Senate File 395 - Reprinted SENATE FILE 395 BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO SSB 1227) (COMPANION TO LSB 1151HV BY COMMITTEE ON HUMAN RESOURCES) (As Amended and Passed by the Senate March 18, 2013 ) A BILL FOR An Act relating to child, adult, and family services under 1 the purview of the department of human services, making 2 penalties applicable, and including effective date 3 provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 SF 395 (6) 85 pf/nh/jh

S.F. 395 Section 1. Section 225C.38, subsection 1, paragraph c, Code 1 2013, is amended to read as follows: 2 c. Except as provided in section 225C.41 , a family support 3 subsidy for a fiscal year shall be in an amount determined by 4 the department in consultation with the comprehensive family 5 support council created in section 225C.48 . The parent or 6 legal guardian receiving a family support subsidy may elect 7 to receive a payment amount which is less than the amount 8 determined in accordance with this paragraph. 9 Sec. 2. Section 225C.42, subsection 1, Code 2013, is amended 10 to read as follows: 11 1. The department shall conduct an annual evaluation of 12 the family support subsidy program in conjunction with the 13 comprehensive family support council and shall submit the 14 evaluation report with recommendations to the governor and 15 general assembly. The report shall be submitted on or before 16 October 30 and provide an evaluation of the latest completed 17 fiscal year. 18 Sec. 3. Section 225C.47, subsection 5, unnumbered paragraph 19 1, Code 2013, is amended to read as follows: 20 The department shall design the program in consultation with 21 the comprehensive family support council created in section 22 225C.48 . The department shall adopt rules to implement the 23 program which provide for all of the following: 24 Sec. 4. Section 225C.49, subsection 4, Code 2013, is amended 25 to read as follows: 26 4. The department shall designate one individual whose sole 27 duties are to provide central coordination of the programs 28 under sections 225C.36 and 225C.47 and to work with the 29 comprehensive family support council to oversee development and 30 implementation of the programs. 31 Sec. 5. Section 239B.5, Code 2013, is amended by adding the 32 following new subsection: 33 NEW SUBSECTION . 4. a. The department shall implement 34 policies and procedures as necessary to comply with provisions 35 -1- SF 395 (6) 85 pf/nh/jh 1/ 8

S.F. 395 of the federal Middle Class Tax Relief and Job Creation Act 1 of 2012, Pub. L. No. 112-96, to prevent assistance provided 2 under this chapter from being used in any electronic benefit 3 transfer transaction in any liquor store; any casino, gambling 4 casino, or gaming establishment; or any retail establishment 5 which provides adult-oriented entertainment in which performers 6 disrobe or perform in an unclothed state for entertainment. 7 For purposes of this paragraph, the definitions found in the 8 federal Middle Class Tax Relief and Job Creation Act and 9 related rules and statutes apply. 10 b. Unless otherwise precluded by federal law or regulation, 11 policies and procedures implemented under this subsection shall 12 at a minimum impose the prohibition described in paragraph “a” 13 as a condition for continued eligibility for assistance under 14 this chapter. 15 c. The department may implement additional measures as may 16 be necessary to comply with federal regulations in implementing 17 paragraph “a” . 18 d. The department shall adopt rules as necessary to 19 implement this subsection. 20 Sec. 6. Section 239B.14, subsection 1, Code 2013, is amended 21 to read as follows: 22 1. a. An individual who obtains, or attempts to obtain, 23 or aids or abets an individual to obtain, by means of a 24 willfully false statement or representation, by knowingly 25 failing to disclose a material fact, or by impersonation, or 26 any fraudulent device, any assistance or other benefits under 27 this chapter to which the individual is not entitled, commits 28 a fraudulent practice. 29 b. An individual who accesses benefits provided under 30 this chapter in violation of any prohibition imposed by the 31 department pursuant to section 239B.5, subsection 4, commits 32 a fraudulent practice. 33 Sec. 7. Section 249A.3, subsection 1, Code 2013, is amended 34 by adding the following new paragraph: 35 -2- SF 395 (6) 85 pf/nh/jh 2/ 8

