Senate
Study
Bill
1172
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
STATE
GOVERNMENT
BILL
BY
CHAIRPERSON
DANIELSON)
A
BILL
FOR
An
Act
relating
to
licensure
of
durable
medical
equipment
1
providers,
providing
penalties,
and
including
effective
date
2
and
implementation
provisions.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
TLSB
1109XC
(3)
86
tr/nh
S.F.
_____
Section
1.
Section
147.1,
subsections
3
and
6,
Code
2015,
1
are
amended
to
read
as
follows:
2
3.
“Licensed”
or
“certified”
,
when
applied
to
a
physician
3
and
surgeon,
podiatric
physician,
osteopathic
physician
and
4
surgeon,
physician
assistant,
psychologist,
chiropractor,
5
nurse,
dentist,
dental
hygienist,
dental
assistant,
6
optometrist,
speech
pathologist,
audiologist,
pharmacist,
7
physical
therapist,
physical
therapist
assistant,
occupational
8
therapist,
occupational
therapy
assistant,
orthotist,
9
prosthetist,
pedorthist,
respiratory
care
practitioner,
10
practitioner
of
cosmetology
arts
and
sciences,
practitioner
11
of
barbering,
funeral
director,
dietitian,
marital
and
family
12
therapist,
mental
health
counselor,
social
worker,
massage
13
therapist,
athletic
trainer,
acupuncturist,
nursing
home
14
administrator,
hearing
aid
dispenser,
durable
medical
equipment
15
provider,
or
sign
language
interpreter
or
transliterator
means
16
a
person
licensed
under
this
subtitle
.
17
6.
“Profession”
means
medicine
and
surgery,
podiatry,
18
osteopathic
medicine
and
surgery,
practice
as
a
physician
19
assistant,
psychology,
chiropractic,
nursing,
dentistry,
20
dental
hygiene,
dental
assisting,
optometry,
speech
pathology,
21
audiology,
pharmacy,
physical
therapy,
physical
therapist
22
assisting,
occupational
therapy,
occupational
therapy
23
assisting,
respiratory
care,
cosmetology
arts
and
sciences,
24
barbering,
mortuary
science,
marital
and
family
therapy,
mental
25
health
counseling,
social
work,
dietetics,
massage
therapy,
26
athletic
training,
acupuncture,
nursing
home
administration,
27
hearing
aid
dispensing,
durable
medical
equipment
providing,
28
sign
language
interpreting
or
transliterating,
orthotics,
29
prosthetics,
or
pedorthics.
30
Sec.
2.
Section
147.2,
subsection
1,
Code
2015,
is
amended
31
to
read
as
follows:
32
1.
A
person
shall
not
engage
in
the
practice
of
medicine
33
and
surgery,
podiatry,
osteopathic
medicine
and
surgery,
34
psychology,
chiropractic,
physical
therapy,
physical
35
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therapist
assisting,
nursing,
dentistry,
dental
hygiene,
1
dental
assisting,
optometry,
speech
pathology,
audiology,
2
occupational
therapy,
occupational
therapy
assisting,
3
orthotics,
prosthetics,
pedorthics,
respiratory
care,
4
pharmacy,
cosmetology
arts
and
sciences,
barbering,
social
5
work,
dietetics,
marital
and
family
therapy
or
mental
health
6
counseling,
massage
therapy,
mortuary
science,
athletic
7
training,
acupuncture,
nursing
home
administration,
hearing
8
aid
dispensing,
durable
medical
equipment
providing,
or
sign
9
language
interpreting
or
transliterating,
or
shall
not
practice
10
as
a
physician
assistant,
unless
the
person
has
obtained
a
11
license
for
that
purpose
from
the
board
for
the
profession.
12
Sec.
3.
Section
147.13,
Code
2015,
is
amended
by
adding
the
13
following
new
subsection:
14
NEW
SUBSECTION
.
25.
For
durable
medical
equipment
15
providers,
the
board
of
durable
medical
equipment
providers.
16
Sec.
4.
Section
147.14,
subsection
1,
Code
2015,
is
amended
17
by
adding
the
following
new
paragraph:
18
NEW
PARAGRAPH
.
x.
For
durable
medical
equipment
providers,
19
seven
licensed
durable
medical
equipment
providers.
20
Sec.
5.
NEW
SECTION
.
154G.1
Definitions.
21
For
purposes
of
this
chapter:
22
1.
“Accrediting
organization”
means
any
organization
23
recognized
by
the
centers
for
Medicare
and
Medicaid
services
of
24
the
United
States
department
of
health
and
human
services
as
an
25
accreditation
body
for
durable
medical
equipment
providers.
26
2.
“Affiliated
person”
means
any
person
who
directly
or
27
indirectly
manages,
controls,
or
oversees
the
operation
of
28
a
corporation
or
other
business
entity
that
is
a
licensee,
29
regardless
of
whether
such
person
is
a
partner,
shareholder,
30
owner,
officer,
director,
agent,
or
employee
of
the
entity.
31
3.
