H.F. 2662 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 created in section 35A.2. 5 2. “Department” means the Iowa department of veterans 6 affairs established 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, a hard-sided or soft-sided hyperbaric oxygen 14 chamber. 15 5. “Program” means the veterans recovery program established 16 under section 35E.2. 17 6. “Traumatic brain injury” means an injury to the brain 18 acquired during military service. 19 7. “Treatment facility” means a hospital as defined in 20 section 135B.1, an organized outpatient health facility as 21 defined in section 135.61, or any other facility that is 22 authorized by the department to provide hyperbaric oxygen 23 treatment under this chapter. 24 8. “Veteran” means a veteran as defined in section 35.1. 25 9. “Veterans traumatic brain injury recovery fund” means 26 the veterans traumatic brain injury recovery fund created in 27 section 35E.3. 28 Sec. 2. NEW SECTION . 35E.2 Veterans recovery program —— 29 establishment —— reports —— rules. 30 1. The department shall establish a veterans recovery 31 program, subject to sufficient moneys in the veterans 32 traumatic brain injury recovery fund to operate the program, 33 to award grants to statewide veterans service organizations to 34 coordinate the provision of hyperbaric oxygen treatment and 35 -1- LSB 5470HV (1) 91 sc/ns 1/ 7

H.F. 2662 support services to eligible veterans who have been diagnosed 1 with post-traumatic stress disorder or a traumatic brain injury 2 pursuant to the requirements of this chapter. 3 2. The department shall adopt rules to implement and 4 administer this chapter. 5 3. By January 1 of each year, the department shall submit 6 to the governor and the general assembly a report regarding 7 the program that includes an evaluation of the effectiveness 8 of the program, including as shown by cognitive testing before 9 and after treatment, and the number of veterans and treatment 10 facilities participating in the program. 11 Sec. 3. NEW SECTION . 35E.3 Veterans traumatic brain injury 12 recovery fund. 13 1. A veterans traumatic brain injury recovery fund is 14 created in the state treasury under the control of the 15 department. 16 2. The fund shall consist of moneys appropriated for 17 purposes of the program, and any other devise, gift, bequest, 18 donation, federal or other grant, reimbursement of payments 19 made by any responsible third-party payor, repayment, judgment, 20 transfer, or payment intended to be used for the purposes of 21 the fund. 22 3. Moneys in the fund are appropriated to the department 23 and may be expended by the department for any of the following 24 purposes: 25 a. Expenses incurred by the department in administering the 26 program. 27 b. To award grants to statewide veterans service 28 organizations for expenses authorized pursuant to a treatment 29 plan approved pursuant to section 35E.4 for hyperbaric oxygen 30 treatment of a veteran under the program. 31 4. Notwithstanding section 12C.7, subsection 2, interest or 32 earnings on moneys in the fund shall be credited to the fund. 33 Notwithstanding section 8.33, unencumbered or unobligated 34 moneys in the fund shall not revert but shall remain available 35 -2- LSB 5470HV (1) 91 sc/ns 2/ 7

H.F. 2662 for expenditure for the purposes designated. 1 Sec. 4. NEW SECTION . 35E.4 Hyperbaric oxygen treatment —— 2 treatment plan. 3 1. A veterans service organization seeking reimbursement 4 for a treatment facility’s provision of hyperbaric oxygen 5 treatment to a veteran under the program shall, prior to the 6 provision of such treatment, submit a proposed treatment plan 7 to the department in a manner as prescribed by the department. 8 2. The proposed treatment plan must include all of the 9 following information: 10 a. A prescription order for hyperbaric oxygen treatment 11 issued by a health care practitioner. 12 b. Information verifying the eligibility of the veteran to 13 receive treatment and that the treatment facility is authorized 14 to provide hyperbaric oxygen treatment. 15 c. An estimate of the costs for providing hyperbaric oxygen 16 treatment by the treatment facility. 17 d. Any other information required by the department. 18 3. Upon receipt of a proposed treatment plan, the department 19 and the commission shall approve or disapprove the treatment 20 plan within a reasonable time as established by rule. The 21 department shall not approve the treatment plan if moneys in 22 the veterans traumatic brain injury recovery fund are not 23 sufficient to reimburse the estimated costs and expenses 24 provided in the proposed treatment plan. The department shall 25 notify the veterans service organization whether the treatment 26 plan was approved or disapproved. 27 4. A veterans service organization may, following approval 28 of a proposed treatment plan, submit a modified treatment plan 29 if actual expenses are anticipated to exceed the estimated 30 costs approved in the initial treatment plan. The department 31 and the commission shall approve or disapprove the modified 32 treatment plan, subject to sufficient moneys in the veterans 33 traumatic brain injury recovery fund for the increased 34 expenses, and shall notify the veterans service organization 35 -3- LSB 5470HV (1) 91 sc/ns 3/ 7

