HF 2662 (LSB 5470HV (1) 91)

HOUSE FILE 2662

BY  COMMITTEE ON VETERANS AFFAIRS

(SUCCESSOR TO HF 2481)

A BILL FOR

An Act establishing a veterans recovery program and fund for the reimbursement of expenses related to providing hyperbaric oxygen treatment to eligible veterans, and making appropriations.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  35E.1  Definitions.
   As used in this chapter, unless the context otherwise requires:
   1.  “Commission” means the commission of veterans affairs created in section 35A.2.
   2.  “Department” means the Iowa department of veterans affairs established in section 35A.4.
   3.  “Health care practitioner” means a practitioner as defined in section 155A.3.
   4.  “Hyperbaric oxygen treatment” means treatment, including diagnostic testing and other related medical treatments, for traumatic brain injury or post-traumatic stress disorder prescribed by a health care practitioner that utilizes, as part of the treatment, a hard-sided or soft-sided hyperbaric oxygen chamber.
   5.  “Program” means the veterans recovery program established under section 35E.2.
   6.  “Traumatic brain injury” means an injury to the brain acquired during military service. 
   7.  “Treatment facility” means a hospital as defined in section 135B.1, an organized outpatient health facility as defined in section 135.61, or any other facility that is authorized by the department to provide hyperbaric oxygen treatment under this chapter.
   8.  “Veteran” means a veteran as defined in section 35.1.
   9.  “Veterans traumatic brain injury recovery fund” means the veterans traumatic brain injury recovery fund created in section 35E.3.
    Sec. 2.  NEW SECTION.  35E.2  Veterans recovery program —— establishment —— reports —— rules.
   1.  The department shall establish a veterans recovery program, subject to sufficient moneys in the veterans traumatic brain injury recovery fund to operate the program, to award grants to statewide veterans service organizations to coordinate the provision of hyperbaric oxygen treatment and support services to eligible veterans who have been diagnosed with post-traumatic stress disorder or a traumatic brain injury pursuant to the requirements of this chapter.
   2.  The department shall adopt rules to implement and administer this chapter.
   3.  By January 1 of each year, the department shall submit to the governor and the general assembly a report regarding the program that includes an evaluation of the effectiveness of the program, including as shown by cognitive testing before and after treatment, and the number of veterans and treatment facilities participating in the program.
    Sec. 3.  NEW SECTION.  35E.3  Veterans traumatic brain injury recovery fund.
   1.  A veterans traumatic brain injury recovery fund is created in the state treasury under the control of the department.
   2.  The fund shall consist of moneys appropriated for purposes of the program, and any other devise, gift, bequest, donation, federal or other grant, reimbursement of payments made by any responsible third-party payor, repayment, judgment, transfer, or payment intended to be used for the purposes of the fund. 
   3.  Moneys in the fund are appropriated to the department and may be expended by the department for any of the following purposes:
   a.  Expenses incurred by the department in administering the program.
   b.  To award grants to statewide veterans service organizations for expenses authorized pursuant to a treatment plan approved pursuant to section 35E.4 for hyperbaric oxygen treatment of a veteran under the program.
   4.  Notwithstanding section 12C.7, subsection 2, interest or earnings on moneys in the fund shall be credited to the fund. Notwithstanding section 8.33, unencumbered or unobligated moneys in the fund shall not revert but shall remain available for expenditure for the purposes designated.
    Sec. 4.  NEW SECTION.  35E.4  Hyperbaric oxygen treatment —— treatment plan.
   1.  A veterans service organization seeking reimbursement for a treatment facility’s provision of hyperbaric oxygen treatment to a veteran under the program shall, prior to the provision of such treatment, submit a proposed treatment plan to the department in a manner as prescribed by the department.
   2.  The proposed treatment plan must include all of the following information:
   a.  A prescription order for hyperbaric oxygen treatment issued by a health care practitioner.
   b.  Information verifying the eligibility of the veteran to receive treatment and that the treatment facility is authorized to provide hyperbaric oxygen treatment.
   c.  An estimate of the costs for providing hyperbaric oxygen treatment by the treatment facility.
   d.  Any other information required by the department.
   3.  Upon receipt of a proposed treatment plan, the department and the commission shall approve or disapprove the treatment plan within a reasonable time as established by rule. The department shall not approve the treatment plan if moneys in the veterans traumatic brain injury recovery fund are not sufficient to reimburse the estimated costs and expenses provided in the proposed treatment plan. The department shall notify the veterans service organization whether the treatment plan was approved or disapproved. 
   4.  A veterans service organization may, following approval of a proposed treatment plan, submit a modified treatment plan if actual expenses are anticipated to exceed the estimated costs approved in the initial treatment plan. The department and the commission shall approve or disapprove the modified treatment plan, subject to sufficient moneys in the veterans traumatic brain injury recovery fund for the increased expenses, and shall notify the veterans service organization within a reasonable time as established by rule whether the modified treatment plan was approved or disapproved.
    Sec. 5.  NEW SECTION.  35E.5  Provision of treatment —— reimbursement of expenses.
   1.  A treatment facility shall receive reimbursement of expenses incurred in providing hyperbaric oxygen treatment under the program to a veteran from a veterans service organization if the department and the commission have approved a treatment plan under section 35E.4 for the veteran.
