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House File 205 - IntroducedA Bill ForAn Act 1relating to reimbursement rates for providers of
2substance use disorder treatment services and behavioral
3health services.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2Integrated provider network providers — reimbursement Rate
3 Section 1. INTEGRATED PROVIDER NETWORK PROVIDERS —
4MEDICAID PROVIDERS — REIMBURSEMENT. The department of
5human services shall establish an integrated provider network
6provider as a participating provider type under the Medicaid
7program consistent with the community mental health system
8provider type. The department shall reimburse the integrated
9network provider type consistent with the Medicaid community
10mental health center enhanced fee schedule.
11DIVISION II
12substance use disorder TREATMENT SERVICES and Behavioral health
13services providers — reimbursement RATE
14 Sec. 2. SUBSTANCE USE DISORDER TREATMENT SERVICES AND
15BEHAVIORAL HEALTH SERVICES PROVIDERS — REIMBURSEMENT RATES.
161. The department of public health in collaboration
17with the department of human services shall review and make
18recommendations for Medicaid 1915(b)(3) waiver reimbursement
19rates for substance use disorder intensive outpatient and
20residential treatment services using a projected cost report
21agreed upon by the departments and the integrated provider
22network providers. The departments shall establish time frames
23for release of the agreed-upon projected cost report form to
24providers and the deadline for submission of the completed
25projected cost reports by providers to the departments, in
26order to allow sufficient time for review and the making of
27recommended adjustments to the Medicaid 1915(b)(3) waiver
28reimbursement rates for Medicaid integrated provider network
29providers.
302. The department of public health in collaboration with
31the department of human services and behavioral health services
32providers shall review reimbursement rates for behavioral
33health services and Medicaid 1915(b)(3) waiver services using
34the projected cost report agreed upon by the departments and
35the integrated provider network providers. The departments
-1-1shall establish time frames for release of the agreed-upon
2projected cost report form to behavioral health services
3providers and the deadline for submission of the completed
4projected cost reports by behavioral health services providers
5to the departments, in order to allow sufficient time for the
6departments to review and make recommended adjustments to
7the Medicaid 1915(b)(3) waiver reimbursement rates and the
8behavioral health services fee schedule.
93. The department of public health, in collaboration with
10the department of human services, shall establish an ongoing
11plan for regular review of reimbursement rates for providers
12of substance use disorder treatment services and behavioral
13health services and provide information to the governor and the
14general assembly in a timely manner to allow for the provision
15of appropriate funding for any change in reimbursement rates.
16EXPLANATION
17The inclusion of this explanation does not constitute agreement with
18the explanation’s substance by the members of the general assembly.
19This bill relates to reimbursement rates for providers of
20substance use disorder treatment services and behavioral health
21services.
22Division I of the bill requires the department of human
23services (DHS) to establish an integrated provider network
24provider as a participating provider type under the Medicaid
25program consistent with the community mental health system
26provider type. The bill requires DHS to reimburse the
27integrated network provider type consistent with the Medicaid
28community mental health center enhanced fee schedule.
29Division II of the bill relates to reimbursement rates
30for providers of substance use disorder treatment services
31and behavioral health services. Division II requires the
32department of public health (DPH), in collaboration with DHS,
33to review and make recommendations for Medicaid 1915(b)(3)
34waiver reimbursement rates for substance use disorder intensive
35outpatient and residential treatment services using a projected
-2-1cost report agreed upon by the departments and the integrated
2provider network providers. The departments are required
3to establish time frames for release of the agreed-upon
4projected cost report form to providers and the deadline for
5submission of the completed projected cost reports by providers
6to the departments, to allow sufficient time for review and
7adjustments to reimbursement rates for Medicaid integrated
8provider network service providers. Division II also requires
9DPH, in collaboration with DHS and behavioral health services
10providers, to review reimbursement rates for behavioral health
11services and Medicaid 1915(b)(3) waiver services using the
12projected cost report agreed upon. Again, the departments
13shall establish time frames and deadlines for the cost reports
14to allow sufficient time for the departments to review and make
15recommended adjustments to the reimbursement rates and the
16behavioral health services fee schedule. Finally, the division
17directs DPH in collaboration with DHS to establish an ongoing
18plan for regular review of reimbursement rates for providers of
19substance use disorder treatment services and behavioral health
20services and to provide information to the governor and the
21general assembly in a timely manner to allow for the provision
22of appropriate funding for any change in reimbursement rates.