“Applicant”
means
an
individual
applicant
in
the
case
of
32
a
sole
proprietorship
or
any
officer,
director,
agent,
managing
33
employee,
general
manager,
or
affiliated
person
or
any
partner
34
or
shareholder
having
an
ownership
interest
equal
to
five
35
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percent
or
greater
in
the
corporation
or
other
business
entity.
1
4.
“Board”
means
the
board
of
durable
medical
equipment
2
providers.
3
5.
“Consumer”
or
“patient”
means
a
person
who
uses
durable
4
medical
equipment
in
the
person’s
residence.
5
6.
“Durable
medical
equipment”
means
any
product
reimbursed
6
under
Medicare
part
B
durable
medical
equipment
benefits
and
7
any
product
as
defined
by
the
federal
Food,
Drug,
and
Cosmetic
8
Act
or
reimbursable
under
Medicaid
as
provided
by
the
board
by
9
rule.
“Durable
medical
equipment”
includes
but
is
not
limited
10
to
hospital
beds,
oxygen,
walkers,
continuous
positive
airway
11
pressure
machines,
customized
wheelchairs,
and
related
seating
12
and
positioning
devices,
but
does
not
include
prosthetics
or
13
orthotics
or
any
splints,
braces,
or
aids
custom-fabricated
by
14
a
licensed
health
care
practitioner.
15
7.
“Durable
medical
equipment
provider”
means
a
person
or
16
entity
that
sells
or
rents,
or
offers
to
sell
or
rent,
to
or
17
for
a
consumer
any
durable
medical
equipment
or
durable
medical
18
equipment
services.
19
8.
“Durable
medical
equipment
provider
personnel”
means
20
persons
who
are
employed
by
or
under
contract
with
a
durable
21
medical
equipment
provider.
22
9.
“Durable
medical
equipment
services”
means
equipment
23
management
and
consumer
instruction,
including
selection,
24
delivery,
setup,
and
maintenance
of
equipment
and
other
related
25
services
for
the
use
of
durable
medical
equipment
in
the
26
consumer’s
regular
or
temporary
residence.
27
10.
“General
manager”
means
the
individual
who
has
the
28
general
administrative
charge
of
the
premises
of
a
licensed
29
durable
medical
equipment
provider.
30
11.
“Licensee”
means
the
person
or
entity
to
whom
a
license
31
to
operate
as
a
durable
medical
equipment
provider
is
issued
32
by
the
board.
33
12.
“Moratorium”
means
a
mandated
temporary
cessation
or
34
suspension
of
the
sale,
rental,
or
offering
of
durable
medical
35
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_____
equipment,
except
that
services
related
to
durable
medical
1
equipment
sold
or
rented
prior
to
the
moratorium
shall
be
2
continued
without
interruption,
unless
ordered
otherwise
by
the
3
board.
4
13.
“Premises”
means
those
buildings
and
equipment
which
5
are
located
at
the
address
of
the
licensed
durable
medical
6
equipment
provider
for
the
provision
of
durable
medical
7
equipment
services
which
are
in
such
reasonable
proximity
as
to
8
appear
to
the
public
to
be
a
single
provider
location.
9
14.
“Residence”
means
a
consumer’s
home
or
place
of
10
residence,
which
may
include
a
nursing
home
as
defined
in
11
section
155.1,
assisted
living
program
as
defined
in
section
12
231C.2,
elder
group
home
as
defined
in
section
231B.1,
13
transitional
living
facility,
or
other
congregate
residential
14
facility.
15
15.
“Retail
sale”
means
a
sale
or
rental
of
durable
medical
16
equipment
directly
to
a
consumer
which
does
not
require
a
17
prescription
or
billing
of
Medicare,
Medicaid,
or
any
other
18
third-party
insurance.
19
Sec.
6.
NEW
SECTION
.
154G.2
License
required
——
exemptions.
20
1.
A
person
shall
not
do
any
of
the
following
without
21
obtaining
a
license
from
the
board
under
this
chapter:
22
a.
Hold
oneself
out
to
the
public
as
providing
durable
23
medical
equipment
or
durable
medical
equipment
services
or
24
accept
physician
orders
for
durable
medical
equipment
or
25
durable
medical
equipment
services.
26
b.
Hold
oneself
out
to
the
public
as
providing
durable
27
medical
equipment
that
typically
requires
durable
medical
28
equipment
services.
29
c.
Provide
durable
medical
equipment
or
durable
medical
30
equipment
services
to
consumers
in
this
state.
31
2.
A
separate
license
is
required
for
all
durable
medical
32
equipment
providers
operating
on
separate
premises,
even
if
33
the
providers
are
operating
under
the
same
management.
For
34
each
location
a
provider
operates,
an
initial
inspection
by
the
35
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_____
board
pursuant
to
section
154G.9
shall
be
required
to
obtain
1
a
license.
2
3.
The
following
persons
are
exempt
from
durable
medical
3
equipment
provider
licensure
unless
the
person
operates
a
4
separate
company,
corporation,
or
division
that
is
in
the
5
business
of
providing
durable
medical
equipment
and
services
6
for
sale
or
rent
to
consumers
at
their
regular
or
temporary
7
place
of
residence
pursuant
to
the
provisions
of
this
chapter:
8
a.
