Senate Study Bill 1193 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON HUMAN RESOURCES BILL BY CHAIRPERSON EDLER) A BILL FOR An Act relating to a study regarding reimbursement for 1 administrative days. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 2475XC (3) 89 pf/rh
S.F. _____ Section 1. MEDICAID REIMBURSEMENT FOR ADMINISTRATIVE DAYS 1 —— STUDY. The department of human services shall conduct 2 a study to determine the feasibility of providing Medicaid 3 reimbursement to hospitals for administrative days. Following 4 its review, the department shall work with the Iowa hospital 5 association, the managed care organizations, and other relevant 6 stakeholders to develop and submit a report including findings, 7 options and criteria for reimbursement, and the estimated 8 costs associated with providing such reimbursement to the 9 governor and the general assembly by December 15, 2021. For 10 the purposes of this section, “administrative day” means an 11 inpatient stay day during which a Medicaid-eligible individual 12 no longer meets medical necessity criteria for acute hospital 13 care and is awaiting placement in a nursing facility or other 14 subacute or post-acute care. 15 EXPLANATION 16 The inclusion of this explanation does not constitute agreement with 17 the explanation’s substance by the members of the general assembly. 18 This bill requires the department of human services (DHS) 19 to conduct a study to determine the feasibility of providing 20 Medicaid reimbursement to hospitals for administrative days. 21 Following its review, DHS shall work with relevant stakeholders 22 to develop and submit a report including findings, options and 23 criteria for reimbursement, and the estimated costs associated 24 with providing such reimbursement to the governor and the 25 general assembly by December 15, 2021. Under the bill, an 26 “administrative day” means an inpatient stay day during which a 27 Medicaid-eligible individual no longer meets medical necessity 28 criteria for acute hospital care and is awaiting placement in a 29 nursing facility or other subacute or post-acute care. 30 -1- LSB 2475XC (3) 89 pf/rh 1/ 1