H.F. 2355 Section 1. NEW SECTION . 35E.1 Definitions. 1 As used in this chapter, unless the context otherwise 2 requires: 3 1. “Commission” means the commission of veterans affairs 4 established in section 35A.2. 5 2. “Department” means the Iowa department of veterans 6 affairs created in section 35A.4. 7 3. “Health care practitioner” means a practitioner as 8 defined in section 155A.3. 9 4. “Hyperbaric oxygen treatment” means treatment, including 10 diagnostic testing and other related medical treatments, for 11 traumatic brain injury or post-traumatic stress disorder 12 prescribed by a health care practitioner that utilizes, as part 13 of the treatment, any of the following: 14 a. A hyperbaric chamber approved by the United States food 15 and drug administration. 16 b. A hyperbaric oxygen device that is approved by the United 17 States food and drug administration for investigational use 18 under the direction of an institutional review board with a 19 national clinical trial number. 20 5. “Pilot program” means the veterans recovery pilot program 21 established under this chapter. 22 6. “Traumatic brain injury” means an acquired injury to the 23 brain. “Traumatic brain injury” does not mean brain dysfunction 24 caused by congenital or degenerative disorders or birth trauma. 25 7. “Treatment facility” means a hospital as defined in 26 section 135B.1, an organized outpatient health facility as 27 defined in section 135.61, or any other facility that is 28 authorized by the department to provide hyperbaric oxygen 29 treatment under this chapter. 30 8. “Veteran” means a veteran as defined in section 35.1, a 31 member of the national guard or reserve forces of the United 32 States, and a former member of the national guard or reserve 33 forces of the United States who was discharged under honorable 34 conditions. 35 -1- LSB 5363HV (2) 87 ec/rn 1/ 8

H.F. 2355 9. “Veterans recovery fund” means the veterans recovery fund 1 created in section 35E.3. 2 Sec. 2. NEW SECTION . 35E.2 Veterans recovery pilot program 3 —— establishment —— reports —— rules. 4 1. The department shall establish a veterans recovery pilot 5 program, subject to sufficient funds in the veterans recovery 6 fund to operate the pilot program, to provide hyperbaric oxygen 7 treatment and support services to eligible veterans who have 8 been diagnosed with a post-traumatic stress disorder or a 9 traumatic brain injury pursuant to the requirements of this 10 chapter. 11 2. The department shall adopt rules to implement and 12 administer this chapter. 13 3. By October 1 of each odd-numbered year, the department 14 shall submit a biennial report regarding the pilot program 15 that includes an evaluation of the effectiveness of the pilot 16 program and the number of veterans and treatment facilities 17 participating in the pilot program. 18 Sec. 3. NEW SECTION . 35E.3 Veterans recovery fund. 19 1. A veterans recovery fund is created in the state treasury 20 under the control of the department. 21 2. The fund shall consist of moneys appropriated for 22 purposes of the pilot program, and any other devise, gift, 23 bequest, donation, federal or other grant, reimbursement of 24 payments made by any responsible third-party payor, repayment, 25 judgment, transfer, or payment intended to be used for the 26 purposes of the fund. 27 3. Moneys in the fund are appropriated to the department 28 and may be expended by the department for any of the following 29 purposes: 30 a. Expenses incurred by the department in administering the 31 pilot program. 32 b. Expenses authorized pursuant to a treatment plan approved 33 pursuant to section 35E.4 for hyperbaric oxygen treatment of a 34 veteran under the pilot program. 35 -2- LSB 5363HV (2) 87 ec/rn 2/ 8

H.F. 2355 c. Expenses authorized pursuant to a treatment plan approved 1 pursuant to section 35E.4 for any necessary travel and living 2 expenses of a veteran required to travel to obtain hyperbaric 3 oxygen treatment under the pilot program. 4 4. Notwithstanding section 12C.7, subsection 2, interest or 5 earnings on moneys in the fund shall be credited to the fund. 6 Moneys in the fund may be used for cash flow purposes during a 7 fiscal year provided that any moneys so allocated are returned 8 to the fund by the end of that fiscal year. 9 5. For purposes of section 8.33, unencumbered or 10 unobligated moneys in the fund shall not revert but shall 11 remain available for expenditure for the purposes designated 12 until June 30, 2024. Any unencumbered or unobligated moneys 13 remaining in the fund as of June 30, 2024, shall not revert but 14 shall be transferred for deposit in the veterans trust fund 15 created in section 35A.13. 16 Sec. 4. NEW SECTION . 35E.4 Hyperbaric oxygen treatment —— 17 treatment plan. 18 1. A treatment facility seeking reimbursement for providing 19 hyperbaric oxygen treatment to a veteran under the pilot 20 program shall, prior to providing such treatment, submit a 21 proposed treatment plan to the department in a manner as 22 prescribed by the department. 23 2. The proposed treatment plan shall include the following 24 information: 25 a. A prescription order for hyperbaric oxygen treatment 26 issued by a health care practitioner. 27 b. Information verifying the eligibility of the veteran to 28 receive treatment and that the treatment facility is authorized 29 to provide hyperbaric oxygen treatment. 30 c. An estimate of the costs for providing hyperbaric oxygen 31 treatment by the treatment facility. 32 d. An estimate of cost for reimbursing any necessary travel 33 and living expenses of the veteran required to travel to obtain 34 the hyperbaric oxygen treatment. 35 -3- LSB 5363HV (2) 87 ec/rn 3/ 8