S.F. 395 NEW PARAGRAPH . v. Beginning January 1, 2014, is an 1 individual who meets all of the following requirements: 2 (1) Is under twenty-six years of age. 3 (2) Was in foster care under the responsibility of the state 4 on the date of attaining eighteen years of age or such higher 5 age to which foster care is provided. 6 (3) Was enrolled in the medical assistance program under 7 this chapter while in such foster care. 8 Sec. 8. Section 249A.3, subsection 2, paragraph a, 9 subparagraph (2), Code 2013, is amended to read as follows: 10 (2) (a) As provided under the federal Breast and Cervical 11 Cancer Prevention and Treatment Act of 2000, Pub. L. No. 12 106-354, women individuals who meet all of the following 13 criteria: 14 (i) Are not described in 42 U.S.C. § 1396a(a)(10)(A)(i). 15 (ii) Have not attained age sixty-five. 16 (iii) Have been screened for breast and cervical cancer 17 under the United States centers for disease control and 18 prevention breast and cervical cancer early detection program 19 established under 42 U.S.C. § 300k et seq., in accordance 20 with the requirements of 42 U.S.C. § 300n, and need treatment 21 for breast or cervical cancer. A woman An individual is 22 considered screened for breast and cervical cancer under this 23 subparagraph subdivision if the woman individual is screened 24 by any provider or entity, and the state grantee of the United 25 States centers for disease control and prevention funds under 26 Tit. XV of the federal Public Health Services Act has elected 27 to include screening activities by that provider or entity 28 as screening activities pursuant to Tit. XV of the federal 29 Public Health Services Act. This screening includes but is 30 not limited to breast or cervical cancer screenings or related 31 diagnostic services provided or funded by family planning or 32 centers, community health centers and breast cancer screenings 33 funded by the Susan G. Komen foundation which , or nonprofit 34 organizations, and the screenings or services are provided 35 -3- SF 395 (6) 85 pf/nh/jh 3/ 8

S.F. 395 to women individuals who meet the eligibility requirements 1 established by the state grantee of the United States centers 2 for disease control and prevention funds under Tit. XV of the 3 federal Public Health Services Act. 4 (iv) Are not otherwise covered under creditable coverage as 5 defined in 42 U.S.C. § 300gg(c). 6 (b) A woman An individual who meets the criteria of this 7 subparagraph (2) shall be presumptively eligible for medical 8 assistance. 9 Sec. 9. Section 249A.3, subsection 2, paragraph a, 10 subparagraph (9), Code 2013, is amended by striking the 11 subparagraph. 12 Sec. 10. Section 249J.26, subsection 2, Code 2013, is 13 amended to read as follows: 14 2. This chapter is repealed October December 31, 2013. 15 Sec. 11. Section 514I.4, subsection 5, paragraph a, Code 16 2013, is amended by striking the paragraph. 17 Sec. 12. Section 514I.5, subsection 7, paragraph f, Code 18 2013, is amended to read as follows: 19 f. Review, in consultation with the department, and take 20 necessary steps to improve interaction between the program and 21 other public and private programs which provide services to the 22 population of eligible children. The board, in consultation 23 with the department, shall also develop and implement a plan 24 to improve the medical assistance program in coordination with 25 the hawk-i program, including but not limited to a provision to 26 coordinate eligibility between the medical assistance program 27 and the hawk-i program, and to provide for common processes 28 and procedures under both programs to reduce duplication and 29 bureaucracy. 30 Sec. 13. Section 514I.5, subsection 8, paragraphs b and f, 31 Code 2013, are amended by striking the paragraphs. 32 Sec. 14. Section 514I.7, subsection 2, paragraphs a and g, 33 Code 2013, are amended to read as follows: 34 a. Determine individual eligibility for program enrollment 35 -4- SF 395 (6) 85 pf/nh/jh 4/ 8

S.F. 395 based upon review of completed applications and supporting 1 documentation as prescribed by federal law and regulation, 2 using policies and procedures adopted by rule of the department 3 pursuant to chapter 17A . The administrative contractor shall 4 not enroll a child who has group health coverage , unless 5 expressly authorized by such rules . 6 g. Create and Utilize the department’s eligibility system 7 to maintain eligibility files that are compatible with the 8 data system of the department with pertinent eligibility 9 determination and ongoing enrollment information including , but 10 not limited to , data regarding beneficiaries, enrollment dates, 11 disenrollments, and annual financial redeterminations. 12 Sec. 15. Section 514I.7, subsection 2, paragraphs c, d, e, 13 f, and k, Code 2013, are amended by striking the paragraphs. 14 Sec. 16. Section 514I.8, subsection 1, Code 2013, is amended 15 to read as follows: 16 1. a. Effective July 1, 1998, and notwithstanding any 17 medical assistance program eligibility criteria to the 18 contrary, medical assistance shall be provided to, or on behalf 19 of, an eligible child under the age of nineteen whose family 20 income does not exceed one hundred thirty-three percent of the 21 federal poverty level, as defined by the most recently revised 22 poverty income guidelines published by the United States 23 department of health and human services. 24 b. Additionally, effective Effective July 1, 2000, and 25 notwithstanding any medical assistance program eligibility 26 criteria to the contrary, medical assistance shall be provided 27 to, or on behalf of, an eligible infant whose family income 28 does not exceed two hundred percent of the federal poverty 29 level, as defined by the most recently revised poverty income 30 guidelines published by the United States department of health 31 and human services. 32 c. Effective July 1, 2009, and notwithstanding any medical 33 assistance program eligibility criteria to the contrary, 34 medical assistance shall be provided to, or on behalf of, a 35 -5- SF 395 (6) 85 pf/nh/jh 5/ 8

