HF 2045 (LSB 5363YH (4) 87)

HOUSE FILE 2045

BY  PETTENGILL

A BILL FOR

An Act establishing a veterans recovery pilot program and fund for the reimbursement of expenses related to providing hyperbaric oxygen treatment to eligible veterans.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  35E.1  Definitions.
   As used in this chapter, unless the context otherwise requires:
   1.  “Department” means the Iowa department of veterans affairs created in section 35A.4.
   2.  “Health care practitioner” means a practitioner as defined in section 155A.3.
   3.  “Hyperbaric oxygen treatment” means treatment, including diagnostic testing and other related medical treatments, for traumatic brain injury or post-traumatic stress disorder prescribed by a health care practitioner that utilizes, as part of the treatment, any of the following:
   a.  A hyperbaric chamber approved by the United States food and drug administration. 
   b.  A hyperbaric oxygen device that is approved by the United States food and drug administration for investigational use under the direction of an institutional review board with a national clinical trial number.
   4.  “Pilot program” means the veterans recovery pilot program established under this chapter.
   5.  “Traumatic brain injury” means an acquired injury to the brain. “Traumatic brain injury” does not mean brain dysfunction caused by congenital or degenerative disorders or birth trauma.
   6.  “Treatment facility” means a hospital as defined in section 135B.1, an organized outpatient health facility as defined in section 135.61, or any other facility that is authorized by the department of inspections and appeals to provide hyperbaric oxygen treatment under this chapter.
   7.  “Veteran” means a veteran as defined in section 35.1, a member of the national guard or reserve forces of the United States, and a former member of the national guard or reserve forces of the United States who was discharged under honorable conditions.
   8.  “Veterans recovery fund” means the veterans recovery fund created in section 35E.3.
    Sec. 2.  NEW SECTION.  35E.2  Veterans recovery pilot program —— establishment —— reports —— rules.
   1.  The department shall establish a veterans recovery pilot program, subject to sufficient funds in the veterans recovery fund to operate the pilot program, to provide hyperbaric oxygen treatment and support services to eligible veterans who have been diagnosed with a post-traumatic stress disorder or a traumatic brain injury pursuant to the requirements of this chapter.
   2.  The department, and the department of inspections and appeals, shall adopt rules to implement and administer this chapter.
   3.  By October 1 of each odd-numbered year, the department and the department of inspections and appeals shall submit a biennial report regarding the pilot program that includes an evaluation of the effectiveness of the pilot program and the number of veterans and treatment facilities participating in the pilot program.
    Sec. 3.  NEW SECTION.  35E.3  Veterans recovery fund.
   1.  A veterans recovery fund is created in the state treasury under the control of the department.
   2.  The fund shall consist of moneys appropriated for purposes of the pilot program, and any other devise, gift, bequest, donation, federal or other grant, reimbursement of payments made by any responsible third-party payor, repayment, judgment, transfer, or payment intended to be used for the purposes of the fund. 
   3.  Moneys in the fund are appropriated to the department and may be expended by the department for any of the following purposes:
   a.  Expenses incurred by the department and the department of inspections and appeals in administering the pilot program.
   b.  Expenses authorized pursuant to a treatment plan approved pursuant to section 35E.4 for hyperbaric oxygen treatment of a veteran under the pilot program.
   c.  Expenses authorized pursuant to a treatment plan approved pursuant to section 35E.4 for any necessary travel and living expenses of a veteran required to travel to obtain hyperbaric oxygen treatment under the pilot program.
   4.  Notwithstanding section 12C.7, subsection 2, interest or earnings on moneys in the fund shall be credited to the fund. Moneys in the fund may be used for cash flow purposes during a fiscal year provided that any moneys so allocated are returned to the fund by the end of that fiscal year.
   5.  For purposes of section 8.33, unencumbered or unobligated moneys in the fund shall not revert but shall remain available for expenditure for the purposes designated until June 30, 2024. Any unencumbered or unobligated moneys remaining in the fund as of June 30, 2024, shall not revert but shall be transferred for deposit in the veterans trust fund created in section 35A.13.