Durable
medical
equipment
providers
operated
by
the
9
federal
government.
10
b.
Nursing
homes
as
defined
in
section
155.1.
11
c.
Assisted
living
programs
as
defined
in
section
231C.2.
12
d.
Home
health
agencies
as
defined
in
42
C.F.R.
pt.
484.
13
e.
Hospice
programs
as
defined
in
section
135J.1.
14
f.
Intermediate
care
facilities
for
persons
with
15
intellectual
disabilities
or
mental
illnesses
as
defined
in
16
section
135C.1.
17
g.
Homes
for
special
services.
18
h.
Transitional
living
facilities.
19
i.
Hospitals
licensed
pursuant
to
chapter
135B.
20
j.
Ambulatory
surgical
centers.
21
k.
Manufacturers
and
wholesale
distributors
when
not
selling
22
directly
to
consumers.
23
l.
Licensed
health
care
practitioners
who
utilize
durable
24
medical
equipment
in
the
course
of
their
practice,
but
do
not
25
sell
or
rent
durable
medical
equipment
to
their
patients.
26
m.
Pharmacies
licensed
pursuant
to
chapter
155A.
27
n.
Any
durable
medical
equipment
provider
who
only
provides
28
items
for
retail
sale.
29
4.
A
person
shall
not
offer
or
advertise
durable
medical
30
equipment
or
durable
medical
equipment
services
to
the
public
31
unless
such
person
has
a
valid
license
under
this
chapter
or
is
32
exempted
from
licensure
under
subsection
3.
A
person
holding
33
a
license
issued
under
this
chapter
shall
not
advertise
or
34
indicate
to
the
public
that
the
person
holds
a
durable
medical
35
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_____
equipment
provider
license
other
than
the
license
the
person
1
has
been
issued.
2
Sec.
7.
NEW
SECTION
.
154G.3
Principal
place
of
business
3
out
of
state.
4
A
durable
medical
equipment
provider
that
provides
durable
5
medical
equipment
or
durable
medical
equipment
services
6
to
persons
in
this
state
and
that
has
a
principal
place
of
7
business
outside
this
state
shall
maintain
an
office
or
place
8
of
business
within
this
state
unless
the
principal
place
of
9
business
is
located
in
a
bordering
state,
is
within
fifty
miles
10
of
a
border
with
this
state,
and
meets
the
other
requirements
11
of
this
chapter.
12
Sec.
8.
NEW
SECTION
.
154G.4
Accreditation.
13
A
durable
medical
equipment
provider
accredited
by
an
14
accrediting
organization
may
submit
documents
to
the
board
15
evidencing
current
accreditation
and
shall
be
presumed
to
16
comply
with
the
licensing
requirements
of
this
chapter.
17
Licensing
of
a
durable
medical
equipment
provider
that
has
18
been
accredited
by
an
accrediting
organization
shall
become
19
effective
upon
written
notification
from
the
board
that
the
20
accreditation
meets
the
standards
set
out
in
rules
adopted
by
21
the
board.
22
Sec.
9.
NEW
SECTION
.
154G.5
License
application
——
renewal
23
——
duplicates
——
fees.
24
1.
An
application
for
an
initial
license
or
for
renewal
of
25
an
existing
license
shall
be
made
under
oath
to
the
board
on
26
forms
furnished
by
the
board
and
must
be
accompanied
by
the
27
appropriate
license
fee
as
established
by
the
board
by
rule.
28
2.
The
applicant
shall
file
with
the
application
29
information
demonstrating
that
the
applicant
is
in
compliance
30
with
this
chapter
and
applicable
rules.
Such
information
shall
31
include
the
following:
32
a.
A
report
specifying
by
category
the
durable
medical
33
equipment
to
be
provided
and
indicating
the
durable
medical
34
equipment
offered
either
directly
by
the
applicant
or
through
35
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contractual
arrangements
with
existing
durable
medical
1
equipment
providers.
Categories
of
equipment
include
but
are
2
not
limited
to
the
following:
3
(1)
Respiratory
modalities.
4
(2)
Ambulation
aids.
5
(3)
Mobility
aids.
6
(4)
Sickroom
setup.
7
(5)
Disposables.
8
b.
A
report
specifying
by
category
the
durable
medical
9
equipment
services
to
be
provided
and
indicating
those
offered
10
either
directly
by
the
applicant
or
through
contractual
11
arrangements
with
existing
providers.
Categories
of
services
12
include
but
are
not
limited
to
the
following:
13
(1)
Intake.
14
(2)
Equipment
selection.
15
(3)
Delivery.
16
(4)
Setup
and
installation.
17
(5)
Patient
training.
18
(6)
Ongoing
service
and
maintenance.
19
(7)
Retrieval.
20
c.
A
list
of
those
persons
with
whom
the
applicant
contracts
21
to
provide
durable
medical
equipment
or
durable
medical
22
equipment
services
to
its
consumers
and
those
persons
for
whom
23
the
applicant
provides
durable
medical
equipment
or
durable
24
medical
equipment
services.
25
d.
