House File 135 - Introduced HOUSE FILE 135 BY HEDDENS , ABDUL-SAMAD , ANDERSON , BEARINGER , BENNETT , BRECKENRIDGE , BROWN-POWERS , COHOON , DERRY , DONAHUE , EHLERT , FORBES , GAINES , GASKILL , HALL , HUNTER , ISENHART , JACOBY , JAMES , JUDGE , KACENA , KONFRST , KRESSIG , KURTH , KURTZ , LENSING , MASCHER , MATSON , McCONKEY , B. MEYER , NIELSEN , OLDSON , OLSON , OURTH , PRICHARD , RUNNING-MARQUARDT , M. SMITH , R. SMITH , STAED , STECKMAN , SUNDE , THEDE , WESSEL-KROESCHELL , WILLIAMS , WINCKLER , and WOLFE A BILL FOR An Act relating to long-term services and supports and certain 1 capitation rates under the Medicaid program, and including 2 effective date provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 1513YH (7) 88 pf/rh

H.F. 135 Section 1. TERMINATION OF MEDICAID MANAGED CARE CONTRACTS 1 RELATIVE TO LONG-TERM SERVICES AND SUPPORTS POPULATION —— 2 TRANSITION TO FEE-FOR-SERVICE. The department of human 3 services shall, upon the effective date of this Act, provide 4 written notice in accordance with the termination provisions 5 of the contract, to each managed care organization with whom 6 the department executed a contract to administer the Iowa 7 high quality health care initiative as established by the 8 department, to terminate such contracts as applicable to 9 the Medicaid long-term services and supports population, 10 following a sixty-day transition period. The department shall 11 transfer the long-term services and supports population to 12 fee-for-service program administration. The transition shall 13 be based on a transition plan developed by the department and 14 submitted to the council on human services and the medical 15 assistance advisory council for review. 16 Sec. 2. RECALCULATION OF CERTAIN CAPITATION RATES UNDER 17 MEDICAID MANAGED CARE. For the fiscal year beginning July 1, 18 2019, the department of human services shall utilize Medicaid 19 program claims paid data for the period beginning April 1, 20 2015, and ending March 31, 2016, as base data to develop and 21 certify capitation rates for home and community-based services 22 provided through the intellectual disability waiver under 23 Medicaid managed care. 24 Sec. 3. MEDICAID STATE PLAN OR WAIVER AMENDMENTS. The 25 department of human services shall seek any Medicaid state plan 26 or waiver amendments necessary to administer this Act. 27 Sec. 4. EFFECTIVE DATE. This Act, being deemed of immediate 28 importance, takes effect upon enactment. 29 EXPLANATION 30 The inclusion of this explanation does not constitute agreement with 31 the explanation’s substance by the members of the general assembly. 32 This bill directs the department of human services (DHS) 33 to provide written notice in accordance with the termination 34 provisions of the contract, to each managed care organization 35 -1- LSB 1513YH (7) 88 pf/rh 1/ 2

H.F. 135 (MCO) with whom DHS executed a contract to administer the Iowa 1 high quality health care initiative as established by the 2 department, to terminate such contracts as applicable to the 3 long-term services and supports population, following a 60-day 4 transition period. DHS is directed to transfer the long-term 5 services and supports population to fee-for-service program 6 administration. The transition is to be based on a transition 7 plan developed by the department and submitted to the council 8 on human services and the medical assistance advisory council 9 for review. 10 The bill requires DHS to use Medicaid program claims paid 11 data for the period beginning April 1, 2015, and ending March 12 31, 2016, as base data to develop and certify capitation rates 13 for home and community-based services provided through the 14 intellectual disability waiver under Medicaid managed care for 15 the fiscal year beginning July 1, 2019. 16 The bill requires DHS to seek any Medicaid state plan or 17 waiver amendments necessary to administer the bill. 18 The bill takes effect upon enactment. 19 -2- LSB 1513YH (7) 88 pf/rh 2/ 2