    Sec. 4.  NEW SECTION.  35E.4  Hyperbaric oxygen treatment —— treatment plan.
   1.  A treatment facility seeking reimbursement for providing hyperbaric oxygen treatment to a veteran under the pilot program shall, prior to providing such treatment, submit a proposed treatment plan to the department of inspections and appeals in a manner as prescribed by the department of inspections and appeals.
   2.  The proposed treatment plan shall include the following information:
   a.  A prescription order for hyperbaric oxygen treatment issued by a health care practitioner.
   b.  Information verifying the eligibility of the veteran to receive treatment and that the treatment facility is authorized to provide hyperbaric oxygen treatment.
   c.  An estimate of the costs for providing hyperbaric oxygen treatment by the treatment facility.
   d.  An estimate of cost for reimbursing any necessary travel and living expenses of the veteran required to travel to obtain the hyperbaric oxygen treatment.
   e.  Any other information required by the department of inspections and appeals.
   3.  Upon receipt of a proposed treatment plan, the department of inspections and appeals shall approve or disapprove the treatment plan within a reasonable time as established by rule. The department shall not approve the treatment plan if there is not sufficient money in the veterans recovery fund to reimburse the estimate of costs and expenses provided in the proposed treatment plan. The department of inspections and appeals shall notify the treatment facility whether the treatment plan was approved or disapproved. 
   4.  A treatment facility may, following approval of a proposed treatment plan, submit a modified treatment plan if actual expenses are anticipated to exceed the estimated costs approved in the initial treatment plan. The department of inspections and appeals shall approve or disapprove the modified treatment plan, subject to sufficient moneys in the veterans recovery fund for the increased expenses, and shall notify the treatment facility within a reasonable time as established by rule whether the modified treatment plan was approved or disapproved within a reasonable time as established by rule. 
    Sec. 5.  NEW SECTION.  35E.5  Provision of treatment —— reimbursement of expenses.
   1.  A treatment facility shall receive reimbursement of expenses incurred in providing hyperbaric oxygen treatment under the pilot program to a veteran if the department of inspections and appeals has approved a treatment plan under section 35E.4 for the veteran.
   2.  A treatment facility that elects to provide hyperbaric oxygen treatment to a veteran under the pilot program shall provide the treatment without charge to the veteran. A veteran receiving treatment under the pilot program is not liable for the cost of treatment or expenses incurred under the pilot program.
   3.  A treatment facility that elects to provide treatment under the pilot program shall submit to the department of inspections and appeals regular reports, in the form prescribed by the department, of the veteran’s measured health improvements under the treatment plan and whether treatments are continuing or have concluded. If hyperbaric oxygen treatment has concluded, the treatment facility shall indicate the date the treatment concluded.
   4.  A treatment facility providing hyperbaric oxygen treatment under the pilot program may submit a request for reimbursement of expenses incurred by the treatment facility to the department of inspections and appeals. The department of inspections and appeals shall approve the request and notify the department to reimburse the expenses from the veterans recovery fund if all of the following criteria are met:
   a.  The hyperbaric oxygen treatment was provided according to the treatment plan or modified treatment plan approved by the commission.
   b.  The expenses do not exceed the estimated cost of the hyperbaric oxygen treatment as provided in the approved treatment plan or modified treatment plan.
   c.  The treatment facility demonstrates in the reports submitted to the department of inspections and appeals as required by subsection 3 that the veteran is making measured health improvements or that continuing treatment is recommended.
   5.  The department shall reimburse a veteran from moneys in the veterans recovery fund for any travel and living expenses incurred by the veteran receiving hyperbaric oxygen treatment under the pilot program if the amount requested does not exceed the estimated cost of travel and living expenses as provided in the approved treatment plan or modified treatment plan.
   6.  After six months from the date specified in the reports submitted to the department of inspections and appeals from a treatment facility that treatment has concluded, the department of inspections and appeals shall notify the treatment facility and veteran in writing of the expenses that have been reimbursed and whether the amounts reimbursed are less than the costs authorized to be reimbursed pursuant to an approved treatment plan or modified treatment plan. The written notification shall further notify the treatment facility and the veteran that any requests for reimbursement shall not be authorized if a request for reimbursement is not submitted within ninety days after receiving the notice unless, prior to the ninety days, the treatment facility indicates that treatment has not been completed. 