A
description
and
explanation
of
any
exclusions,
26
permanent
suspensions,
or
terminations
of
the
applicant
27
from
the
Medicare
or
medical
assistance
program.
Proof
28
of
compliance
with
the
disclosure
of
ownership
and
control
29
interest
requirements
of
the
Medicare
or
medical
assistance
30
program
shall
be
accepted
in
lieu
of
this
submission.
31
e.
A
description
and
explanation
of
any
felony
committed
32
by
a
member
of
the
board
of
directors
of
the
applicant,
its
33
officers,
or
any
individual
owning
five
percent
or
more
of
the
34
applicant.
This
requirement
does
not
apply
to
a
director
of
35
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a
not-for-profit
corporation
or
organization
if
the
director
1
serves
solely
in
a
voluntary
capacity
for
the
corporation
or
2
organization,
does
not
regularly
take
part
in
the
day-to-day
3
operational
decisions
of
the
corporation
or
organization,
4
receives
no
remuneration
for
such
director’s
services
on
the
5
corporation’s
or
organization’s
board
of
directors,
and
has
6
no
financial
interest
and
no
family
members
with
a
financial
7
interest
in
the
corporation
or
organization,
provided
that
the
8
director
and
the
not-for-profit
corporation
or
organization
9
include
in
the
application
a
statement
affirming
that
the
10
director’s
relationship
to
the
corporation
satisfies
the
11
requirements
of
this
paragraph.
12
3.
An
applicant
for
initial
licensure
shall
demonstrate
13
financial
ability
to
operate,
which
may
be
accomplished
by
the
14
submission
of
a
surety
bond
in
the
amount
of
fifty
thousand
15
dollars
to
the
board.
An
existing
surety
bond
for
Medicare
16
credentialing
held
by
the
applicant
shall
be
sufficient
in
lieu
17
of
an
additional
bond.
18
4.
An
applicant
for
license
renewal
who
has
demonstrated
19
financial
inability
to
operate
shall
demonstrate
financial
20
ability
to
operate
before
the
board
may
renew
the
applicant’s
21
license.
22
5.
The
board
shall
initiate
a
criminal
background
check
of
23
the
applicant
upon
receipt
of
a
completed,
signed,
and
dated
24
application.
As
used
in
this
subsection,
“applicant”
means
the
25
general
manager
and
the
financial
officer
or
similarly
titled
26
individual
who
is
responsible
for
the
financial
operation
of
27
the
durable
medical
equipment
provider.
28
a.
The
applicant
shall
supply
fingerprint
samples
or
29
submit
to
a
criminal
history
records
check
to
be
conducted
30
by
the
division
of
criminal
investigation
of
the
department
31
of
public
safety.
Any
costs
incurred
by
the
division
of
32
criminal
investigation
of
the
department
of
public
safety
in
33
conducting
such
investigation
of
an
applicant
shall
be
paid
by
34
the
potential
licensee.
35
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_____
b.
The
board
may
require
a
criminal
background
check
for
a
1
member
of
the
board
of
directors
of
the
potential
licensee
or
2
an
officer
or
an
individual
owning
five
percent
or
more
of
the
3
potential
licensee
if
the
board
has
probable
cause
to
believe
4
that
such
individual
has
been
convicted
of
a
felony.
5
6.
The
board
shall
not
issue
a
license
to
an
applicant
if
6
the
applicant
or
an
administrator
or
financial
officer
of
the
7
durable
medical
equipment
provider
has
been
found
guilty
of
or
8
has
entered
a
plea
of
nolo
contendere
or
guilty
to
any
felony.
9
7.
Proof
of
professional
and
commercial
liability
insurance
10
shall
be
submitted
with
the
application.
The
board
shall
11
set
the
required
amounts
of
liability
insurance
by
rule,
12
but
the
required
amount
shall
not
be
less
than
two
hundred
13
fifty
thousand
dollars
per
claim.
In
the
case
of
contracted
14
services,
the
contractor
shall
have
liability
insurance
of
not
15
less
than
two
hundred
fifty
thousand
dollars
per
claim.
16
8.
Ninety
days
before
the
expiration
date
of
a
license,
the
17
durable
medical
equipment
provider
shall
submit
an
application
18
for
license
renewal
to
the
board
under
oath
on
forms
furnished
19
by
the
board.
The
license
shall
be
renewed
if
the
applicant
20
has
met
the
requirements
established
under
this
chapter
and
21
applicable
rules.
The
durable
medical
equipment
provider
must
22
file
with
the
application
satisfactory
proof
that
it
is
in
23
compliance
with
this
chapter
and
applicable
rules.
The
durable
24
medical
equipment
provider
must
submit
satisfactory
proof
of
25
its
financial
ability
to
comply
with
the
requirements
of
this
26
chapter.
27
9.
When
a
duplicate
license
is
issued,
a
fee
shall
be
28
assessed
not
exceeding
the
actual
cost
of
duplicating
and
29
mailing
the
duplicate
license.
30
10.
The
license
must
be
displayed
in
a
conspicuous
place
31
in
the
administrative
office
of
the
durable
medical
equipment
32
provider
and
is
valid
only
while
in
the
possession
of
the
33
person
or
entity
to
which
it
is
issued.
