SF 395 (LSB 1151SV (6) 85)

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 2013-03-18)

A BILL FOR

An Act relating to child, adult, and family services under the purview of the department of human services, making penalties applicable, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 225C.38, subsection 1, paragraph c, Code 2013, is amended to read as follows:
   c.  Except as provided in section 225C.41, a family support subsidy for a fiscal year shall be in an amount determined by the department in consultation with the comprehensive family support council created in section 225C.48. The parent or legal guardian receiving a family support subsidy may elect to receive a payment amount which is less than the amount determined in accordance with this paragraph.
    Sec. 2.  Section 225C.42, subsection 1, Code 2013, is amended to read as follows:
   1.  The department shall conduct an annual evaluation of the family support subsidy program in conjunction with the comprehensive family support council and shall submit the evaluation report with recommendations to the governor and general assembly. The report shall be submitted on or before October 30 and provide an evaluation of the latest completed fiscal year.
    Sec. 3.  Section 225C.47, subsection 5, unnumbered paragraph 1, Code 2013, is amended to read as follows:
   The department shall design the program in consultation with the comprehensive family support council created in section 225C.48. The department shall adopt rules to implement the program which provide for all of the following:
    Sec. 4.  Section 225C.49, subsection 4, Code 2013, is amended to read as follows:
   4.  The department shall designate one individual whose sole duties are to provide central coordination of the programs under sections 225C.36 and 225C.47 and to work with the comprehensive family support council to oversee development and implementation of the programs.
    Sec. 5.  Section 239B.5, Code 2013, is amended by adding the following new subsection:
   NEW SUBSECTION.  4.
  a.  The department shall implement policies and procedures as necessary to comply with provisions of the federal Middle Class Tax Relief and Job Creation Act of 2012, Pub. L. No. 112-96, to prevent assistance provided under this chapter from being used in any electronic benefit transfer transaction in any liquor store; any casino, gambling casino, or gaming establishment; or any retail establishment which provides adult-oriented entertainment in which performers disrobe or perform in an unclothed state for entertainment. For purposes of this paragraph, the definitions found in the federal Middle Class Tax Relief and Job Creation Act and related rules and statutes apply.
   b.  Unless otherwise precluded by federal law or regulation, policies and procedures implemented under this subsection shall at a minimum impose the prohibition described in paragraph “a” as a condition for continued eligibility for assistance under this chapter.
   c.  The department may implement additional measures as may be necessary to comply with federal regulations in implementing paragraph “a”.
   d.  The department shall adopt rules as necessary to implement this subsection.
    Sec. 6.  Section 239B.14, subsection 1, Code 2013, is amended to read as follows:
   1.
  a.  An individual who obtains, or attempts to obtain, or aids or abets an individual to obtain, by means of a willfully false statement or representation, by knowingly failing to disclose a material fact, or by impersonation, or any fraudulent device, any assistance or other benefits under this chapter to which the individual is not entitled, commits a fraudulent practice.
   b.  An individual who accesses benefits provided under this chapter in violation of any prohibition imposed by the department pursuant to section 239B.5, subsection 4, commits a fraudulent practice.
    Sec. 7.  Section 249A.3, subsection 1, Code 2013, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  v.  Beginning January 1, 2014, is an individual who meets all of the following requirements:
   (1)  Is under twenty-six years of age.
   (2)  Was in foster care under the responsibility of the state on the date of attaining eighteen years of age or such higher age to which foster care is provided.
   (3)  Was enrolled in the medical assistance program under this chapter while in such foster care.
    Sec. 8.  Section 249A.3, subsection 2, paragraph a, subparagraph (2), Code 2013, is amended to read as follows:
   (2)
  (a)  As provided under the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000, Pub. L. No. 106-354, women
 
individuals who meet all of the following criteria:
   (i)  Are not described in 42 U.S.C. § 1396a(a)(10)(A)(i).
   (ii)  Have not attained age sixty-five.
   (iii)  Have been screened for breast and cervical cancer under the United States centers for disease control and prevention breast and cervical cancer early detection program established under 42 U.S.C. § 300k et seq., in accordance with the requirements of 42 U.S.C. § 300n, and need treatment for breast or cervical cancer. A woman
 
An individual is considered screened for breast and cervical cancer under this subparagraph subdivision if the woman
 
individual is screened by any provider or entity, and the state grantee of the United States centers for disease control and prevention funds under Tit. XV of the federal Public Health Services Act has elected to include screening activities by that provider or entity as screening activities pursuant to Tit. XV of the federal Public Health Services Act. This screening includes but is not limited to breast or cervical cancer screenings or related diagnostic services provided
 
or funded by family planning or
 
centers, community health centers and breast cancer screenings funded by the Susan G. Komen foundation which, or nonprofit organizations, and the screenings or services are provided to women
 
individuals who meet the eligibility requirements established by the state grantee of the United States centers for disease control and prevention funds under Tit. XV of the federal Public Health Services Act.
   (iv)  Are not otherwise covered under creditable coverage as defined in 42 U.S.C. § 300gg(c).
   (b)  A woman
 
An individual who meets the criteria of this subparagraph (2) shall be presumptively eligible for medical assistance.
    Sec. 9.  Section 249A.3, subsection 2, paragraph a, subparagraph (9), Code 2013, is amended by striking the subparagraph.
    Sec. 10.  Section 249J.26, subsection 2, Code 2013, is amended to read as follows:
   2.  This chapter is repealed October
 
