S.F. 529 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 department of human services 6 created in section 217.1. 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 1926SV (3) 88 mo/rn 1/ 9

S.F. 529 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 even-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 of veterans affairs. 21 2. The fund shall consist of moneys received in the form 22 of a devise, gift, bequest, donation, federal or other grant, 23 reimbursement of payments made by any responsible third-party 24 payor, repayment, judgment, transfer, or payment intended to be 25 used for the purposes of the fund. The general assembly shall 26 make no appropriation to the fund from public moneys of the 27 state. 28 3. The department of veterans affairs shall have the 29 authority and is directed to solicit contributions, gifts, 30 devises, bequests, and donations for the veterans recovery fund 31 to be expended for the purposes identified in this section. 32 4. Moneys in the fund are appropriated to the department of 33 veterans affairs and may be expended for any of the following 34 purposes: 35 -2- LSB 1926SV (3) 88 mo/rn 2/ 9

S.F. 529 a. Expenses incurred by the department of human services and 1 the department of veterans affairs in administering the pilot 2 program. 3 b. Expenses authorized pursuant to a treatment plan approved 4 pursuant to section 35E.4 for hyperbaric oxygen treatment of a 5 veteran under the pilot program. 6 c. Expenses authorized pursuant to a treatment plan approved 7 pursuant to section 35E.4 for any necessary travel and living 8 expenses of a veteran required to travel to obtain hyperbaric 9 oxygen treatment under the pilot program. 10 5. Any unencumbered or unobligated moneys remaining in the 11 fund as of June 30, 2025, shall be transferred for deposit in 12 the veterans trust fund created in section 35A.13. 13 Sec. 4. NEW SECTION . 35E.4 Hyperbaric oxygen treatment —— 14 treatment plan. 15 1. A treatment facility seeking reimbursement for providing 16 hyperbaric oxygen treatment to a veteran under the pilot 17 program shall, prior to providing such treatment, submit a 18 proposed treatment plan to the department in a manner as 19 prescribed by the department. 20 2. The proposed treatment plan shall include the following 21 information: 22 a. A prescription order for hyperbaric oxygen treatment 23 issued by a health care practitioner. 24 b. Information verifying the eligibility of the veteran to 25 receive treatment and that the treatment facility is authorized 26 to provide hyperbaric oxygen treatment. 27 c. An estimate of the costs for providing hyperbaric oxygen 28 treatment by the treatment facility. 29 d. An estimate of cost for reimbursing any necessary travel 30 and living expenses of the veteran required to travel to obtain 31 the hyperbaric oxygen treatment. 32 e. Any other information required by the department. 33 3. Upon receipt of a proposed treatment plan, the department 34 shall approve or disapprove the treatment plan within a 35 -3- LSB 1926SV (3) 88 mo/rn 3/ 9

S.F. 529 reasonable time as established by rule. The department shall 1 not approve the treatment plan if there is not sufficient money 2 in the veterans recovery fund to reimburse the estimate of 3 costs and expenses provided in the proposed treatment plan. 4 The department shall notify the treatment facility whether the 5 treatment plan was approved or disapproved. 6 4. A treatment facility may, following approval of a 7 proposed treatment plan, submit a modified treatment plan if 8 actual expenses are anticipated to exceed the estimated costs 9 approved in the initial treatment plan. The department shall 10 approve or disapprove the modified treatment plan, subject 11 to sufficient moneys in the veterans recovery fund for the 12 increased expenses, and shall notify the treatment facility 13 within a reasonable time as established by rule whether the 14 modified treatment plan was approved or disapproved within a 15 reasonable time as established by rule. 16 5. The department of human services shall transmit the 17 approval or disapproval of a proposed treatment plan or a 18 modified treatment plan to the department of veterans affairs. 19 If the proposed treatment plan or modified treatment plan is 20 approved, the department of veterans affairs shall disburse 21 moneys from the veterans recovery fund accordingly. 22 Sec. 5. NEW SECTION . 35E.5 Provision of treatment —— 23 reimbursement of expenses. 24 1. A treatment facility shall receive reimbursement of 25 expenses incurred in providing hyperbaric oxygen treatment 26 under the pilot program to a veteran if the department has 27 approved a treatment plan under section 35E.4 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 1926SV (3) 88 mo/rn 4/ 9