The
license
may
34
not
be
sold,
assigned,
or
otherwise
transferred,
voluntarily
35
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_____
or
involuntarily,
and
is
valid
only
for
the
durable
medical
1
equipment
provider
and
location
for
which
originally
issued.
2
11.
All
license
fees
required
of
a
durable
medical
equipment
3
provider
are
nonrefundable.
The
board
shall
set
license
4
renewal
fees
by
rule
sufficient
to
cover
its
costs
in
carrying
5
out
its
responsibilities.
6
12.
State,
county,
or
municipal
governments
applying
for
7
licenses
under
this
chapter
are
exempt
from
the
payment
of
8
license
fees.
9
13.
An
applicant
for
initial
licensure,
or
following
a
10
change
of
ownership
as
described
in
section
154G.6,
shall
pay
11
a
license
processing
fee
not
to
exceed
three
hundred
dollars
12
and
an
inspection
fee
not
to
exceed
four
hundred
dollars
to
be
13
paid
by
all
applicants
except
those
not
subject
to
licensure
14
inspection
by
the
board.
15
Sec.
10.
NEW
SECTION
.
154G.6
Provisional
licenses
——
change
16
of
ownership.
17
1.
A
provisional
license
shall
be
issued
by
the
board
18
to
an
approved
applicant
for
initial
licensure
for
a
period
19
of
ninety
days.
During
that
time,
the
board
shall
conduct
20
an
investigation
to
determine
substantial
compliance,
as
21
determined
by
the
board,
with
the
requirements
of
section
22
154G.5,
including
any
determination
to
be
made
by
the
board
23
pending
the
outcome
of
the
criminal
background
check
performed
24
pursuant
to
section
154G.5,
subsection
5.
If
substantial
25
compliance
is
demonstrated,
a
license
shall
be
issued,
to
26
expire
two
years
after
the
effective
date
of
the
provisional
27
license.
28
2.
A
durable
medical
equipment
provider
against
whom
a
29
proceeding
by
the
board
for
revocation
or
suspension
or
for
30
denial
of
a
renewal
application
is
pending
may
be
issued
a
31
provisional
license
effective
until
final
disposition
of
such
32
proceedings.
If
judicial
relief
is
sought
from
the
final
33
disposition,
the
court
that
has
jurisdiction
may
direct
the
34
board
to
issue
a
provisional
license
for
the
duration
of
the
35
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_____
judicial
proceeding.
1
3.
a.
When
a
change
of
ownership
of
a
durable
medical
2
equipment
provider
occurs,
the
prospective
owner
shall
submit
3
an
initial
application
for
a
license
to
the
board
at
least
4
fifteen
days
before
the
effective
date
of
the
change
of
5
ownership.
An
application
for
change
of
ownership
of
a
license
6
is
required
when
ownership,
a
majority
of
the
ownership,
or
7
controlling
interest
of
a
licensed
durable
medical
equipment
8
provider
is
transferred
or
assigned
and
when
the
prospective
9
owner
agrees
to
undertake
or
provide
services
to
the
extent
10
that
legal
liability
for
operation
of
the
durable
medical
11
equipment
provider
rests
with
the
prospective
owner.
12
b.
A
provisional
license
shall
be
issued
to
the
new
owner
13
for
a
period
of
ninety
days
during
which
time
all
required
14
documentation
must
be
submitted
and
an
investigation
must
15
be
conducted
demonstrating
substantial
compliance
with
this
16
section.
If
substantial
compliance
is
demonstrated
a
license
17
shall
be
issued,
to
expire
two
years
after
the
issuance
of
the
18
provisional
license.
19
4.
a.
When
a
change
of
the
general
manager
of
a
durable
20
medical
equipment
provider
occurs,
the
licensee
shall
notify
21
the
board
of
the
change
within
forty-five
days
and
shall
22
provide
evidence
of
compliance
with
the
background
check
23
requirements
in
section
154G.5,
subsection
5.
24
b.
A
general
manager
who
has
met
the
standards
for
the
abuse
25
registry
background
check
and
the
criminal
background
check,
26
but
for
whom
background
screening
results
from
the
division
of
27
criminal
investigation
of
the
department
of
public
safety
have
28
not
yet
been
received,
may
be
employed
pending
receipt
of
the
29
division
of
criminal
investigation
of
the
department
of
public
30
safety
background
screening
report.
31
5.
When
a
change
is
reported
which
requires
issuance
of
a
32
license,
the
board
shall
assess
a
fee.
The
fee
must
be
based
on
33
the
actual
cost
of
processing
and
issuing
the
license.
34
Sec.
11.
NEW
SECTION
.
154G.7
Standards.
35
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_____
The
following
standards
shall
govern
the
manner
in
which
a
1
licensed
durable
medical
equipment
provider
operates:
2
1.
A
licensed
durable
medical
equipment
provider
must
be
in
3
compliance
with
all
applicable
federal
and
state
licensure
and
4
regulatory
requirements.
5
2.
A
licensed
durable
medical
equipment
provider
must
honor
6
all
warranties
under
applicable
law.
