S.F. _____ 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 1926XC (3) 88 mo/rn 1/ 8

S.F. _____ 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. 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. Moneys in the fund are appropriated to the department 29 and may be expended by the department for any of the following 30 purposes: 31 a. Expenses incurred by the department in administering the 32 pilot program. 33 b. Expenses authorized pursuant to a treatment plan approved 34 pursuant to section 35E.4 for hyperbaric oxygen treatment of a 35 -2- LSB 1926XC (3) 88 mo/rn 2/ 8

S.F. _____ veteran under the pilot program. 1 c. Expenses authorized pursuant to a treatment plan approved 2 pursuant to section 35E.4 for any necessary travel and living 3 expenses of a veteran required to travel to obtain hyperbaric 4 oxygen treatment under the pilot program. 5 4. Any unencumbered or unobligated moneys remaining in the 6 fund as of June 30, 2025, shall be transferred for deposit in 7 the veterans trust fund created in section 35A.13. 8 Sec. 4. NEW SECTION . 35E.4 Hyperbaric oxygen treatment —— 9 treatment plan. 10 1. A treatment facility seeking reimbursement for providing 11 hyperbaric oxygen treatment to a veteran under the pilot 12 program shall, prior to providing such treatment, submit a 13 proposed treatment plan to the department in a manner as 14 prescribed by the department. 15 2. The proposed treatment plan shall include the following 16 information: 17 a. A prescription order for hyperbaric oxygen treatment 18 issued by a health care practitioner. 19 b. Information verifying the eligibility of the veteran to 20 receive treatment and that the treatment facility is authorized 21 to provide hyperbaric oxygen treatment. 22 c. An estimate of the costs for providing hyperbaric oxygen 23 treatment by the treatment facility. 24 d. An estimate of cost for reimbursing any necessary travel 25 and living expenses of the veteran required to travel to obtain 26 the hyperbaric oxygen treatment. 27 e. Any other information required by the department. 28 3. Upon receipt of a proposed treatment plan, the department 29 and the commission shall approve or disapprove the treatment 30 plan within a reasonable time as established by rule. The 31 department shall not approve the treatment plan if there 32 is not sufficient money in the veterans recovery fund to 33 reimburse the estimate of costs and expenses provided in the 34 proposed treatment plan. The department shall notify the 35 -3- LSB 1926XC (3) 88 mo/rn 3/ 8

S.F. _____ treatment facility whether the treatment plan was approved or 1 disapproved. 2 4. A treatment facility may, following approval of a 3 proposed treatment plan, submit a modified treatment plan if 4 actual expenses are anticipated to exceed the estimated costs 5 approved in the initial treatment plan. The department and the 6 commission shall approve or disapprove the modified treatment 7 plan, subject to sufficient moneys in the veterans recovery 8 fund for the increased expenses, and shall notify the treatment 9 facility within a reasonable time as established by rule 10 whether the modified treatment plan was approved or disapproved 11 within a reasonable time as established by rule. 12 Sec. 5. NEW SECTION . 35E.5 Provision of treatment —— 13 reimbursement of expenses. 14 1. A treatment facility shall receive reimbursement of 15 expenses incurred in providing hyperbaric oxygen treatment 16 under the pilot program to a veteran if the department and the 17 commission have approved a treatment plan under section 35E.4 18 for the veteran. 19 2. A treatment facility that elects to provide hyperbaric 20 oxygen treatment to a veteran under the pilot program shall 21 provide the treatment without charge to the veteran. A veteran 22 receiving treatment under the pilot program is not liable for 23 the cost of treatment or expenses incurred under the pilot 24 program. 25 3. A treatment facility that elects to provide treatment 26 under the pilot program shall submit to the department regular 27 reports, in the form prescribed by the department, of the 28 veteran’s measured health improvements under the treatment 29 plan and whether treatments are continuing or have concluded. 30 If hyperbaric oxygen treatment has concluded, the treatment 31 facility shall indicate the date the treatment concluded. 32 4. A treatment facility providing hyperbaric oxygen 33 treatment under the pilot program may submit a request for 34 reimbursement of expenses incurred by the treatment facility to 35 -4- LSB 1926XC (3) 88 mo/rn 4/ 8

S.F. _____ the department. The department shall approve the request and 1 reimburse the expenses from the veterans recovery fund if all 2 of the following criteria are met: 3 a. The hyperbaric oxygen treatment was provided according to 4 the approved treatment plan or modified treatment plan. 5 b. The expenses do not exceed the estimated cost of the 6 hyperbaric oxygen treatment as provided in the approved 7 treatment plan or modified treatment plan. 8 c. The treatment facility demonstrates in the reports 9 submitted to the department as required by subsection 3 that 10 the veteran is making measured health improvements or that 11 continuing treatment is recommended. 12 5. The department shall reimburse a veteran from moneys in 13 the veterans recovery fund for any travel and living expenses 14 incurred by the veteran receiving hyperbaric oxygen treatment 15 under the pilot program if the amount requested does not exceed 16 the estimated cost of travel and living expenses as provided in 17 the approved treatment plan or modified treatment plan. 18 6. After six months from the date specified in the reports 19 submitted to the department from a treatment facility that 20 treatment has concluded, the department shall notify the 21 treatment facility and veteran in writing of the expenses 22 that have been reimbursed and whether the amounts reimbursed 23 are less than the costs authorized to be reimbursed pursuant 24 to an approved treatment plan or modified treatment plan. 25 The written notification shall further notify the treatment 26 facility and the veteran that any requests for reimbursement 27 shall not be authorized if a request for reimbursement is not 28 submitted within ninety days after receiving the notice unless, 29 prior to the ninety days, the treatment facility indicates that 30 treatment has not been completed. 31 Sec. 6. NEW SECTION . 35E.6 Repeal. 32 This chapter is repealed July 1, 2025. 33 Sec. 7. DIRECTIVE TO DEPARTMENT OF VETERANS AFFAIRS. The 34 department of veterans affairs shall submit a notice of 35 -5- LSB 1926XC (3) 88 mo/rn 5/ 8

