SF 2202 (LSB 5969SV (4) 91)

SENATE FILE 2202

BY  COMMITTEE ON HEALTH AND HUMAN SERVICES

(SUCCESSOR TO SSB 3083)

A BILL FOR

An Act relating to subacute mental health care facilities and services, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 135G.1, subsection 12, paragraph c, Code 2026, is amended by striking the paragraph.
    Sec. 2.  Section 135G.3, Code 2026, is amended by adding the following new subsection:
   NEW SUBSECTION.  1A.  Within twenty-four hours of a resident’s admission to a subacute care facility, the subacute care facility shall develop an initial treatment plan with the resident.
    Sec. 3.  NEW SECTION.  135G.3A  Insurance authorization.
   1.  If a mental health professional submits an electronic request through an internet portal designated by the department of health and human services for prior authorization for insurance coverage for an individual’s subacute mental health care service under chapter 249A or chapter 249N, the department of health and human services or the managed care organization responsible for administering the individual’s medical assistance shall provide a determination to the mental health professional for the preauthorization request as follows:
   a.  Within forty-eight hours after the date of receipt of an urgent preauthorization request.
   b.  Within five calendar days after the date of receipt of a nonurgent preauthorization request.
   c.  Within ten calendar days after the date of receipt of a nonurgent preauthorization request involving complex or unique circumstances.
   2.  The director of health and human services shall adopt rules pursuant to chapter 17A as necessary to administer this section.
    Sec. 4.  DEPARTMENTS OF INSPECTIONS, APPEALS, AND LICENSING AND HEALTH AND HUMAN SERVICES —— ADMINISTRATIVE RULE REVIEW.  The department of inspections, appeals, and licensing and the department of health and human services shall do all of the following:
   1.  Collaborate to review each department’s administrative rules adopted pursuant to section 135G.10 and eliminate any rule the departments determine impedes any of the following goals without providing an equal or greater benefit:
   a.  Establishment of new subacute mental health care facilities and services.
   b.  Expansion of existing subacute mental health care facilities and services.
   c.  Ease of access to subacute mental health care facilities and services.
   2.  Modify the departments’ respective rules so that the requirements to employ an individual at a subacute mental health care facility are less stringent than the requirements for the same employment at a state mental health institute.
    Sec. 5.  EFFECTIVE DATE.  This Act, being deemed of immediate importance, takes effect upon enactment.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to subacute mental health care (SMHC) facilities and services.
   The bill eliminates the requirement that SMHC must be limited to a period of 10 calendar days unless a longer period of time is adopted by the department of health and human services (HHS).
   The bill requires a subacute care facility to develop an initial treatment care plan with a resident within 24 hours of the resident’s admission to the subacute care facility.
   The bill requires HHS or the managed care organization responsible for administering an individual’s medical assistance, upon a mental health professional’s request for prior authorization (request) through an internet portal designated by HHS for insurance coverage of the individual’s SMHC service under Code chapter 249A (medical assistance) or 249N (Iowa health and wellness plan), to provide a determination to the mental health professional within 48 hours after the date of the receipt of the request if the request is urgent; within 5 calendar days after the date of the receipt of the request if the request is nonurgent; and within 10 calendar days after the date of the receipt of the request if the request is nonurgent and involves complex or unique circumstances.
   The bill directs the department of inspections, appeals, and licensing (DIAL) and HHS to collaborate to review each department’s administrative rules and eliminate any rule the departments determine impedes the establishment of new SMHC facilities and services; expansion of existing SMHC facilities and services; or ease of access to SMHC facilities and services.
   The bill requires HHS and DIAL to modify their respective rules so that the requirements to employ an individual at an SMHC facility are less stringent than those for the same employment at a state mental health institute.
   The bill takes effect upon enactment.