SSB 3083 (LSB 5969XC (3) 91)

SENATE FILE _____ 

BY  (PROPOSED COMMITTEE ON HEALTH AND HUMAN SERVICES BILL BY CHAIRPERSON WARME)

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 a written treatment care plan with the resident.
    Sec. 3.  NEW SECTION.  135G.3A  Insurance authorization.
   Upon a mental health professional’s request for prior authorization for insurance coverage of an individual’s subacute mental health care service, a managed care organization shall provide a determination to the mental health professional for the preauthorization request as follows:
   1.  Within forty-eight hours after the date of receipt of an urgent preauthorization request.
   2.  Within five calendar days after the date of receipt of a nonurgent preauthorization request.
   3.  Within ten calendar days after the date of receipt of a nonurgent preauthorization request involving complex or unique circumstances.
    Sec. 4.  DEPARTMENTS OF HEALTH AND HUMAN SERVICES AND INSPECTIONS, APPEALS, AND LICENSING —— ADMINISTRATIVE RULE REVIEW.  The department of health and human services and the department of inspections, appeals, and licensing 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 more than the benefit the rule provides:
   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 to allow a subacute mental health care facility to increase the number of beds available to provide subacute mental health care without the facility being defined as a mental health institution.
   3.  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.  EMERGENCY RULES.  The department of health and human services and the department of inspections, appeals, and licensing may adopt emergency rules under section 17A.4, subsection 3, and section 17A.5, subsection 2, paragraph “b”, to implement the provisions of this Act and shall submit such rules to the administrative rules coordinator and the administrative code editor pursuant to section 17A.5, subsection 1, within the same period. The rules shall be effective immediately upon filing unless a later date is specified in the rules. Any rules adopted in accordance with this section shall also be published as a notice of intended action as provided in section 17A.4.
    Sec. 6.  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 a written treatment care plan with a resident within 24 hours of the resident’s admission to the subacute care facility.
   The bill requires, upon a mental health professional’s request for prior authorization (request) for insurance coverage of an individual’s subacute mental health care service, a managed care organization 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 HHS and the department of inspections, appeals, and licensing (DIAL) to collaborate to review each department’s administrative rules and eliminate any rule the departments determine impedes the establishment of new subacute mental health care facilities and services; expansion of existing subacute mental health care facilities and services; or ease of access to subacute mental health care facilities and services.
   The bill requires HHS and DIAL to modify their respective rules to allow a subacute mental health care facility to have more beds to provide subacute mental health care without being considered a mental health institution.
   The bill requires HHS and DIAL to modify their respective rules so that the requirements to employ an individual at a subacute mental health care facility are less stringent than those for the same employment at a state mental health institute.
   The bill allows HHS and DIAL to adopt emergency rules to implement the bill.
   The bill takes effect upon enactment.