increased income eligibility up to 300 percent of the 13 supplemental security income (SSI) federal benefit level; and 14 allows states to provide full Medicaid state plan benefits to 15 those eligible for the 1915(i) HCBS option. Because the HCBS 16 option is based on a state plan amendment rather than a waiver, 17 the HCBS must be offered to all eligible individuals on a 18 statewide basis. The state cannot limit the number of eligible 19 individuals, establish a waiting list for these individuals, or 20 limit services to only specified areas of the state. 21 -2- LSB 5142HH (4) 85 pf/nh 2/ 2