Senate Study Bill 3073 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON JUDICIARY BILL BY CHAIRPERSON ZAUN) A BILL FOR An Act relating to the payment of required medical aid provided 1 to prisoners. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 5593XC (1) 88 pf/rh
S.F. _____ Section 1. Section 356.15, Code 2020, is amended to read as 1 follows: 2 356.15 Expenses. 3 1. All charges and expenses for the safekeeping and 4 maintenance of prisoners shall be allowed by the board of 5 supervisors, except those with the exception of the following 6 prisoners: 7 a. Those committed or detained by the authority of the 8 courts of the United States, in which cases the United States 9 must pay such expenses to the county , or those . 10 b. Those committed for violation of a city ordinance, in 11 which case the city shall pay expenses to the county , or those . 12 c. Those committed or detained from another state, in which 13 case the governmental entity from the other state sending the 14 prisoners shall pay expenses to the county. 15 2. Notwithstanding the charges and expenses allowed 16 pursuant to subsection 1, the costs of required medical aid 17 furnished to prisoners in the custody of the county sheriff 18 pursuant to section 356.5 shall be paid as specified in 19 sections 356.15A and 804.28. 20 Sec. 2. NEW SECTION . 356.15A Responsibility for payment of 21 required medical aid. 22 1. For purposes of this section: 23 a. “Governmental entity” means the state or a state 24 department, division, commission, institution, or authority, 25 an agency, city, county, or special district in this state 26 established pursuant to law, and, except where otherwise 27 indicated, also means the United States or a department, 28 division, or agency of the United States, and an agency, 29 commission, or authority established pursuant to an interstate 30 compact or agreement. 31 b. “Health insurance” means a policy, plan, contract, 32 or other agreement providing health insurance, health care 33 benefits, or health care services, provided by an entity 34 including an insurance company offering sickness and accident 35 -1- LSB 5593XC (1) 88 pf/rh 1/ 5
S.F. _____ plans, a health maintenance organization, a nonprofit health 1 service corporation, or any other entity providing a plan 2 of health insurance, health care benefits, or health care 3 services. “Health insurance” includes but is not limited to 4 private health insurance, Medicaid, and Medicare. 5 c. “Other benefits” includes but is not limited to veterans 6 administration benefits or other benefits for which the 7 prisoner is eligible or entitled to pay for medical aid. 8 d. “Prisoner” means an individual confined in a jail or 9 municipal holding facility. 10 2. A prisoner has the primary responsibility for payment of 11 the costs of required medical aid provided pursuant to section 12 356.5. Payment and reimbursement for medical aid provided to a 13 prisoner shall be sought as follows: 14 a. A governmental entity shall request available sources 15 of health insurance or other benefits from a prisoner at 16 the time of intake into a county jail or municipal holding 17 facility. If the governmental entity identifies health 18 insurance or other benefits to which the prisoner is entitled, 19 the governmental entity shall provide the health insurance 20 or benefit information to a hospital or medical provider at 21 the time the prisoner is presented at the hospital or medical 22 provider or at the earliest possible opportunity. 23 b. A hospital or medical provider shall request available 24 sources of health insurance or other benefits from the 25 governmental entity and the prisoner at the time of intake 26 at or admission of the prisoner into the hospital or medical 27 provider. The hospital or medical provider shall utilize the 28 health insurance or other benefits identified and shall seek 29 payment for medical aid through the prisoner’s health insurance 30 or other benefits prior to a request for reimbursement being 31 presented to a governmental entity. If the prisoner is 32 entitled to health insurance or other benefits to pay for the 33 medical aid, any amounts not met by the prisoner’s health 34 insurance or other benefits shall be the responsibility of the 35 -2- LSB 5593XC (1) 88 pf/rh 2/ 5
