House
File
2297
-
Introduced
HOUSE
FILE
2297
BY
COMMITTEE
ON
COMMERCE
(SUCCESSOR
TO
HSB
585)
A
BILL
FOR
An
Act
relating
to
the
medical
assistance
and
hawk-i
programs,
1
and
managed
care
organizations.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
TLSB
5418HV
(1)
89
ko/rn
H.F.
2297
Section
1.
NEW
SECTION
.
505.34
Medical
assistance
and
1
hawk-i
programs
——
applicability
of
subtitle.
2
1.
The
medical
assistance
program
under
chapter
249A
and
the
3
healthy
and
well
kids
in
Iowa
(hawk-i)
program
under
chapter
4
514I
shall
not
be
subject
to
this
subtitle
unless
otherwise
5
provided
by
law.
6
2.
A
managed
care
organization
acting
pursuant
to
a
contract
7
with
the
department
of
human
services
to
administer
the
medical
8
assistance
program
under
chapter
249A,
or
the
healthy
and
well
9
kids
in
the
Iowa
(hawk-i)
program
under
chapter
514I,
shall
not
10
be
subject
to
this
subtitle
unless
otherwise
provided
by
law.
11
Sec.
2.
Section
514B.32,
Code
2022,
is
amended
by
adding
the
12
following
new
subsection:
13
NEW
SUBSECTION
.
5.
The
provisions
of
this
chapter
shall
be
14
applicable
to
a
managed
care
organization
acting
pursuant
to
a
15
contract
with
the
department
of
human
services
to
administer
16
the
medical
assistance
program
under
chapter
249A,
or
the
17
healthy
and
well
kids
in
Iowa
(hawk-i)
program
under
chapter
18
514I,
only
with
respect
to
licensure
and
solvency
standards
19
as
evidenced
by
the
managed
care
organization
obtaining
20
and
maintaining
a
certificate
of
authority,
and
maintaining
21
compliance
with
the
solvency
standards
set
forth
in
this
22
chapter.
23
Sec.
3.
Section
514I.2,
subsection
9,
Code
2022,
is
amended
24
to
read
as
follows:
25
9.
“Participating
insurer”
means
any
of
the
following:
26
a.
An
entity
licensed
by
the
division
of
insurance
of
the
27
department
of
commerce
to
provide
health
insurance
in
Iowa
that
28
has
contracted
with
the
department
to
provide
health
insurance
29
coverage
to
eligible
children
under
this
chapter
.
30
b.
A
managed
care
organization
acting
pursuant
to
a
contract
31
with
the
department
of
human
services
to
administer
the
hawk-i
32
program.
33
Sec.
4.
Section
514I.5,
subsection
9,
Code
2022,
is
amended
34
to
read
as
follows:
35
-1-
LSB
5418HV
(1)
89
ko/rn
1/
2
H.F.
2297
9.
The
hawk-i
board
shall
monitor
the
capacity
of
Medicaid
1
managed
care
organizations
acting
pursuant
to
a
contract
with
2
the
department
to
administer
the
hawk-i
program
to
specifically
3
and
appropriately
address
the
unique
needs
of
children
and
4
children’s
health
delivery.
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
relates
to
the
medical
assistance
and
hawk-i
9
programs,
and
managed
care
organizations
(MCOs).
10
The
bill
provides
that
the
medical
assistance
program
and
11
the
hawk-i
program,
and
MCOs
acting
pursuant
to
a
contract
with
12
the
department
of
human
services
(department)
to
administer
13
either
program,
shall
not
be
subject
to
Code
Title
XIII,
14
subtitle
I
(insurance
and
regulated
regulation),
unless
15
otherwise
provided
by
law.
16
The
bill
clarifies
that
the
provisions
of
Code
chapter
514B
17
are
applicable
to
an
MCO
acting
pursuant
to
a
contract
with
18
the
department
to
administer
the
medical
assistance
program
or
19
the
hawk-i
program
only
with
respect
to
licensure
and
solvency
20
standards
as
evidenced
by
the
MCO
obtaining
and
maintaining
a
21
certificate
of
authority,
and
maintaining
compliance
with
the
22
solvency
standards
set
forth
in
the
Code
chapter.
23
The
bill
adds
an
MCO
acting
pursuant
to
a
contract
with
the
24
department
to
administer
the
hawk-i
program
to
the
definition
25
of
“participating
insurer”
for
purposes
of
Code
chapter
514I.2.
26
The
bill
makes
conforming
changes
to
Code
section
514I.5.
27
-2-
LSB
5418HV
(1)
89
ko/rn
2/
2