7
3.
A
licensed
durable
medical
equipment
provider
must
8
maintain
a
physical
facility
on
an
appropriate
site
and
must
9
maintain
a
visible
sign
with
posted
hours
of
operation.
The
10
location
must
be
accessible
to
the
public
and
staffed
during
11
posted
hours
of
business.
The
location
must
be
at
least
two
12
hundred
square
feet
and
contain
space
for
storing
records.
13
4.
A
licensed
durable
medical
equipment
provider
must
14
maintain
a
primary
business
telephone
number
listed
under
15
the
name
of
the
business
in
a
local
directory
or
a
toll-free
16
telephone
number
available
through
directory
assistance.
17
The
exclusive
use
of
a
beeper,
answering
machine,
answering
18
service,
or
cell
phone
during
posted
business
hours
is
19
prohibited.
20
5.
A
licensed
durable
medical
equipment
provider
shall
21
furnish
the
board
any
information
required
under
state
law.
22
6.
A
licensed
durable
medical
equipment
provider
must
23
notify
the
accrediting
organization
for
the
durable
medical
24
equipment
provider
when
a
new
location
is
opened.
25
7.
All
durable
medical
equipment
provider
locations,
26
whether
owned
or
subcontracted,
must
adhere
to
the
standards
27
established
pursuant
to
this
section
and
be
separately
28
accredited
in
order
to
comply
with
licensure
requirements.
29
8.
A
licensed
durable
medical
equipment
provider
must
30
disclose
to
the
board
upon
application
for
a
license
all
31
products
and
services,
including
the
addition
of
new
product
32
lines
for
which
the
durable
medical
equipment
provider
is
33
seeking
accreditation.
34
9.
A
licensed
durable
medical
equipment
provider
must
35
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_____
remain
open
to
the
public
for
at
least
thirty
hours
per
week.
1
Sec.
12.
NEW
SECTION
.
154G.8
Duties.
2
A
licensed
durable
medical
equipment
provider
shall
do
all
3
of
the
following:
4
1.
Offer
and
provide
durable
medical
equipment
to
consumers
5
and
offer
and
provide
durable
medical
equipment
services,
as
6
necessary,
to
consumers
who
purchase
or
rent
equipment
that
7
requires
such
services.
8
2.
Provide
at
least
one
category
of
durable
medical
9
equipment
directly
by
filling
orders
from
its
own
inventory.
10
3.
Respond
to
orders
received
for
durable
medical
equipment
11
by
filling
those
orders
from
its
own
inventory
or
inventory
12
from
other
companies
with
which
it
has
contracted
to
fill
such
13
orders,
or
customizing
or
fitting
items
for
sale
from
supplies
14
purchased
under
contract.
15
4.
Maintain
trained
durable
medical
equipment
provider
16
personnel
to
coordinate
order
fulfillment
and
schedule
timely
17
durable
medical
equipment
and
durable
medical
equipment
service
18
delivery.
19
5.
As
necessary
in
relation
to
the
sophistication
of
20
the
durable
medical
equipment
and
durable
medical
equipment
21
services
being
provided:
22
a.
Ensure
that
delivery
personnel
are
appropriately
23
trained
to
conduct
an
environment
and
equipment
compatibility
24
assessment.
25
b.
Appropriately
and
safely
set
up
the
durable
medical
26
equipment.
27
c.
Instruct
patients
and
caregivers
in
the
safe
operation
28
and
client
maintenance
of
the
durable
medical
equipment.
29
d.
Recognize
when
additional
education
or
follow-up
patient
30
compliance
monitoring
is
appropriate.
31
Sec.
13.
NEW
SECTION
.
154G.9
Inspections.
32
1.
The
board
shall
make
or
cause
to
be
made
such
inspections
33
and
investigations
of
a
durable
medical
equipment
provider
as
34
it
considers
necessary,
including:
35
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_____
a.
Licensure
inspections.
1
b.
Inspections
directed
by
the
centers
for
Medicare
and
2
Medicaid
services
of
the
United
States
department
of
health
and
3
human
services.
4
c.
Licensure
complaint
investigations,
including
5
full
licensure
investigations
with
a
review
of
all
6
licensure
standards
as
outlined
in
rules
adopted
by
the
7
board.
Complaints
received
by
the
board
from
individuals,
8
organizations,
or
other
sources
are
subject
to
review
and
9
investigation
by
the
board.
10
2.
The
board
shall
accept,
in
lieu
of
its
own
periodic
11
inspections
for
licensure,
submission
of
a
survey
or
inspection
12
of
an
accrediting
organization,
provided
the
accreditation
13
of
the
licensed
durable
medical
equipment
provider
is
not
14
provisional
and
provided
the
licensed
durable
medical
equipment
15
provider
authorizes
release
of,
and
the
board
receives
the
16
report
of,
the
accrediting
organization.
17
Sec.
14.
NEW
SECTION
.
154G.10
License
denial,
revocation,
18
or
suspension.
19
1.
The
board
may
deny,
revoke,
or
suspend
a
license,
or
20
impose
a
civil
penalty
not
to
exceed
five
thousand
dollars
per
21
violation
per
day
in
accordance
with
this
section.
