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Senate File 286 - IntroducedA Bill ForAn Act 1relating to the reimbursement and cost-reporting
2methodologies and documentation requirements applicable to
3certain Medicaid providers, and including effective date
4provisions.
5BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. MEDICAID HOME AND COMMUNITY-BASED SERVICES
2PROVIDERS — COST-REPORTING METHODOLOGY AND DOCUMENTATION
3CHANGES.
41. Beginning July 1, 2017, the department of human services
5shall discontinue application of the retrospectively limited
6prospective rates reimbursement methodology to and the required
7submission of cost reports by affected providers under 441 IAC
879.1.
92. The department of human services, in consultation with
10affected parties, including but not limited to Medicaid home
11and community-based services providers, shall develop and
12submit to the governor and the general assembly by November 30,
132017, a proposal for a new cost-reporting methodology to be
14used for the purposes of determining actuarially sound rates
15and fee-for-service reimbursement for applicable Medicaid home
16and community-based services providers beginning July 1, 2018.
17The cost-reporting methodology developed shall be based on
18all reasonable costs of doing business as a Medicaid home and
19community-based services provider.
203. The department of human services shall amend 441 IAC
2124.4 relating to standards of service for providers of services
22to persons with mental illness, intellectual disabilities, or
23developmental disabilities pursuant to chapter 225C and 441
24IAC 79.3(2) relating to medical clinical records for providers
25of services under the Medicaid program pursuant to chapter
26249A, to provide, effective November 1, 2017, that in addition
27to allowing documentation of the provision of services or
28standards of service in a narrative format, the following
29providers may also provide documentation in a checkbox form
30format in accordance with the provider’s organizational
31policies and procedures:
32a. Advanced registered nurse practitioners.
33b. Psychologists.
34c. Community mental health centers.
35d. Home and community-based habilitation services
-1-1providers.
2e. Behavioral health intervention.
3f. Case management services including home and
4community-based services case management services.
5g. Home and community-based services waiver services.
6h. Behavioral health services.
7i. Community-based neurobehavioral rehabilitation
8residential services and intermittent services.
9 Sec. 2. EFFECTIVE UPON ENACTMENT. This Act, being deemed of
10immediate importance, takes effect upon enactment.
11EXPLANATION
12The inclusion of this explanation does not constitute agreement with
13the explanation’s substance by the members of the general assembly.
14This bill relates to reimbursement methodologies, cost
15reports, and documentation required of certain Medicaid home
16and community-based services providers.
17The bill requires that beginning July 1, 2017, the
18department of human services (DHS) shall discontinue
19application of the retrospectively limited prospective rates
20reimbursement methodology and the required submission of
21cost reports by affected providers as provided under the
22administrative rule that applies this reimbursement methodology
23and requires submission of cost reports by Medicaid home and
24community-based services (HCBS) supported community living,
25family and community support services, and interim medical
26monitoring and treatment when provided by an HCBS-certified
27supported community agency.
28The bill directs DHS, in consultation with affected parties,
29including but not limited to Medicaid home and community-based
30services providers, to develop and submit to the governor and
31the general assembly by November 30, 2017, a proposal for a
32new cost-reporting methodology to be used for the purposes
33of determining actuarially sound rates and fee-for-service
34reimbursement for applicable HCBS providers beginning July 1,
352018. The cost-reporting methodology developed shall be based
-2-1on all reasonable costs of doing business as a Medicaid home
2and community-based services provider.
3The bill also requires DHS to amend administrative rules
4relating to standards of service for providers of services
5to persons with mental illness, intellectual disabilities,
6or developmental disabilities and those relating to medical
7clinical records for providers of services under the Medicaid
8program to provide, effective November 1, 2017, that in
9addition to allowing documentation of the provision of
10services or standards of service in a narrative format, certain
11providers specified in the bill may also provide documentation
12in a checkbox form format in accordance with the provider’s
13organizational policies and procedures.