S.F. 529 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 to 9 the department. The department shall approve the request and 10 reimburse the expenses from the veterans recovery fund if all 11 of the following criteria are met: 12 a. The hyperbaric oxygen treatment was provided according to 13 the approved treatment plan or modified treatment plan. 14 b. The expenses do not exceed the estimated cost of the 15 hyperbaric oxygen treatment as provided in the approved 16 treatment plan or modified treatment plan. 17 c. The treatment facility demonstrates in the reports 18 submitted to the department as required by subsection 3 that 19 the veteran is making measured health improvements or that 20 continuing treatment is recommended. 21 5. The department of human services shall approve a request 22 for reimbursement of a veteran’s travel and living expenses 23 incurred by the veteran receiving hyperbaric oxygen treatment 24 under the pilot program if the amount requested does not 25 exceed the estimated cost of travel and living expenses as 26 provided in the approved treatment plan or modified treatment 27 plan. The department of human services shall transmit its 28 approval or disapproval of a request for reimbursement under 29 this subsection to the department of veterans affairs. If the 30 request is approved, the department of veterans affairs shall 31 disburse moneys to the veteran from the veterans recovery fund 32 accordingly. 33 6. After six months from the date specified in the reports 34 submitted to the department from a treatment facility that 35 -5- LSB 1926SV (3) 88 mo/rn 5/ 9

S.F. 529 treatment has concluded, the department shall notify the 1 treatment facility and veteran in writing of the expenses 2 that have been reimbursed and whether the amounts reimbursed 3 are less than the costs authorized to be reimbursed pursuant 4 to an approved treatment plan or modified treatment plan. 5 The written notification shall further notify the treatment 6 facility and the veteran that any requests for reimbursement 7 shall not be authorized if a request for reimbursement is not 8 submitted within ninety days after receiving the notice unless, 9 prior to the ninety days, the treatment facility indicates that 10 treatment has not been completed. 11 Sec. 6. NEW SECTION . 35E.6 Repeal. 12 This chapter is repealed July 1, 2025. 13 Sec. 7. DIRECTIVE TO DEPARTMENT OF HUMAN SERVICES. The 14 department of human services shall submit a notice of 15 intended action to the administrative rules coordinator and 16 the administrative code editor pursuant to section 17A.4, 17 subsection 1, paragraph “a”, not later than January 1, 2020, 18 for the adoption of rules to implement and administer chapter 19 35E as enacted in this Act. 20 EXPLANATION 21 The inclusion of this explanation does not constitute agreement with 22 the explanation’s substance by the members of the general assembly. 23 This bill establishes a veterans recovery pilot program, 24 administered by the department of human services for the 25 reimbursement of expenses related to providing hyperbaric 26 oxygen treatment to eligible veterans. 27 New Code section 35E.1 establishes definitions applicable 28 to the new Code chapter. The bill includes definitions for 29 commission, department, health care practitioner, hyperbaric 30 oxygen treatment, traumatic brain injury, treatment facility, 31 and veteran. Specifically, the bill defines hyperbaric oxygen 32 treatment as treatment, including diagnostic testing and other 33 related medical treatments, for traumatic brain injury or 34 post-traumatic stress disorder prescribed by a health care 35 -6- LSB 1926SV (3) 88 mo/rn 6/ 9