H.F. 2355 e. Any other information required by the department of 1 inspections and appeals. 2 3. Upon receipt of a proposed treatment plan, the department 3 and the commission shall approve or disapprove the treatment 4 plan within a reasonable time as established by rule. The 5 department shall not approve the treatment plan if there 6 is not sufficient money in the veterans recovery fund to 7 reimburse the estimate of costs and expenses provided in the 8 proposed treatment plan. The department shall notify the 9 treatment facility whether the treatment plan was approved or 10 disapproved. 11 4. A treatment facility may, following approval of a 12 proposed treatment plan, submit a modified treatment plan if 13 actual expenses are anticipated to exceed the estimated costs 14 approved in the initial treatment plan. The department and the 15 commission shall approve or disapprove the modified treatment 16 plan, subject to sufficient moneys in the veterans recovery 17 fund for the increased expenses, and shall notify the treatment 18 facility within a reasonable time as established by rule 19 whether the modified treatment plan was approved or disapproved 20 within a reasonable time as established by rule. 21 Sec. 5. NEW SECTION . 35E.5 Provision of treatment —— 22 reimbursement of expenses. 23 1. A treatment facility shall receive reimbursement of 24 expenses incurred in providing hyperbaric oxygen treatment 25 under the pilot program to a veteran if the department and the 26 commission have approved a treatment plan under section 35E.4 27 for the veteran. 28 2. A treatment facility that elects to provide hyperbaric 29 oxygen treatment to a veteran under the pilot program shall 30 provide the treatment without charge to the veteran. A veteran 31 receiving treatment under the pilot program is not liable for 32 the cost of treatment or expenses incurred under the pilot 33 program. 34 3. A treatment facility that elects to provide treatment 35 -4- LSB 5363HV (2) 87 ec/rn 4/ 8

H.F. 2355 under the pilot program shall submit to the department regular 1 reports, in the form prescribed by the department, of the 2 veteran’s measured health improvements under the treatment 3 plan and whether treatments are continuing or have concluded. 4 If hyperbaric oxygen treatment has concluded, the treatment 5 facility shall indicate the date the treatment concluded. 6 4. A treatment facility providing hyperbaric oxygen 7 treatment under the pilot program may submit a request for 8 reimbursement of expenses incurred by the treatment facility 9 to the department. The department shall approve the request 10 and notify the department to reimburse the expenses from the 11 veterans recovery fund if all of the following criteria are 12 met: 13 a. The hyperbaric oxygen treatment was provided according to 14 the approved treatment plan or modified treatment plan. 15 b. The expenses do not exceed the estimated cost of the 16 hyperbaric oxygen treatment as provided in the approved 17 treatment plan or modified treatment plan. 18 c. The treatment facility demonstrates in the reports 19 submitted to the department as required by subsection 3 that 20 the veteran is making measured health improvements or that 21 continuing treatment is recommended. 22 5. The department shall reimburse a veteran from moneys in 23 the veterans recovery fund for any travel and living expenses 24 incurred by the veteran receiving hyperbaric oxygen treatment 25 under the pilot program if the amount requested does not exceed 26 the estimated cost of travel and living expenses as provided in 27 the approved treatment plan or modified treatment plan. 28 6. After six months from the date specified in the reports 29 submitted to the department from a treatment facility that 30 treatment has concluded, the department shall notify the 31 treatment facility and veteran in writing of the expenses 32 that have been reimbursed and whether the amounts reimbursed 33 are less than the costs authorized to be reimbursed pursuant 34 to an approved treatment plan or modified treatment plan. 35 -5- LSB 5363HV (2) 87 ec/rn 5/ 8