22
2.
Either
of
the
following
actions
by
a
durable
medical
23
equipment
provider
or
any
of
its
employees
is
grounds
for
24
administrative
action
or
imposition
of
civil
penalties
by
the
25
board:
26
a.
Violation
of
this
chapter
or
rules
adopted
pursuant
to
27
this
chapter.
28
b.
An
intentional,
reckless,
or
negligent
act
that
29
materially
affects
the
health
or
safety
of
a
patient.
30
3.
The
board
may
deny
licensure
to
an
applicant
or
revoke
31
the
license
of
a
licensee
who
does
any
of
the
following:
32
a.
Makes
or
previously
made
a
false
representation
or
33
omission
of
any
material
fact
in
an
application,
including
the
34
submission
of
an
application
that
conceals
the
applicant’s
35
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_____
controlling
or
ownership
interest,
or
any
officer,
director,
1
agent,
managing
employee,
affiliated
person,
partner,
or
2
shareholder
who
may
not
be
eligible
to
participate.
3
b.
Has
been
previously
found
by
any
board
created
under
4
chapter
147
to
have
violated
the
standards
or
conditions
5
relating
to
licensure
or
certification
or
the
quality
of
6
services
provided.
7
c.
Has
been
or
is
currently
excluded,
suspended,
or
8
terminated
from,
or
has
involuntarily
withdrawn
from,
9
participation
in
any
state
Medicaid
program,
the
Medicare
10
program,
or
any
other
governmental
or
private
health
care
or
11
health
insurance
program.
12
4.
The
board
may
issue
an
emergency
order
immediately
13
suspending
or
revoking
a
license
when
it
determines
that
any
14
condition
within
the
responsibility
of
the
durable
medical
15
equipment
provider
presents
a
clear
and
present
danger
to
16
public
health
and
safety.
17
5.
The
board
may
impose
an
immediate
moratorium
on
the
18
license
of
a
licensed
durable
medical
equipment
provider
19
when
the
board
determines
that
any
condition
within
the
20
responsibility
of
the
durable
medical
equipment
provider
21
presents
a
threat
to
public
health
or
safety.
22
Sec.
15.
NEW
SECTION
.
154G.11
Penalties.
23
1.
The
following
penalties
shall
be
imposed
for
operating
as
24
a
durable
medical
equipment
provider
without
a
license
under
25
this
chapter:
26
a.
A
person
who
operates
as
a
durable
medical
equipment
27
provider
without
a
license
under
this
chapter
commits
a
class
28
“D”
felony.
29
b.
For
any
person
who
has
received
government
reimbursement
30
for
services
provided
by
an
unlicensed
durable
medical
31
equipment
provider,
the
board
shall
make
a
fraud
referral
to
32
the
appropriate
government
reimbursement
program.
33
2.
If
the
board
discovers
that
a
licensee
is
concurrently
34
operating
licensed
and
unlicensed
provider
locations,
the
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board
may
impose
a
civil
penalty
of
not
more
than
five
hundred
1
dollars
per
violation
or
suspend
any
of
the
licensee’s
existing
2
licenses.
3
3.
A
durable
medical
equipment
provider
found
to
be
4
operating
without
a
license
may
apply
for
licensure
but
shall
5
cease
operations
until
a
license
is
issued
by
the
board.
6
Sec.
16.
Section
272C.1,
subsection
6,
Code
2015,
is
amended
7
by
adding
the
following
new
paragraph:
8
NEW
PARAGRAPH
.
ag.
The
board
of
durable
medical
equipment
9
providers
created
pursuant
to
chapter
147.
10
Sec.
17.
INITIAL
APPOINTMENTS.
Notwithstanding
any
11
provision
to
the
contrary
in
this
Act,
the
initial
appointees
12
to
the
board
of
durable
medical
equipment
providers
established
13
pursuant
to
this
Act
shall
hold
accreditation
from
an
14
accrediting
organization,
as
defined
in
section
154G.1,
as
15
enacted
in
this
Act.
16
Sec.
18.
EFFECTIVE
UPON
ENACTMENT.
The
following
17
provision
or
provisions
of
this
Act,
being
deemed
of
immediate
18
importance,
take
effect
upon
enactment:
19
1.
The
sections
of
this
Act
amending
sections
147.13,
20
147.14,
and
272C.1,
and
the
section
relating
to
initial
21
appointments
to
the
board
of
durable
medical
equipment
22
providers.
23
Sec.
19.
EFFECTIVE
DATE
AND
IMPLEMENTATION.
The
following
24
provision
or
provisions
of
this
Act
take
effect
January
1,
25
2016,
except
that
the
board
of
durable
medical
equipment
26
providers
may
begin
implementation
prior
to
January
1,
2016,
to
27
the
extent
necessary
to
transition
to
full
implementation
of
28
these
provisions
of
this
Act:
29
1.
The
sections
of
this
Act
amending
sections
147.1
and
30
147.2,
and
enacting
sections
154G.1
through
154G.11.
31
EXPLANATION
32
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
33
the
explanation’s
substance
by
the
members
of
the
general
assembly.
