Senate
File
286
-
Introduced
SENATE
FILE
286
BY
SEGEBART
A
BILL
FOR
An
Act
relating
to
the
reimbursement
and
cost-reporting
1
methodologies
and
documentation
requirements
applicable
to
2
certain
Medicaid
providers,
and
including
effective
date
3
provisions.
4
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
5
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Section
1.
MEDICAID
HOME
AND
COMMUNITY-BASED
SERVICES
1
PROVIDERS
——
COST-REPORTING
METHODOLOGY
AND
DOCUMENTATION
2
CHANGES.
3
1.
Beginning
July
1,
2017,
the
department
of
human
services
4
shall
discontinue
application
of
the
retrospectively
limited
5
prospective
rates
reimbursement
methodology
to
and
the
required
6
submission
of
cost
reports
by
affected
providers
under
441
IAC
7
79.1.
8
2.
The
department
of
human
services,
in
consultation
with
9
affected
parties,
including
but
not
limited
to
Medicaid
home
10
and
community-based
services
providers,
shall
develop
and
11
submit
to
the
governor
and
the
general
assembly
by
November
30,
12
2017,
a
proposal
for
a
new
cost-reporting
methodology
to
be
13
used
for
the
purposes
of
determining
actuarially
sound
rates
14
and
fee-for-service
reimbursement
for
applicable
Medicaid
home
15
and
community-based
services
providers
beginning
July
1,
2018.
16
The
cost-reporting
methodology
developed
shall
be
based
on
17
all
reasonable
costs
of
doing
business
as
a
Medicaid
home
and
18
community-based
services
provider.
19
3.
The
department
of
human
services
shall
amend
441
IAC
20
24.4
relating
to
standards
of
service
for
providers
of
services
21
to
persons
with
mental
illness,
intellectual
disabilities,
or
22
developmental
disabilities
pursuant
to
chapter
225C
and
441
23
IAC
79.3(2)
relating
to
medical
clinical
records
for
providers
24
of
services
under
the
Medicaid
program
pursuant
to
chapter
25
249A,
to
provide,
effective
November
1,
2017,
that
in
addition
26
to
allowing
documentation
of
the
provision
of
services
or
27
standards
of
service
in
a
narrative
format,
the
following
28
providers
may
also
provide
documentation
in
a
checkbox
form
29
format
in
accordance
with
the
provider’s
organizational
30
policies
and
procedures:
31
a.
Advanced
registered
nurse
practitioners.
32
b.
Psychologists.
33
c.
Community
mental
health
centers.
34
d.
Home
and
community-based
habilitation
services
35
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providers.
1
e.
Behavioral
health
intervention.
2
f.
Case
management
services
including
home
and
3
community-based
services
case
management
services.
4
g.
Home
and
community-based
services
waiver
services.
5
h.
Behavioral
health
services.
6
i.
Community-based
neurobehavioral
rehabilitation
7
residential
services
and
intermittent
services.
8
Sec.
2.
EFFECTIVE
UPON
ENACTMENT.
This
Act,
being
deemed
of
9
immediate
importance,
takes
effect
upon
enactment.
10
EXPLANATION
11
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
12
the
explanation’s
substance
by
the
members
of
the
general
assembly.
13
This
bill
relates
to
reimbursement
methodologies,
cost
14
reports,
and
documentation
required
of
certain
Medicaid
home
15
and
community-based
services
providers.
16
The
bill
requires
that
beginning
July
1,
2017,
the
17
department
of
human
services
(DHS)
shall
discontinue
18
application
of
the
retrospectively
limited
prospective
rates
19
reimbursement
methodology
and
the
required
submission
of
20
cost
reports
by
affected
providers
as
provided
under
the
21
administrative
rule
that
applies
this
reimbursement
methodology
22
and
requires
submission
of
cost
reports
by
Medicaid
home
and
23
community-based
services
(HCBS)
supported
community
living,
24
family
and
community
support
services,
and
interim
medical
25
monitoring
and
treatment
when
provided
by
an
HCBS-certified
26
supported
community
agency.
27
The
bill
directs
DHS,
in
consultation
with
affected
parties,
28
including
but
not
limited
to
Medicaid
home
and
community-based
29
services
providers,
to
develop
and
submit
to
the
governor
and
30
the
general
assembly
by
November
30,
2017,
a
proposal
for
a
31
new
cost-reporting
methodology
to
be
used
for
the
purposes
32
of
determining
actuarially
sound
rates
and
fee-for-service
33
reimbursement
for
applicable
HCBS
providers
beginning
July
1,
34
2018.
The
cost-reporting
methodology
developed
shall
be
based
35
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on
all
reasonable
costs
of
doing
business
as
a
Medicaid
home
1
and
community-based
services
provider.
2
The
bill
also
requires
DHS
to
amend
administrative
rules
3
relating
to
standards
of
service
for
providers
of
services
4
to
persons
with
mental
illness,
intellectual
disabilities,
5
or
developmental
disabilities
and
those
relating
to
medical
6
clinical
records
for
providers
of
services
under
the
Medicaid
7
program
to
provide,
effective
November
1,
2017,
that
in
8
addition
to
allowing
documentation
of
the
provision
of
9
services
or
standards
of
service
in
a
narrative
format,
certain
10
providers
specified
in
the
bill
may
also
provide
documentation
11
in
a
checkbox
form
format
in
accordance
with
the
provider’s
12
organizational
policies
and
procedures.
13
The
bill
takes
effect
upon
enactment.
14
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