H.F. 2355 The written notification shall further notify the treatment 1 facility and the veteran that any requests for reimbursement 2 shall not be authorized if a request for reimbursement is not 3 submitted within ninety days after receiving the notice unless, 4 prior to the ninety days, the treatment facility indicates that 5 treatment has not been completed. 6 Sec. 6. NEW SECTION . 35E.6 Repeal. 7 This chapter is repealed July 1, 2024. 8 Sec. 7. DIRECTIVE TO DEPARTMENT OF VETERANS AFFAIRS. The 9 department of veterans affairs shall submit a notice of 10 intended action to the administrative rules coordinator and 11 the administrative code editor pursuant to section 17A.4, 12 subsection 1, paragraph “a”, not later than January 1, 2019, 13 for the adoption of rules to implement and administer chapter 14 35E as enacted in this Act. 15 EXPLANATION 16 The inclusion of this explanation does not constitute agreement with 17 the explanation’s substance by the members of the general assembly. 18 This bill establishes a veterans recovery pilot program, 19 administered by the department of veterans affairs for the 20 reimbursement of expenses related to providing hyperbaric 21 oxygen treatment to eligible veterans. 22 New Code section 35E.1 establishes definitions applicable 23 to the new Code chapter. The bill includes definitions for 24 commission, department, health care practitioner, hyperbaric 25 oxygen treatment, traumatic brain injury, treatment facility, 26 and veteran. Specifically, the bill defines hyperbaric oxygen 27 treatment as treatment, including diagnostic testing and other 28 related medical treatments, for traumatic brain injury or 29 post-traumatic stress disorder prescribed by a health care 30 practitioner that utilizes a United States food and drug 31 administration-approved hyperbaric chamber or hyperbaric oxygen 32 device. 33 New Code section 35E.2 establishes the veterans recovery 34 pilot program, subject to sufficient funds to operate the 35 -6- LSB 5363HV (2) 87 ec/rn 6/ 8

H.F. 2355 program, requires the department of veterans affairs to adopt 1 rules to implement and administer the program, and includes 2 a reporting requirement for each department concerning the 3 operation of the pilot program. 4 New Code section 35E.3 creates a veterans recovery fund 5 in the state treasury under the control of the department of 6 veterans affairs. The new Code section provides that moneys in 7 the fund are appropriated to the department of veterans affairs 8 to be expended for expenses incurred in operating the program 9 and for expenses authorized to be reimbursed for hyperbaric 10 oxygen treatment and any related travel and living expenses 11 incurred by the veteran. The new Code section provides that 12 moneys in the fund shall not revert but shall remain available 13 for use until June 30, 2024. Any moneys remaining in the fund 14 as of June 30, 2024, shall be transferred for deposit in the 15 veterans trust fund. 16 New Code section 35E.4 provides for the process for a 17 treating facility to seek reimbursement from the veterans 18 recovery fund for providing hyperbaric oxygen treatment. The 19 bill provides that a treating facility may submit a proposed 20 treatment plan to the department of veterans affairs and 21 the commission of veterans affairs for their approval. The 22 treatment plan shall include the prescription order for the 23 treatment, information verifying the eligibility of the veteran 24 and the treatment facility to provide the treatment, the 25 estimated costs for providing the treatment and for reimbursing 26 the veteran for any associated travel and living expenses, and 27 any other information required by the department of veterans 28 affairs. The new Code section provides that the treatment 29 plan shall not be approved if sufficient moneys to reimburse 30 the estimated costs are not available in the veterans recovery 31 fund. The new Code section also establishes a process for 32 submitting a modified treatment plan if the estimated costs 33 for providing the treatment are anticipated to exceed the cost 34 estimate in the initial treatment plan. 35 -7- LSB 5363HV (2) 87 ec/rn 7/ 8

H.F. 2355 New Code section 35E.5 provides for requirements relative 1 to providing hyperbaric oxygen treatment and provides for 2 the manner in which treatment-related expenses are to be 3 reimbursed. The Code section provides that a treatment 4 facility shall not be reimbursed for providing treatment 5 unless a treatment plan has been approved. If a treatment 6 facility elects to provide hyperbaric oxygen treatment under 7 the pilot program, the facility shall provide the treatment 8 without charge to a veteran and shall submit regular reports 9 to the department of veterans affairs concerning the efficacy 10 of the treatment and on whether the treatments have been 11 concluded. The new Code section also provides for a process 12 for a treatment facility and a veteran to receive reimbursement 13 for expenses incurred. The new Code sections require the 14 department of veterans affairs to provide written notification 15 to the treatment facility and veteran after treatment has 16 concluded, which notice shall indicate when any additional 17 requests for reimbursement may be made. 18 Code section 35E.6 provides that the new Code chapter is 19 repealed July 1, 2024. 20 The bill further directs the department of veterans affairs 21 to submit a notice of intended action to the administrative 22 rules coordinator and the administrative code editor not later 23 than January 1, 2019, for the adoption of rules necessary to 24 implement and administer the new Code chapter. 25 -8- LSB 5363HV (2) 87 ec/rn 8/ 8