S.F. 395 pregnant woman or an eligible child who is an infant and whose 1 family income is at or below three hundred percent of the 2 federal poverty level, as defined by the most recently revised 3 poverty income guidelines published by the United States 4 department of health and human services. 5 Sec. 17. Section 514I.8, subsection 2, paragraph c, Code 6 2013, is amended to read as follows: 7 c. Is a member of a family whose income does not exceed 8 three hundred percent of the federal poverty level, as defined 9 in 42 U.S.C. § 9902(2), including any revision required by 10 such section, and in accordance with the federal Children’s 11 Health Insurance Program Reauthorization Act of 2009, Pub. L. 12 No. 111-3. The modified adjusted gross income methodology 13 prescribed in section 2101 of the federal Patient Protection 14 and Affordable Care Act, Pub. L. No. 111-148, to determine 15 family income under this paragraph. 16 Sec. 18. Section 514I.8, subsections 3 and 4, Code 2013, are 17 amended to read as follows: 18 3. In accordance with the rules adopted by the board, 19 a child may be determined to be presumptively eligible for 20 the program pending a final eligibility determination. 21 Following final determination of eligibility by the 22 administrative contractor , a child shall be eligible for a 23 twelve-month period. At the end of the twelve-month period, 24 the administrative contractor shall conduct a review of the 25 circumstances of the eligible child’s family shall be conducted 26 to establish eligibility and cost sharing for the subsequent 27 twelve-month period. 28 4. Once an eligible child is enrolled in a plan, the 29 eligible child shall remain enrolled in the plan unless a 30 determination is made, according to criteria established by the 31 board, that the eligible child should be allowed to enroll in 32 another qualified child health plan or should be disenrolled. 33 An enrollee may request to change plans within ninety days of 34 initial enrollment for any reason and at any time for cause, as 35 -6- SF 395 (6) 85 pf/nh/jh 6/ 8

S.F. 395 defined in 42 C.F.R. § 438.56(d)(2). Otherwise, an enrollee 1 may change plan enrollment once a year on the enrollee’s 2 anniversary date. 3 Sec. 19. Section 514I.8, subsections 5 and 6, Code 2013, are 4 amended by striking the subsections. 5 Sec. 20. Section 514I.9, Code 2013, is amended to read as 6 follows: 7 514I.9 Program benefits. 8 1. Until June 30, 1999, the benefits provided under the 9 program shall be those benefits established by rule of the 10 board and in compliance with Tit. XXI of the federal Social 11 Security Act. 12 2. On or before June 30, 1999, the hawk-i board shall adopt 13 rules to amend the benefits package based upon review of the 14 results of the initial benefits package used. 15 3. Subsequent to June 30, 1999, the The hawk-i board shall 16 review the benefits package annually and shall determine 17 additions to or deletions from the benefits package offered. 18 The hawk-i board shall submit the recommendations to the 19 general assembly for any amendment to the benefits package. 20 4. 2. Benefits, in addition to those required by rule, may 21 be provided to eligible children by a participating insurer if 22 the benefits are provided at no additional cost to the state. 23 Sec. 21. REPEAL. Section 225C.48, Code 2013, is repealed. 24 Sec. 22. MEDICAID STATE PLAN AMENDMENT. The department of 25 human services shall submit a medical assistance state plan 26 amendment to the centers for Medicare and Medicaid services of 27 the United States department of health and human services to 28 provide for applicability of the federal Breast and Cervical 29 Cancer Prevention and Treatment Act of 2000, Pub. L. No. 30 106-354, to both men and women. The department shall implement 31 applicability of the program to both men and women upon receipt 32 of federal approval. 33 Sec. 23. EFFECTIVE DATE. The following provision or 34 provisions of this Act take effect December 31, 2013: 35 -7- SF 395 (6) 85 pf/nh/jh 7/ 8