-3-pf/rh
2substance use disorder treatment services and behavioral
3health services.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2Integrated provider network providers — reimbursement Rate
3 Section 1. INTEGRATED PROVIDER NETWORK PROVIDERS —
4MEDICAID PROVIDERS — REIMBURSEMENT. The department of
5human services shall establish an integrated provider network
6provider as a participating provider type under the Medicaid
7program consistent with the community mental health system
8provider type. The department shall reimburse the integrated
9network provider type consistent with the Medicaid community
10mental health center enhanced fee schedule.
11DIVISION II
12substance use disorder TREATMENT SERVICES and Behavioral health
13services providers — reimbursement RATE
14 Sec. 2. SUBSTANCE USE DISORDER TREATMENT SERVICES AND
15BEHAVIORAL HEALTH SERVICES PROVIDERS — REIMBURSEMENT RATES.
161. The department of public health in collaboration
17with the department of human services shall review and make
18recommendations for Medicaid 1915(b)(3) waiver reimbursement
19rates for substance use disorder intensive outpatient and
20residential treatment services using a projected cost report
21agreed upon by the departments and the integrated provider
22network providers. The departments shall establish time frames
23for release of the agreed-upon projected cost report form to
24providers and the deadline for submission of the completed
25projected cost reports by providers to the departments, in
26order to allow sufficient time for review and the making of
27recommended adjustments to the Medicaid 1915(b)(3) waiver
28reimbursement rates for Medicaid integrated provider network
29providers.
302. The department of public health in collaboration with
31the department of human services and behavioral health services
32providers shall review reimbursement rates for behavioral
33health services and Medicaid 1915(b)(3) waiver services using
34the projected cost report agreed upon by the departments and
35the integrated provider network providers. The departments
-1-1shall establish time frames for release of the agreed-upon
2projected cost report form to behavioral health services
3providers and the deadline for submission of the completed
4projected cost reports by behavioral health services providers
5to the departments, in order to allow sufficient time for the
6departments to review and make recommended adjustments to
7the Medicaid 1915(b)(3) waiver reimbursement rates and the
8behavioral health services fee schedule.
93. The department of public health, in collaboration with
10the department of human services, shall establish an ongoing
11plan for regular review of reimbursement rates for providers
12of substance use disorder treatment services and behavioral
13health services and provide information to the governor and the
14general assembly in a timely manner to allow for the provision
15of appropriate funding for any change in reimbursement rates.
16EXPLANATION
17The inclusion of this explanation does not constitute agreement with
18the explanation’s substance by the members of the general assembly.
19This bill relates to reimbursement rates for providers of
20substance use disorder treatment services and behavioral health
21services.
22Division I of the bill requires the department of human
23services (DHS) to establish an integrated provider network
24provider as a participating provider type under the Medicaid
25program consistent with the community mental health system
26provider type. The bill requires DHS to reimburse the
27integrated network provider type consistent with the Medicaid
28community mental health center enhanced fee schedule.
29Division II of the bill relates to reimbursement rates
30for providers of substance use disorder treatment services
31and behavioral health services. Division II requires the
32department of public health (DPH), in collaboration with DHS,
33to review and make recommendations for Medicaid 1915(b)(3)
34waiver reimbursement rates for substance use disorder intensive
35outpatient and residential treatment services using a projected
-2-1cost report agreed upon by the departments and the integrated
2provider network providers. The departments are required
3to establish time frames for release of the agreed-upon
4projected cost report form to providers and the deadline for
5submission of the completed projected cost reports by providers
6to the departments, to allow sufficient time for review and
7adjustments to reimbursement rates for Medicaid integrated
8provider network service providers. Division II also requires
9DPH, in collaboration with DHS and behavioral health services
10providers, to review reimbursement rates for behavioral health
11services and Medicaid 1915(b)(3) waiver services using the
12projected cost report agreed upon. Again, the departments
13shall establish time frames and deadlines for the cost reports
14to allow sufficient time for the departments to review and make
15recommended adjustments to the reimbursement rates and the
16behavioral health services fee schedule. Finally, the division
17directs DPH in collaboration with DHS to establish an ongoing
18plan for regular review of reimbursement rates for providers of
19substance use disorder treatment services and behavioral health
20services and to provide information to the governor and the
21general assembly in a timely manner to allow for the provision
22of appropriate funding for any change in reimbursement rates.
-3-pf/rh