H.F. 2662 within a reasonable time as established by rule whether the 1 modified treatment plan was approved or disapproved. 2 Sec. 5. NEW SECTION . 35E.5 Provision of treatment —— 3 reimbursement of expenses. 4 1. A treatment facility shall receive reimbursement of 5 expenses incurred in providing hyperbaric oxygen treatment 6 under the program to a veteran from a veterans service 7 organization if the department and the commission have approved 8 a treatment plan under section 35E.4 for the veteran. 9 2. A treatment facility that elects to provide hyperbaric 10 oxygen treatment to a veteran under the program shall provide 11 the treatment without charge to the veteran. A veteran 12 receiving treatment under the program is not liable for the 13 cost of treatment or expenses incurred under the program. 14 3. A veterans service organization participating in 15 the program shall submit to the department regular reports, 16 in the form prescribed by the department, of the veteran’s 17 measured health improvements under the treatment plan and 18 whether treatments are continuing or have concluded. If 19 hyperbaric oxygen treatment has concluded, the veterans service 20 organization shall indicate the date the treatment concluded. 21 4. A veterans service organization coordinating hyperbaric 22 oxygen treatment under the program may submit a request for 23 reimbursement of expenses incurred by the treatment facility to 24 the department. The department shall approve the request and 25 reimburse the expenses from the veterans traumatic brain injury 26 recovery fund if all of the following criteria are met: 27 a. The hyperbaric oxygen treatment was provided according to 28 the approved treatment plan or modified treatment plan. 29 b. The expenses do not exceed the estimated cost of the 30 hyperbaric oxygen treatment as provided in the approved 31 treatment plan or modified treatment plan. 32 c. The veterans service organization demonstrates in the 33 reports submitted to the department as required by subsection 3 34 that the veteran is making measured health improvements or that 35 -4- LSB 5470HV (1) 91 sc/ns 4/ 7

H.F. 2662 continuing treatment is recommended. 1 5. After six months from the date specified in the 2 reports submitted to the department from a veterans service 3 organization that treatment has concluded, the department 4 shall notify the veterans service organization and veteran in 5 writing of the expenses that have been reimbursed and whether 6 the amounts reimbursed are less than the costs authorized to be 7 reimbursed pursuant to an approved treatment plan or modified 8 treatment plan. The written notification must further notify 9 the veterans service organization and the veteran that any 10 requests for reimbursement shall not be authorized if a request 11 for reimbursement is not submitted within ninety days after 12 receiving the notice unless, prior to the ninety days, the 13 veterans service organization indicates that treatment has not 14 been completed. 15 Sec. 6. DIRECTIVE TO DEPARTMENT OF VETERANS AFFAIRS. The 16 department of veterans affairs shall submit a regulatory 17 analysis of proposed rules to the administrative code editor 18 pursuant to section 17A.4A, subsection 4, not later than 19 January 1, 2027, for the adoption of rules to implement and 20 administer chapter 35E as enacted in this Act. 21 EXPLANATION 22 The inclusion of this explanation does not constitute agreement with 23 the explanation’s substance by the members of the general assembly. 24 This bill establishes a veterans recovery program, 25 administered by the department of veterans affairs (department) 26 for the reimbursement of expenses related to providing 27 hyperbaric oxygen treatment to eligible veterans. 28 New Code section 35E.1 establishes definitions applicable to 29 the new Code chapter, including definitions for “commission”, 30 “department”, “health care practitioner”, “hyperbaric oxygen 31 treatment”, “traumatic brain injury”, “treatment facility”, 32 and “veteran”. Specifically, the bill defines “hyperbaric 33 oxygen treatment” as treatment, including diagnostic testing 34 and other related medical treatments, for traumatic brain 35 -5- LSB 5470HV (1) 91 sc/ns 5/ 7

H.F. 2662 injury or post-traumatic stress disorder prescribed by a health 1 care practitioner that utilizes a hard-sided or soft-sided 2 hyperbaric oxygen chamber. 3 New Code section 35E.2 establishes the veterans recovery 4 program, subject to sufficient moneys to operate the program, 5 requires the department to adopt rules to implement and 6 administer the program, and includes a reporting requirement 7 for the department concerning the operation of the program. 8 New Code section 35E.3 creates a veterans traumatic brain 9 injury recovery fund in the state treasury under the control 10 of the department. Moneys in the fund are appropriated to the 11 department to be expended for expenses incurred in operating 12 the program and for expenses authorized to be reimbursed for 13 hyperbaric oxygen treatment. 14 New Code section 35E.4 provides for the process for a 15 veterans service organization to seek reimbursement from the 16 veterans traumatic brain injury recovery fund for hyperbaric 17 oxygen treatment. The bill provides that a veterans service 18 organization may submit a proposed treatment plan to the 19 department and the commission of veterans affairs for their 20 approval. The treatment plan shall include the prescription 21 order for the treatment, information verifying the eligibility 22 of the veteran to receive and the treatment facility to provide 23 the treatment, the estimated costs for providing the treatment, 24 and any other information required by the department. The 25 treatment plan shall not be approved if sufficient moneys 26 to reimburse the estimated costs are not available in the 27 veterans traumatic brain injury recovery fund. The bill also 28 establishes a process for submitting a modified treatment 29 plan if the estimated costs for providing the treatment 30 are anticipated to exceed the cost estimate in the initial 31 treatment plan. 32 New Code section 35E.5 provides for requirements relative 33 to providing hyperbaric oxygen treatment and provides for 34 the manner in which treatment-related expenses are to be 35 -6- LSB 5470HV (1) 91 sc/ns 6/ 7

H.F. 2662 reimbursed. The bill provides that a veterans service 1 organization shall not be reimbursed for treatment unless a 2 treatment plan has been approved. If a treatment facility 3 elects to provide hyperbaric oxygen treatment under the 4 program, the facility shall provide the treatment without 5 charge to a veteran. A participating veterans service 6 organization shall submit regular reports to the department 7 concerning the efficacy of the treatment and whether the 8 treatments have been concluded. The bill also provides for 9 a process for a treatment facility and a veteran to receive 10 reimbursement for expenses incurred. The bill requires the 11 department to provide written notification to the veterans 12 service organization and veteran after treatment has concluded, 13 which notice shall indicate when any additional requests for 14 reimbursement may be made. 15 The bill further directs the department to submit a 16 regulatory analysis of proposed rules to the administrative 17 code editor not later than January 1, 2027, for the adoption 18 of rules necessary to implement and administer the new Code 19 chapter. 20 -7- LSB 5470HV (1) 91 sc/ns 7/ 7