34
This
bill
establishes
a
licensing
procedure
and
standards
of
35
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practice
for
durable
medical
equipment
providers.
1
The
bill
creates
a
new
licensing
board,
the
board
of
durable
2
medical
equipment
providers.
The
board
shall
be
responsible
3
for
administering
the
licensing
procedure
and
regulating
4
durable
medical
equipment
providers.
The
bill
makes
Code
5
chapters
147
and
272C,
including
penalty
and
other
regulatory
6
provisions,
applicable
to
the
practice
of
durable
medical
7
equipment
providing.
8
Under
the
bill,
persons
or
entities
who
hold
themselves
out
9
to
the
public
as
providers
of
durable
medical
equipment
must
10
have
a
license
issued
by
the
board.
To
operate
as
a
durable
11
medical
equipment
provider,
a
person
or
entity
must
have
a
12
place
of
business
open
to
the
public
at
least
30
hours
per
13
week.
If
the
person
or
entity
has
multiple
locations,
it
must
14
have
a
license
for
each
location.
If
the
person
or
entity’s
15
principal
place
of
business
is
located
out
of
state
but
within
16
50
miles
of
the
state
and
does
business
in
the
state,
it
need
17
not
maintain
a
location
in
Iowa.
18
If
a
durable
medical
equipment
provider
is
accredited
by
19
an
organization
recognized
by
the
centers
for
Medicare
and
20
Medicaid
services
of
the
United
States
department
of
health
and
21
human
services
and
provides
proof
of
such
accreditation
to
the
22
board,
the
board
shall
grant
the
provider
a
license.
Licenses
23
shall
be
issued
for
two
years.
An
inspection
is
required
24
before
a
license
can
be
issued.
The
board
shall
establish
the
25
fees
for
new
licenses
and
for
renewals.
The
bill
enumerates
26
a
list
of
groups
who
are
not
required
to
meet
the
licensure
27
requirements.
28
Any
person
operating
as
a
durable
medical
equipment
provider
29
without
a
license
commits
a
class
“D”
felony
and
shall
cease
30
operation
until
a
license
is
issued
by
the
board.
31
An
applicant
for
a
durable
medical
equipment
provider
32
license
must
complete
the
form
made
available
by
the
board.
33
The
applicant
must
also
provide
a
report
specifying
by
category
34
the
equipment
and
services
to
be
provided
and
indicating
those
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offered
either
directly
by
the
applicant
or
through
contractual
1
arrangements
with
existing
providers.
An
applicant
must
2
provide
a
list
of
entities
with
whom
it
contracts
for
the
3
provision
of
equipment
and
services.
An
initial
applicant
4
must
provide
proof
of
professional
and
commercial
liability
5
insurance
as
well
as
financial
stability
in
the
form
of
a
6
$50,000
surety
bond
or
an
existing
surety
bond
for
Medicare
7
credentialing.
8
An
applicant’s
general
manager
and
senior
financial
officer
9
must
submit
to
and
pay
for
the
costs
of
a
criminal
background
10
check
conducted
by
the
division
of
criminal
investigation
11
of
the
department
of
public
safety.
The
board
may
require
12
background
checks
of
any
board
of
director
members
or
of
owners
13
who
hold
at
least
a
5
percent
stake
in
an
applicant
entity.
14
The
applicant
must
disclose
information
regarding
felonies
15
committed
by
a
member
of
the
board
of
directors,
its
officers,
16
or
any
individual
owning
5
percent
or
more
of
the
applicant
17
entity.
18
The
board
may
deny,
revoke,
or
suspend
a
license,
or
impose
19
a
civil
penalty
not
to
exceed
$5,000
per
violation
per
day
if
20
a
durable
medical
equipment
provider
or
any
of
its
employees
21
violates
the
bill
or
rules
or
commits
an
intentional,
reckless,
22
or
negligent
act
that
materially
affects
the
health
or
safety
23
of
a
patient.
The
board
may
deny
or
revoke
the
license
of
any
24
applicant
that
made
a
false
representation
or
omission
of
any
25
material
fact
on
its
application,
has
been
previously
found
by
26
any
professional
licensing,
certifying,
or
standards
board
or
27
agency
to
have
violated
its
standards
or
conditions,
or
has
28
been
excluded,
suspended,
or
terminated
or
has
involuntarily
29
withdrawn
from
participation
in
any
governmental
or
private
30
health
care
or
health
insurance
program.
31
The
board
may
investigate
or
inspect
an
applicant
or
32
licensee
as
it
considers
necessary.
The
board
shall
accept
33
a
survey
or
inspection
of
an
accrediting
organization
if
34
the
accreditation
of
the
licensed
durable
medical
equipment
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provider
is
not
provisional
and
the
provider
authorizes
the
1
release
of
the
organization’s
report,
which
is
received
by
the
2
board.
3
The
provisions
of
the
bill
that
create
the
board,
allow
for
4
initial
board
appointments,
and
grant
the
board
rulemaking
5
authority
shall
be
effective
upon
enactment.
The
remaining
6
provisions
shall
take
effect
on
January
1,
2016.
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