S.F. _____ prisoner. 1 c. (1) If health insurance is denied or other benefits are 2 not available to pay for medical aid provided to a prisoner, 3 a hospital or medical provider shall submit any bill for 4 reimbursement of medical aid to the governmental entity within 5 thirty days of treatment or shall submit any written denial 6 of coverage to the governmental entity within thirty days of 7 receipt of the denial, as applicable. 8 (2) The governmental entity shall submit the bill for 9 reimbursement within thirty days of receipt of the bill and 10 shall remit payment to the hospital or medical provider in the 11 governmental entity’s next billing cycle. 12 (3) The hospital or medical provider shall be reimbursed 13 by the governmental entity at the rate negotiated and agreed 14 upon by the hospital or medical provider and the governmental 15 entity. If a rate has not been agreed to, the governmental 16 entity shall reimburse the hospital or medical provider the 17 hospital’s or medical provider’s published Medicaid rate for 18 such treatment, regardless of the prisoner’s eligibility for 19 Medicaid. 20 3. Except as provided in chapters 669 and 670, a 21 governmental entity shall not be responsible for payment of the 22 costs of any medical aid provided to a prisoner if such medical 23 aid is provided after the prisoner is released from the custody 24 of the governmental entity or when the individual is released 25 on parole. 26 4. This section does not preclude a city or a county from 27 seeking reimbursement from a prisoner for the costs of medical 28 aid incurred by the city or county for the prisoner’s medical 29 aid including as provided pursuant to section 356.7. 30 5. Notwithstanding any provision of this section to the 31 contrary, payment for medical aid provided to a prisoner at a 32 state-funded hospital shall be provided through state funds 33 received by the hospital. 34 EXPLANATION 35 -3- LSB 5593XC (1) 88 pf/rh 3/ 5
S.F. _____ The inclusion of this explanation does not constitute agreement with 1 the explanation’s substance by the members of the general assembly. 2 This bill relates to the payment of required medical aid 3 provided to prisoners confined in a jail or municipal holding 4 facility. 5 The bill provides definitions for “governmental entity”, 6 “health insurance”, “other benefits”, and “prisoner” for the 7 purposes of the bill. 8 The bill provides that a prisoner has the primary 9 responsibility for payment of the costs of required medical aid 10 provided to the prisoner. 11 Payment and reimbursement for medical aid provided to a 12 prisoner is to be sought by a governmental entity, hospital, or 13 medical provider in accordance with the bill. 14 A governmental entity is required to request available 15 sources of health insurance or other benefits from a prisoner 16 at the time of intake into a county jail or municipal holding 17 facility. If identified, the governmental entity is required 18 to provide the prisoner’s health insurance or benefit 19 information to a hospital or medical provider at the time the 20 prisoner is presented at the hospital or medical provider or at 21 the earliest possible opportunity. 22 A hospital or medical provider is required to request 23 available sources of health insurance or other benefits from 24 the governmental entity and the prisoner at the time of intake 25 at or admission of the prisoner to the hospital or medical 26 provider. The hospital or medical provider shall utilize the 27 health insurance or other benefits identified and shall seek 28 payment for medical aid through the prisoner’s health insurance 29 or other benefits prior to a request for reimbursement being 30 presented to a governmental entity. If the prisoner is 31 entitled to health insurance or other benefits to pay for the 32 medical aid, any amounts not met by the prisoner’s health 33 insurance or other benefits shall be the responsibility of the 34 prisoner. 35 -4- LSB 5593XC (1) 88 pf/rh 4/ 5
S.F. _____ If health insurance is denied or other benefits are not 1 available to pay for medical aid provided to a prisoner, 2 a hospital or medical provider shall submit any bill for 3 reimbursement of medical aid to the governmental entity within 4 30 days of treatment or shall submit any written denial of 5 coverage to the governmental entity within 30 days of receipt 6 of the denial, as applicable. The governmental entity shall 7 submit the bill for reimbursement within 30 days of receipt of 8 the bill and shall remit payment to the hospital or medical 9 provider in the governmental entity’s next billing cycle. 10 The hospital or medical provider shall be reimbursed by the 11 governmental entity at the rate negotiated and agreed upon by 12 the hospital or medical provider and the governmental entity. 13 If a rate has not been agreed to, the governmental entity shall 14 reimburse the hospital or medical provider the hospital’s or 15 medical provider’s published Medicaid rate for such treatment, 16 regardless of the prisoner’s eligibility for Medicaid. 17 Except as otherwise provided by law, a governmental entity 18 shall not be responsible for payment of the costs of any 19 medical aid provided to a prisoner if such medical aid is 20 provided after the prisoner is released from the custody of 21 the governmental entity or when the individual is released on 22 parole. The bill does not preclude a city or a county from 23 seeking reimbursement from a prisoner for the costs of medical 24 aid incurred by the city or county for the prisoner’s medical 25 aid. Payment for medical aid provided to a prisoner at a 26 state-funded hospital shall be provided through state funds 27 received by the hospital. 28 -5- LSB 5593XC (1) 88 pf/rh 5/ 5