December 31, 2013.
    Sec. 11.  Section 514I.4, subsection 5, paragraph a, Code 2013, is amended by striking the paragraph.
    Sec. 12.  Section 514I.5, subsection 7, paragraph f, Code 2013, is amended to read as follows:
   f.  Review, in consultation with the department, and take necessary steps to improve interaction between the program and other public and private programs which provide services to the population of eligible children. The board, in consultation with the department, shall also develop and implement a plan to improve the medical assistance program in coordination with the hawk-i program, including but not limited to a provision to coordinate eligibility between the medical assistance program and the hawk-i program, and to provide for common processes and procedures under both programs to reduce duplication and bureaucracy.
    Sec. 13.  Section 514I.5, subsection 8, paragraphs b and f, Code 2013, are amended by striking the paragraphs.
    Sec. 14.  Section 514I.7, subsection 2, paragraphs a and g, Code 2013, are amended to read as follows:
   a.  Determine individual eligibility for program enrollment based upon review of completed applications and supporting documentation
 
as prescribed by federal law and regulation, using policies and procedures adopted by rule of the department pursuant to chapter 17A. The administrative contractor shall not enroll a child who has group health coverage, unless expressly authorized by such rules.
   g.  Create and
 
Utilize the department’s eligibility system to maintain eligibility files that are compatible with the data system of the department
 
with pertinent eligibility determination and ongoing enrollment information including, but not limited to, data regarding beneficiaries, enrollment dates, disenrollments, and annual financial redeterminations.
    Sec. 15.  Section 514I.7, subsection 2, paragraphs c, d, e, f, and k, Code 2013, are amended by striking the paragraphs.
    Sec. 16.  Section 514I.8, subsection 1, Code 2013, is amended to read as follows:
   1.
  a.  Effective July 1, 1998, and notwithstanding any medical assistance program eligibility criteria to the contrary, medical assistance shall be provided to, or on behalf of, an eligible child under the age of nineteen whose family income does not exceed one hundred thirty-three percent of the federal poverty level, as defined by the most recently revised poverty income guidelines published by the United States department of health and human services.

b.  Additionally, effective
 
Effective July 1, 2000, and notwithstanding any medical assistance program eligibility criteria to the contrary, medical assistance shall be provided to, or on behalf of, an eligible infant whose family income does not exceed two hundred percent of the federal poverty level, as defined by the most recently revised poverty income guidelines published by the United States department of health and human services.

c.  Effective July 1, 2009, and notwithstanding any medical assistance program eligibility criteria to the contrary, medical assistance shall be provided to, or on behalf of, a pregnant woman or an eligible child who is an infant and whose family income is at or below three hundred percent of the federal poverty level, as defined by the most recently revised poverty income guidelines published by the United States department of health and human services.
    Sec. 17.  Section 514I.8, subsection 2, paragraph c, Code 2013, is amended to read as follows:
   c.  Is a member of a family whose income does not exceed three hundred percent of the federal poverty level, as defined in 42 U.S.C. § 9902(2), including any revision required by such section, and in accordance with the federal Children’s Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111-3.

The modified adjusted gross income methodology prescribed in section 2101 of the federal Patient Protection and Affordable Care Act, Pub. L. No. 111-148, to determine family income under this paragraph.
    Sec. 18.  Section 514I.8, subsections 3 and 4, Code 2013, are amended to read as follows:
   3.  In accordance with the rules adopted by the board, a child may be determined to be presumptively eligible for the program pending a final eligibility determination. Following final determination of eligibility by the administrative contractor, a child shall be eligible for a twelve-month period. At the end of the twelve-month period, the administrative contractor shall conduct a review of the circumstances of the eligible child’s family
 
shall be conducted to establish eligibility and cost sharing for the subsequent twelve-month period.
   4.  Once an eligible child is enrolled in a plan, the eligible child shall remain enrolled in the plan unless a determination is made, according to criteria established by the board, that the eligible child should be allowed to enroll in another qualified child health plan or should be disenrolled. An enrollee may
 
request to change plans within ninety days of initial enrollment for any reason and at any time for cause, as defined in 42 C.F.R. § 438.56(d)(2). Otherwise, an enrollee may change plan enrollment once a year on the enrollee’s anniversary date.
    Sec. 19.  Section 514I.8, subsections 5 and 6, Code 2013, are amended by striking the subsections.
    Sec. 20.  Section 514I.9, Code 2013, is amended to read as follows:
   514I.9  Program benefits.
   1.  Until June 30, 1999, the benefits provided under the program shall be those benefits established by rule of the board and in compliance with Tit. XXI of the federal Social Security Act.
   2.  On or before June 30, 1999, the hawk-i board shall adopt rules to amend the benefits package based upon review of the results of the initial benefits package used.
   3.  Subsequent to June 30, 1999, the
 
The hawk-i board shall review the benefits package annually and shall determine additions to or deletions from the benefits package offered. The hawk-i board shall submit the recommendations to the general assembly for any amendment to the benefits package.
   4.

2.  Benefits, in addition to those required by rule, may be provided to eligible children by a participating insurer if the benefits are provided at no additional cost to the state.
    Sec. 21.  REPEAL.  Section 225C.48, Code 2013, is repealed.
    Sec. 22.  MEDICAID STATE PLAN AMENDMENT.  The department of human services shall submit a medical assistance state plan amendment to the centers for Medicare and Medicaid services of the United States department of health and human services to provide for applicability of the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000, Pub. L. No. 106-354, to both men and women. The department shall implement applicability of the program to both men and women upon receipt of federal approval.
    Sec. 23.  EFFECTIVE DATE.  The following provision or provisions of this Act take effect December 31, 2013:
   1.  The section of this Act amending section 249A.3, subsection 2, paragraph “a”, subparagraph (9).