14The bill takes effect upon enactment.
-3-pf/nh
2methodologies and documentation requirements applicable to
3certain Medicaid providers, and including effective date
4provisions.
5BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. MEDICAID HOME AND COMMUNITY-BASED SERVICES
2PROVIDERS — COST-REPORTING METHODOLOGY AND DOCUMENTATION
3CHANGES.
41. Beginning July 1, 2017, the department of human services
5shall discontinue application of the retrospectively limited
6prospective rates reimbursement methodology to and the required
7submission of cost reports by affected providers under 441 IAC
879.1.
92. The department of human services, in consultation with
10affected parties, including but not limited to Medicaid home
11and community-based services providers, shall develop and
12submit to the governor and the general assembly by November 30,
132017, a proposal for a new cost-reporting methodology to be
14used for the purposes of determining actuarially sound rates
15and fee-for-service reimbursement for applicable Medicaid home
16and community-based services providers beginning July 1, 2018.
17The cost-reporting methodology developed shall be based on
18all reasonable costs of doing business as a Medicaid home and
19community-based services provider.
203. The department of human services shall amend 441 IAC
2124.4 relating to standards of service for providers of services
22to persons with mental illness, intellectual disabilities, or
23developmental disabilities pursuant to chapter 225C and 441
24IAC 79.3(2) relating to medical clinical records for providers
25of services under the Medicaid program pursuant to chapter
26249A, to provide, effective November 1, 2017, that in addition
27to allowing documentation of the provision of services or
28standards of service in a narrative format, the following
29providers may also provide documentation in a checkbox form
30format in accordance with the provider’s organizational
31policies and procedures:
32a. Advanced registered nurse practitioners.
33b. Psychologists.
34c. Community mental health centers.
35d. Home and community-based habilitation services
-1-1providers.
2e. Behavioral health intervention.
3f. Case management services including home and
4community-based services case management services.
5g. Home and community-based services waiver services.
6h. Behavioral health services.
7i. Community-based neurobehavioral rehabilitation
8residential services and intermittent services.
9 Sec. 2. EFFECTIVE UPON ENACTMENT. This Act, being deemed of
10immediate importance, takes effect upon enactment.
11EXPLANATION
12The inclusion of this explanation does not constitute agreement with
13the explanation’s substance by the members of the general assembly.
14This bill relates to reimbursement methodologies, cost
15reports, and documentation required of certain Medicaid home
16and community-based services providers.
17The bill requires that beginning July 1, 2017, the
18department of human services (DHS) shall discontinue
19application of the retrospectively limited prospective rates
20reimbursement methodology and the required submission of
21cost reports by affected providers as provided under the
22administrative rule that applies this reimbursement methodology
23and requires submission of cost reports by Medicaid home and
24community-based services (HCBS) supported community living,
25family and community support services, and interim medical
26monitoring and treatment when provided by an HCBS-certified
27supported community agency.
28The bill directs DHS, in consultation with affected parties,
29including but not limited to Medicaid home and community-based
30services providers, to develop and submit to the governor and
31the general assembly by November 30, 2017, a proposal for a
32new cost-reporting methodology to be used for the purposes
33of determining actuarially sound rates and fee-for-service
34reimbursement for applicable HCBS providers beginning July 1,
352018. The cost-reporting methodology developed shall be based
-2-1on all reasonable costs of doing business as a Medicaid home
2and community-based services provider.
3The bill also requires DHS to amend administrative rules
4relating to standards of service for providers of services
5to persons with mental illness, intellectual disabilities,
6or developmental disabilities and those relating to medical
7clinical records for providers of services under the Medicaid
8program to provide, effective November 1, 2017, that in
9addition to allowing documentation of the provision of
10services or standards of service in a narrative format, certain
11providers specified in the bill may also provide documentation
12in a checkbox form format in accordance with the provider’s
13organizational policies and procedures.
14The bill takes effect upon enactment.
-3-pf/nh