House File 479 - IntroducedA Bill ForAn Act 1establishing a veterans recovery pilot program and fund
2for the reimbursement of expenses related to providing
3hyperbaric oxygen treatment to eligible veterans.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1   Section 1.  NEW SECTION.  35E.1  Definitions.
   2As used in this chapter, unless the context otherwise
3requires:
   41.  “Commission” means the commission of veterans affairs
5established in section 35A.2.
   62.  “Department” means the Iowa department of veterans
7affairs created in section 35A.4.
   83.  “Health care practitioner” means a practitioner as
9defined in section 155A.3.
   104.  “Hyperbaric oxygen treatment” means treatment, including
11diagnostic testing and other related medical treatments, for
12diabetic foot ulcers, traumatic brain injury, or post-traumatic
13stress disorder prescribed by a health care practitioner that
14utilizes, as part of the treatment, any of the following:
   15a.  A hyperbaric chamber approved by the United States food
16and drug administration.
   17b.  A hyperbaric oxygen device that is approved by the United
18States food and drug administration for investigational use
19under the direction of an institutional review board with a
20national clinical trial number.
   215.  “Pilot program” means the veterans recovery pilot program
22established under this chapter.
   236.  “Traumatic brain injury” means an acquired injury to the
24brain. “Traumatic brain injury” does not mean brain dysfunction
25caused by congenital or degenerative disorders or birth trauma.
   267.  “Treatment facility” means a hospital as defined in
27section 135B.1, an organized outpatient health facility as
28defined in section 135.61, or any other facility that is
29authorized by the department to provide hyperbaric oxygen
30treatment under this chapter.
   318.  “Veteran” means a veteran as defined in section 35.1, a
32member of the national guard or reserve forces of the United
33States, and a former member of the national guard or reserve
34forces of the United States who was discharged under honorable
35conditions.
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   19.  “Veterans recovery fund” means the veterans recovery fund
2created in section 35E.3.
3   Sec. 2.  NEW SECTION.  35E.2  Veterans recovery pilot program
4— establishment — reports — rules.
   51.  The department shall establish a veterans recovery pilot
6program, subject to sufficient funds in the veterans recovery
7fund to operate the pilot program, to provide hyperbaric oxygen
8treatment and support services to eligible veterans who have
9been diagnosed with a post-traumatic stress disorder or a
10traumatic brain injury pursuant to the requirements of this
11chapter.
   122.  The department shall adopt rules to implement and
13administer this chapter.
   143.  By October 1 of each even-numbered year, the department
15shall submit a biennial report regarding the pilot program
16that includes an evaluation of the effectiveness of the pilot
17program and the number of veterans and treatment facilities
18participating in the pilot program.
19   Sec. 3.  NEW SECTION.  35E.3  Veterans recovery fund.
   201.  A veterans recovery fund is created in the state treasury
21under the control of the department.
   222.  The fund shall consist of moneys appropriated for
23purposes of the pilot program, and any other devise, gift,
24bequest, donation, federal or other grant, reimbursement of
25payments made by any responsible third-party payor, repayment,
26judgment, transfer, or payment intended to be used for the
27purposes of the fund.
   283.  Moneys in the fund are appropriated to the department
29and may be expended by the department for any of the following
30purposes:
   31a.  Expenses incurred by the department in administering the
32pilot program.
   33b.  Expenses authorized pursuant to a treatment plan approved
34pursuant to section 35E.4 for hyperbaric oxygen treatment of a
35veteran under the pilot program.
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   1c.  Expenses authorized pursuant to a treatment plan approved
2pursuant to section 35E.4 for any necessary travel and living
3expenses of a veteran required to travel to obtain hyperbaric
4oxygen treatment under the pilot program.
   54.  Notwithstanding section 12C.7, subsection 2, interest or
6earnings on moneys in the fund shall be credited to the fund.
7Moneys in the fund may be used for cash flow purposes during a
8fiscal year provided that any moneys so allocated are returned
9to the fund by the end of that fiscal year.
   105.  For purposes of section 8.33, unencumbered or
11unobligated moneys in the fund shall not revert but shall
12remain available for expenditure for the purposes designated
13until June 30, 2029. Any unencumbered or unobligated moneys
14remaining in the fund as of June 30, 2029, shall not revert but
15shall be transferred for deposit in the veterans trust fund
16created in section 35A.13.
