Senate File 2045 - Introduced SENATE FILE 2045 BY CHELGREN A BILL FOR An Act relating to the provision of benefits to residents 1 of health care facilities, including the creation of a 2 provisional application for the medical assistance program 3 by or for a resident of a health care facility. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 5249XS (4) 87 pf/rh

S.F. 2045 Section 1. Section 135C.31A, Code 2018, is amended to read 1 as follows: 2 135C.31A Assessment of residents —— program eligibility —— 3 prescription drug coverage —— provisional medical assistance 4 program application for private pay residents . 5 1. A health care facility shall assist the Iowa department 6 of veterans affairs in identifying, upon admission of a 7 resident, the resident’s eligibility for benefits through the 8 United States department of veterans affairs. The department 9 of inspections and appeals, in cooperation with the department 10 of human services, shall adopt rules to administer this 11 section , including a provision that ensures that if a resident 12 is eligible for benefits through the United States department 13 of veterans affairs or other third-party payor, the payor of 14 last resort for reimbursement to the health care facility is 15 the medical assistance program. The rules shall also require 16 the health care facility to request information from a resident 17 or resident’s personal representative regarding the resident’s 18 veteran status and to report to the Iowa department of veterans 19 affairs only the names of residents identified as potential 20 veterans along with the names of their spouses and any 21 dependents. Information reported by the health care facility 22 shall be verified by the Iowa department of veterans affairs. 23 This section shall not apply to the admission of an individual 24 to a state mental health institute for acute psychiatric care 25 or to the admission of an individual to the Iowa veterans home. 26 2. a. If a resident is identified, upon admission to a 27 health care facility, as eligible for benefits through the 28 United States department of veterans affairs pursuant to 29 subsection 1 or through other means, the health care facility 30 shall allow the resident to access any prescription drug 31 benefit included in such benefits for which the resident is 32 also eligible. The health care facility shall also assist the 33 Iowa department of veterans affairs in identifying individuals 34 residing in such health care facilities on July 1, 2009, who 35 -1- LSB 5249XS (4) 87 pf/rh 1/ 3

S.F. 2045 are eligible for the prescription drug benefit. 1 b. The department of inspections and appeals, the department 2 of veterans affairs, and the department of human services 3 shall identify any barriers to residents in accessing such 4 prescription drug benefits and shall assist health care 5 facilities in adjusting their procedures for medication 6 administration to comply with this subsection . 7 3. A health care facility, upon admission of a resident 8 whose source of payment is private pay, shall assist the 9 resident or the resident’s personal representative in 10 completing a provisional application for the medical assistance 11 program. The department of inspections and appeals, in 12 cooperation with the department of human services, shall 13 adopt rules to administer this subsection, including the 14 establishment of a process to ensure that approval of a 15 resident’s provisional application is expedited when the 16 resident meets all financial and other eligibility requirements 17 for the medical assistance program. 18 4. This section shall not apply to the admission of an 19 individual to a state mental health institute for acute 20 psychiatric care or to the admission of an individual to the 21 Iowa veterans home. 22 EXPLANATION 23 The inclusion of this explanation does not constitute agreement with 24 the explanation’s substance by the members of the general assembly. 25 This bill provides for the completion of a provisional 26 application for the medical assistance program by a resident 27 or resident’s personal representative, upon admission of a 28 resident to a health care facility, if the resident’s source 29 of payment is private pay. The bill directs the department of 30 inspections and appeals and the department of human services 31 to adopt rules to administer the provision, including the 32 establishment of a process to ensure that approval of a 33 resident’s provisional application is expedited when the 34 resident meets all financial and other eligibility requirements 35 -2- LSB 5249XS (4) 87 pf/rh 2/ 3

S.F. 2045 for the medical assistance program. The bill also eliminates 1 an outdated reference to identification of individuals residing 2 in health care facilities on July 1, 2009, who were eligible 3 for the department of veterans affairs prescription drug 4 benefit. 5 The provisions of the bill do not apply to the admission of 6 an individual to a state mental health institution for acute 7 psychiatric care or to the admission of an individual to the 8 Iowa veterans home. 9 -3- LSB 5249XS (4) 87 pf/rh 3/ 3