S.F. _____ intended action to the administrative rules coordinator and 1 the administrative code editor pursuant to section 17A.4, 2 subsection 1, paragraph “a”, not later than January 1, 2020, 3 for the adoption of rules to implement and administer chapter 4 35E as enacted in this Act. 5 EXPLANATION 6 The inclusion of this explanation does not constitute agreement with 7 the explanation’s substance by the members of the general assembly. 8 This bill establishes a veterans recovery pilot program, 9 administered by the department of veterans affairs for the 10 reimbursement of expenses related to providing hyperbaric 11 oxygen treatment to eligible veterans. 12 New Code section 35E.1 establishes definitions applicable 13 to the new Code chapter. The bill includes definitions for 14 commission, department, health care practitioner, hyperbaric 15 oxygen treatment, traumatic brain injury, treatment facility, 16 and veteran. Specifically, the bill defines hyperbaric oxygen 17 treatment as treatment, including diagnostic testing and other 18 related medical treatments, for traumatic brain injury or 19 post-traumatic stress disorder prescribed by a health care 20 practitioner that utilizes a United States food and drug 21 administration-approved hyperbaric chamber or hyperbaric oxygen 22 device. 23 New Code section 35E.2 establishes the veterans recovery 24 pilot program, subject to sufficient funds to operate the 25 program, requires the department of veterans affairs to adopt 26 rules to implement and administer the program, and includes 27 a reporting requirement for each department concerning the 28 operation of the pilot program. 29 New Code section 35E.3 creates a veterans recovery fund 30 in the state treasury under the control of the department of 31 veterans affairs. The new Code section provides that the fund 32 shall consist of moneys contributed through or received from 33 any devise, gift, bequest, donation, federal or other grant, 34 reimbursement of payments made by any responsible third-party 35 -6- LSB 1926XC (3) 88 mo/rn 6/ 8

S.F. _____ payor, repayment, judgment, transfer, or payment intended to be 1 used for the purposes of the fund. The department of veterans 2 affairs is to expend moneys in the fund, as appropriated by the 3 department, for expenses incurred in operating the program and 4 for expenses authorized to be reimbursed for hyperbaric oxygen 5 treatment and any related travel and living expenses incurred 6 by the veteran. The new Code section provides that any moneys 7 remaining in the fund as of June 30, 2025, shall be transferred 8 for deposit in the veterans trust fund. 9 New Code section 35E.4 provides for the process for a 10 treating facility to seek reimbursement from the veterans 11 recovery fund for providing hyperbaric oxygen treatment. The 12 bill provides that a treating facility may submit a proposed 13 treatment plan to the department of veterans affairs and 14 the commission of veterans affairs for their approval. The 15 treatment plan shall include the prescription order for the 16 treatment, information verifying the eligibility of the veteran 17 and the treatment facility to provide the treatment, the 18 estimated costs for providing the treatment and for reimbursing 19 the veteran for any associated travel and living expenses, and 20 any other information required by the department of veterans 21 affairs. The new Code section provides that the treatment 22 plan shall not be approved if sufficient moneys to reimburse 23 the estimated costs are not available in the veterans recovery 24 fund. The new Code section also establishes a process for 25 submitting a modified treatment plan if the estimated costs 26 for providing the treatment are anticipated to exceed the cost 27 estimate in the initial treatment plan. 28 New Code section 35E.5 provides for requirements relative 29 to providing hyperbaric oxygen treatment and provides for 30 the manner in which treatment-related expenses are to be 31 reimbursed. The Code section provides that a treatment 32 facility shall not be reimbursed for providing treatment 33 unless a treatment plan has been approved. If a treatment 34 facility elects to provide hyperbaric oxygen treatment under 35 -7- LSB 1926XC (3) 88 mo/rn 7/ 8

S.F. _____ the pilot program, the facility shall provide the treatment 1 without charge to a veteran and shall submit regular reports 2 to the department of veterans affairs concerning the efficacy 3 of the treatment and on whether the treatments have been 4 concluded. The new Code section also provides for a process 5 for a treatment facility and a veteran to receive reimbursement 6 for expenses incurred. The new Code sections require the 7 department of veterans affairs to provide written notification 8 to the treatment facility and veteran after treatment has 9 concluded, which notice shall indicate when any additional 10 requests for reimbursement may be made. 11 Code section 35E.6 provides that the new Code chapter is 12 repealed July 1, 2025. 13 The bill further directs the department of veterans affairs 14 to submit a notice of intended action to the administrative 15 rules coordinator and the administrative code editor not later 16 than January 1, 2020, for the adoption of rules necessary to 17 implement and administer the new Code chapter. 18 -8- LSB 1926XC (3) 88 mo/rn 8/ 8