   2.  A treatment facility that elects to provide hyperbaric oxygen treatment to a veteran under the program shall provide the treatment without charge to the veteran. A veteran receiving treatment under the program is not liable for the cost of treatment or expenses incurred under the program.
   3.  A veterans service organization participating in the program shall submit to the department regular reports, in the form prescribed by the department, of the veteran’s measured health improvements under the treatment plan and whether treatments are continuing or have concluded. If hyperbaric oxygen treatment has concluded, the veterans service organization shall indicate the date the treatment concluded.
   4.  A veterans service organization coordinating hyperbaric oxygen treatment under the program may submit a request for reimbursement of expenses incurred by the treatment facility to the department. The department shall approve the request and reimburse the expenses from the veterans traumatic brain injury recovery fund if all of the following criteria are met:
   a.  The hyperbaric oxygen treatment was provided according to the approved treatment plan or modified treatment plan.
   b.  The expenses do not exceed the estimated cost of the hyperbaric oxygen treatment as provided in the approved treatment plan or modified treatment plan.
   c.  The veterans service organization demonstrates in the reports submitted to the department as required by subsection 3 that the veteran is making measured health improvements or that continuing treatment is recommended.
   5.  After six months from the date specified in the reports submitted to the department from a veterans service organization that treatment has concluded, the department shall notify the veterans service organization and veteran in writing of the expenses that have been reimbursed and whether the amounts reimbursed are less than the costs authorized to be reimbursed pursuant to an approved treatment plan or modified treatment plan. The written notification must further notify the veterans service organization and the veteran that any requests for reimbursement shall not be authorized if a request for reimbursement is not submitted within ninety days after receiving the notice unless, prior to the ninety days, the veterans service organization indicates that treatment has not been completed. 
    Sec. 6.  DIRECTIVE TO DEPARTMENT OF VETERANS AFFAIRS.  The department of veterans affairs shall submit a regulatory analysis of proposed rules to the administrative code editor pursuant to section 17A.4A, subsection 4, not later than January 1, 2027, for the adoption of rules to implement and administer chapter 35E as enacted in this Act.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill establishes a veterans recovery program, administered by the department of veterans affairs (department) for the reimbursement of expenses related to providing hyperbaric oxygen treatment to eligible veterans.
   New Code section 35E.1 establishes definitions applicable to the new Code chapter, including definitions for “commission”, “department”, “health care practitioner”, “hyperbaric oxygen treatment”, “traumatic brain injury”, “treatment facility”, and “veteran”. Specifically, the bill defines “hyperbaric oxygen treatment” as treatment, including diagnostic testing and other related medical treatments, for traumatic brain injury or post-traumatic stress disorder prescribed by a health care practitioner that utilizes a hard-sided or soft-sided hyperbaric oxygen chamber. 
   New Code section 35E.2 establishes the veterans recovery program, subject to sufficient moneys to operate the program, requires the department to adopt rules to implement and administer the program, and includes a reporting requirement for the department concerning the operation of the program.
   New Code section 35E.3 creates a veterans traumatic brain injury recovery fund in the state treasury under the control of the department. Moneys in the fund are appropriated to the department to be expended for expenses incurred in operating the program and for expenses authorized to be reimbursed for hyperbaric oxygen treatment.
   New Code section 35E.4 provides for the process for a veterans service organization to seek reimbursement from the veterans traumatic brain injury recovery fund for hyperbaric oxygen treatment. The bill provides that a veterans service organization may submit a proposed treatment plan to the department and the commission of veterans affairs for their approval. The treatment plan shall include the prescription order for the treatment, information verifying the eligibility of the veteran to receive and the treatment facility to provide the treatment, the estimated costs for providing the treatment, and any other information required by the department. The treatment plan shall not be approved if sufficient moneys to reimburse the estimated costs are not available in the veterans traumatic brain injury recovery fund. The bill also establishes a process for submitting a modified treatment plan if the estimated costs for providing the treatment are anticipated to exceed the cost estimate in the initial treatment plan. 
   New Code section 35E.5 provides for requirements relative to providing hyperbaric oxygen treatment and provides for the manner in which treatment-related expenses are to be reimbursed. The bill provides that a veterans service organization shall not be reimbursed for treatment unless a treatment plan has been approved. If a treatment facility elects to provide hyperbaric oxygen treatment under the program, the facility shall provide the treatment without charge to a veteran. A participating veterans service organization shall submit regular reports to the department concerning the efficacy of the treatment and whether the treatments have been concluded. The bill also provides for a process for a treatment facility and a veteran to receive reimbursement for expenses incurred. The bill requires the department to provide written notification to the veterans service organization and veteran after treatment has concluded, which notice shall indicate when any additional requests for reimbursement may be made. 
   The bill further directs the department to submit a regulatory analysis of proposed rules to the administrative code editor not later than January 1, 2027, for the adoption of rules necessary to implement and administer the new Code chapter.