S.F. 529 practitioner that utilizes a United States food and drug 1 administration-approved hyperbaric chamber or hyperbaric oxygen 2 device. 3 New Code section 35E.2 establishes the veterans recovery 4 pilot program, subject to sufficient funds to operate the 5 program, requires the department of human services to adopt 6 rules to implement and administer the program, and includes a 7 reporting requirement concerning the operation of the pilot 8 program. 9 New Code section 35E.3 creates a veterans recovery fund 10 in the state treasury under the control of the department of 11 veterans affairs. The new Code section provides that the fund 12 shall consist of moneys contributed through or received from 13 any devise, gift, bequest, donation, federal or other grant, 14 reimbursement of payments made by any responsible third-party 15 payor, repayment, judgment, transfer, or payment intended to be 16 used for the purposes of the fund. The department of veterans 17 affairs is directed to solicit contributions, gifts, devises, 18 bequests, and donations for the veterans recovery fund. The 19 department of veterans affairs is to expend moneys in the fund 20 for expenses incurred in operating the program and for expenses 21 authorized to be reimbursed for hyperbaric oxygen treatment and 22 any related travel and living expenses incurred by the veteran. 23 The new Code section provides that any moneys remaining in the 24 fund as of June 30, 2025, shall be transferred for deposit in 25 the veterans trust fund. 26 New Code section 35E.4 provides for the process for a 27 treating facility to seek reimbursement from the veterans 28 recovery fund for providing hyperbaric oxygen treatment. The 29 bill provides that a treating facility may submit a proposed 30 treatment plan to the department of human services for its 31 approval. The treatment plan shall include the prescription 32 order for the treatment, information verifying the eligibility 33 of the veteran and the treatment facility to provide the 34 treatment, the estimated costs for providing the treatment 35 -7- LSB 1926SV (3) 88 mo/rn 7/ 9

S.F. 529 and for reimbursing the veteran for any associated travel and 1 living expenses, and any other information required by the 2 department of human services. The new Code section provides 3 that the treatment plan shall not be approved if sufficient 4 moneys to reimburse the estimated costs are not available 5 in the veterans recovery fund. The new Code section also 6 establishes a process for submitting a modified treatment 7 plan if the estimated costs for providing the treatment 8 are anticipated to exceed the cost estimate in the initial 9 treatment plan. The bill provides that the department of 10 human services shall transmit the approval or disapproval of 11 a proposed or modified treatment plan to the department of 12 veterans affairs. If the proposed or modified treatment plan 13 is approved, the department of veterans affairs shall disburse 14 moneys from the veterans recovery fund accordingly. 15 New Code section 35E.5 provides for requirements relative 16 to providing hyperbaric oxygen treatment and provides for 17 the manner in which treatment-related expenses are to be 18 reimbursed. The Code section provides that a treatment 19 facility shall not be reimbursed for providing treatment 20 unless a treatment plan has been approved. If a treatment 21 facility elects to provide hyperbaric oxygen treatment under 22 the pilot program, the facility shall provide the treatment 23 without charge to a veteran and shall submit regular reports 24 to the department of human services concerning the efficacy 25 of the treatment and on whether the treatments have been 26 concluded. The new Code section also provides for a process 27 for a treatment facility and a veteran to receive reimbursement 28 for expenses incurred. The new Code section provides that 29 the department of human services shall approve a request 30 for reimbursement of a veteran’s travel and living expenses 31 incurred by the veteran receiving hyperbaric oxygen treatment 32 under the pilot program if the amount requested does not exceed 33 the estimated cost of travel and living expenses as provided in 34 the approved treatment plan or modified treatment plan. The 35 -8- LSB 1926SV (3) 88 mo/rn 8/ 9

S.F. 529 department of human services shall transmit its approval or 1 disapproval of a request for reimbursement to the department of 2 veterans affairs. If the request is approved, the department 3 of veterans affairs shall disburse moneys to the veteran from 4 the veterans recovery fund accordingly. The new Code section 5 requires the department of human services to provide written 6 notification to the treatment facility and veteran after 7 treatment has concluded, which notice shall indicate when any 8 additional requests for reimbursement may be made. 9 Code section 35E.6 provides that the new Code chapter is 10 repealed July 1, 2025. 11 The bill further directs the department of human services 12 to submit a notice of intended action to the administrative 13 rules coordinator and the administrative code editor not later 14 than January 1, 2020, for the adoption of rules necessary to 15 implement and administer the new Code chapter. 16 -9- LSB 1926SV (3) 88 mo/rn 9/ 9