17   Sec. 4.  NEW SECTION.  35E.4  Hyperbaric oxygen treatment —
18treatment plan.
   191.  A treatment facility seeking reimbursement for providing
20hyperbaric oxygen treatment to a veteran under the pilot
21program shall, prior to providing such treatment, submit a
22proposed treatment plan to the department in a manner as
23prescribed by the department.
   242.  The proposed treatment plan shall include the following
25information:
   26a.  A prescription order for hyperbaric oxygen treatment
27issued by a health care practitioner.
   28b.  Information verifying the eligibility of the veteran to
29receive treatment and that the treatment facility is authorized
30to provide hyperbaric oxygen treatment.
   31c.  An estimate of the costs for providing hyperbaric oxygen
32treatment by the treatment facility.
   33d.  An estimate of cost for reimbursing any necessary travel
34and living expenses of the veteran required to travel to obtain
35the hyperbaric oxygen treatment.
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   1e.  Any other information required by the department.
   23.  Upon receipt of a proposed treatment plan, the department
3and the commission shall approve or disapprove the treatment
4plan within a reasonable time as established by rule. The
5department shall not approve the treatment plan if there
6is not sufficient money in the veterans recovery fund to
7reimburse the estimate of costs and expenses provided in the
8proposed treatment plan. The department shall notify the
9treatment facility whether the treatment plan was approved or
10disapproved.
   114.  A treatment facility may, following approval of a
12proposed treatment plan, submit a modified treatment plan if
13actual expenses are anticipated to exceed the estimated costs
14approved in the initial treatment plan. The department and the
15commission shall approve or disapprove the modified treatment
16plan, subject to sufficient moneys in the veterans recovery
17fund for the increased expenses, and shall notify the treatment
18facility within a reasonable time as established by rule
19whether the modified treatment plan was approved or disapproved
20within a reasonable time as established by rule.
21   Sec. 5.  NEW SECTION.  35E.5  Provision of treatment —
22reimbursement of expenses.
   231.  A treatment facility shall receive reimbursement of
24expenses incurred in providing hyperbaric oxygen treatment
25under the pilot program to a veteran if the department and the
26commission have approved a treatment plan under section 35E.4
27for the veteran.
   282.  A treatment facility that elects to provide hyperbaric
29oxygen treatment to a veteran under the pilot program shall
30provide the treatment without charge to the veteran. A veteran
31receiving treatment under the pilot program is not liable for
32the cost of treatment or expenses incurred under the pilot
33program.
   343.  A treatment facility that elects to provide treatment
35under the pilot program shall submit to the department regular
-4-1reports, in the form prescribed by the department, of the
2veteran’s measured health improvements under the treatment
3plan and whether treatments are continuing or have concluded.
4If hyperbaric oxygen treatment has concluded, the treatment
5facility shall indicate the date the treatment concluded.
   64.  A treatment facility providing hyperbaric oxygen
7treatment under the pilot program may submit a request for
8reimbursement of expenses incurred by the treatment facility to
9the department. The department shall approve the request and
10reimburse the expenses from the veterans recovery fund if all
11of the following criteria are met:
   12a.  The hyperbaric oxygen treatment was provided according to
13the approved treatment plan or modified treatment plan.
   14b.  The expenses do not exceed the estimated cost of the
15hyperbaric oxygen treatment as provided in the approved
16treatment plan or modified treatment plan.
   17c.  The treatment facility demonstrates in the reports
18submitted to the department as required by subsection 3 that
19the veteran is making measured health improvements or that
20continuing treatment is recommended.
   215.  The department shall reimburse a veteran from moneys in
22the veterans recovery fund for any travel and living expenses
23incurred by the veteran receiving hyperbaric oxygen treatment
24under the pilot program if the amount requested does not exceed
25the estimated cost of travel and living expenses as provided in
26the approved treatment plan or modified treatment plan.
   276.  After six months from the date specified in the reports
28submitted to the department from a treatment facility that
29treatment has concluded, the department shall notify the
30treatment facility and veteran in writing of the expenses
31that have been reimbursed and whether the amounts reimbursed
32are less than the costs authorized to be reimbursed pursuant
33to an approved treatment plan or modified treatment plan.
34The written notification shall further notify the treatment
35facility and the veteran that any requests for reimbursement
-5-1shall not be authorized if a request for reimbursement is not
2submitted within ninety days after receiving the notice unless,
3prior to the ninety days, the treatment facility indicates that
4treatment has not been completed.