    Sec. 6.  NEW SECTION.  35E.6  Repeal.
   This chapter is repealed July 1, 2024.
    Sec. 7.  DIRECTIVE TO DEPARTMENTS OF VETERANS AFFAIRS AND INSPECTIONS AND APPEALS.  The departments of veterans affairs and inspections and appeals shall each submit a notice of intended action to the administrative rules coordinator and the administrative code editor pursuant to section 17A.4, subsection 1, paragraph “a”, not later than January 1, 2019, for the adoption of rules to implement and administer chapter 35E as enacted in this Act.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill establishes a veterans recovery pilot program, administered in part by both the departments of veterans affairs and inspections and appeals, for the reimbursement of expenses related to providing hyperbaric oxygen treatment to eligible veterans.
   New Code section 35E.1 establishes definitions applicable to the new Code chapter. The bill includes definitions for department, health care practitioner, hyperbaric oxygen treatment, traumatic brain injury, treatment facility, and veteran. Specifically, the bill defines hyperbaric oxygen treatment as treatment, including diagnostic testing and other related medical treatments, for traumatic brain injury or post-traumatic stress disorder prescribed by a health care practitioner that utilizes a United States food and drug administration-approved hyperbaric chamber or hyperbaric oxygen device. 
   New Code section 35E.2 establishes the veterans recovery pilot program, subject to sufficient funds to operate the program, requires the departments of veterans affairs and inspections and appeals to adopt rules to implement and administer the program, and includes a reporting requirement for each department concerning the operation of the pilot program.
   New Code section 35E.3 creates a veterans recovery fund in the state treasury under the control of the department of veterans affairs. The new Code section provides that moneys in the fund are appropriated to the department of veterans affairs to be expended for expenses incurred in operating the program and for expenses authorized to be reimbursed for hyperbaric oxygen treatment and any related travel and living expenses incurred by the veteran. The new Code section provides that moneys in the fund shall not revert but shall remain available for use until June 30, 2024. Any moneys remaining in the fund as of June 30, 2024, shall be transferred for deposit in the veterans trust fund.
   New Code section 35E.4 provides for the process for a treating facility to seek reimbursement from the veterans recovery fund for providing hyperbaric oxygen treatment. The bill provides that a treating facility may submit a proposed treatment plan to the department of inspections and appeals for their approval. The treatment plan shall include the prescription order for the treatment, information verifying the eligibility of the veteran and the treatment facility to provide the treatment, the estimated costs for providing the treatment and for reimbursing the veteran for any associated travel and living expenses, and any other information required by the department of inspections and appeals. The new Code section provides that the treatment plan shall not be approved if sufficient moneys to reimburse the estimated costs are not available in the veterans recovery fund. The new Code section also establishes a process for submitting a modified treatment plan if the estimated costs for providing the treatment are anticipated to exceed the cost estimate in the initial treatment plan. 
   New Code section 35E.5 provides for requirements relative to providing hyperbaric oxygen treatment and provides for the manner in which treatment-related expenses are to be reimbursed. The Code section provides that a treatment facility shall not be reimbursed for providing treatment unless a treatment plan has been approved. If a treatment facility elects to provide hyperbaric oxygen treatment under the pilot program, the facility shall provide the treatment without charge to a veteran and shall submit regular reports to the department of inspections and appeals concerning the efficacy of the treatment and on whether the treatments have been concluded. The new Code section also provides for a process for a treatment facility and a veteran to receive reimbursement for expenses incurred. The new Code sections require the department of inspections and appeals to provide written notification to the treatment facility and veteran after treatment has concluded, which notice shall indicate when any additional requests for reimbursement may be made. 
   Code section 35E.6 provides that the new Code chapter is repealed July 1, 2024.
   The bill further directs the departments of veterans affairs and inspections and appeals to each submit a notice of intended action to the administrative rules coordinator and the administrative code editor not later than January 1, 2019, for the adoption of rules necessary to implement and administer the new Code chapter.