5   Sec. 6.  NEW SECTION.  35E.6  Repeal.
   6This chapter is repealed July 1, 2029.
7   Sec. 7.  DIRECTIVE TO DEPARTMENT OF VETERANS AFFAIRS.  The
8department of veterans affairs shall submit a notice of
9intended action to the administrative rules coordinator and
10the administrative code editor pursuant to section 17A.4,
11subsection 1, paragraph “a”, not later than January 1, 2024,
12for the adoption of rules to implement and administer chapter
1335E as enacted in this Act.
14EXPLANATION
15The inclusion of this explanation does not constitute agreement with
16the explanation’s substance by the members of the general assembly.
   17This bill establishes a veterans recovery pilot program,
18administered by the department of veterans affairs for the
19reimbursement of expenses related to providing hyperbaric
20oxygen treatment to eligible veterans.
   21New Code section 35E.1 establishes definitions applicable
22to the new Code chapter. The bill includes definitions for
23commission, department, health care practitioner, hyperbaric
24oxygen treatment, traumatic brain injury, treatment facility,
25and veteran. Specifically, the bill defines hyperbaric oxygen
26treatment as treatment, including diagnostic testing and other
27related medical treatments, for diabetic foot ulcers, traumatic
28brain injury, or post-traumatic stress disorder prescribed by a
29health care practitioner that utilizes a United States food and
30drug administration-approved hyperbaric chamber or hyperbaric
31oxygen device.
   32New Code section 35E.2 establishes the veterans recovery
33pilot program, subject to sufficient funds to operate the
34program, requires the department of veterans affairs to adopt
35rules to implement and administer the program, and includes
-6-1a reporting requirement for each department concerning the
2operation of the pilot program.
   3New Code section 35E.3 creates a veterans recovery fund
4in the state treasury under the control of the department of
5veterans affairs. The new Code section provides that moneys in
6the fund are appropriated to the department of veterans affairs
7to be expended for expenses incurred in operating the program
8and for expenses authorized to be reimbursed for hyperbaric
9oxygen treatment and any related travel and living expenses
10incurred by the veteran. The new Code section provides that
11moneys in the fund shall not revert but shall remain available
12for use until June 30, 2029. Any moneys remaining in the fund
13as of June 30, 2029, shall be transferred for deposit in the
14veterans trust fund.
   15New Code section 35E.4 provides for the process for a
16treating facility to seek reimbursement from the veterans
17recovery fund for providing hyperbaric oxygen treatment. The
18bill provides that a treating facility may submit a proposed
19treatment plan to the department of veterans affairs and
20the commission of veterans affairs for their approval. The
21treatment plan shall include the prescription order for the
22treatment, information verifying the eligibility of the veteran
23and the treatment facility to provide the treatment, the
24estimated costs for providing the treatment and for reimbursing
25the veteran for any associated travel and living expenses, and
26any other information required by the department of veterans
27affairs. The new Code section provides that the treatment
28plan shall not be approved if sufficient moneys to reimburse
29the estimated costs are not available in the veterans recovery
30fund. The new Code section also establishes a process for
31submitting a modified treatment plan if the estimated costs
32for providing the treatment are anticipated to exceed the cost
33estimate in the initial treatment plan.
   34New Code section 35E.5 provides for requirements relative
35to providing hyperbaric oxygen treatment and provides for
-7-1the manner in which treatment-related expenses are to be
2reimbursed. The Code section provides that a treatment
3facility shall not be reimbursed for providing treatment
4unless a treatment plan has been approved. If a treatment
5facility elects to provide hyperbaric oxygen treatment under
6the pilot program, the facility shall provide the treatment
7without charge to a veteran and shall submit regular reports
8to the department of veterans affairs concerning the efficacy
9of the treatment and on whether the treatments have been
10concluded. The new Code section also provides for a process
11for a treatment facility and a veteran to receive reimbursement
12for expenses incurred. The new Code sections require the
13department of veterans affairs to provide written notification
14to the treatment facility and veteran after treatment has
15concluded, which notice shall indicate when any additional
16requests for reimbursement may be made.
   17Code section 35E.6 provides that the new Code chapter is
18repealed July 1, 2029.
   19The bill further directs the department of veterans affairs
20to submit a notice of intended action to the administrative
21rules coordinator and the administrative code editor not later
22than January 1, 2024, for the adoption of rules necessary to
23implement and administer the new Code chapter.
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