Bill Text: IA SF2256 | 2019-2020 | 88th General Assembly | Introduced
Bill Title: A bill for an act relating to a pilot program to allow the Medicaid program to act as a third-party payor under direct primary care agreements. (See SF 2346.)
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2020-02-20 - Committee report approving bill, renumbered as SF 2346. S.J. 374. [SF2256 Detail]
Download: Iowa-2019-SF2256-Introduced.html
Senate
File
2256
-
Introduced
SENATE
FILE
2256
BY
GARRETT
A
BILL
FOR
An
Act
relating
to
a
pilot
program
to
allow
the
Medicaid
1
program
to
act
as
a
third-party
payor
under
direct
primary
2
care
agreements.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
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2256
Section
1.
DIRECT
PRIMARY
CARE
AGREEMENTS
——
MEDICAID
——
1
PILOT
PROGRAM.
The
department
of
human
services
shall
submit
2
any
Medicaid
state
plan
amendment
or
waiver
request
necessary
3
to
the
centers
for
Medicare
and
Medicaid
services
of
the
United
4
States
department
of
health
and
human
services
for
approval
5
to
implement
a
pilot
program
relating
to
direct
primary
care
6
agreements
in
accordance
with
chapter
135N
and
as
specified
in
7
this
section.
The
request
shall
authorize
the
department
to
8
develop
and
oversee
a
pilot
program
beginning
January
1,
2021,
9
and
ending
December
31,
2026,
to
allow
Medicaid
members
in
10
specified
categories
to
receive
primary
care
health
services,
11
as
defined
in
section
135N.1,
through
a
direct
primary
care
12
arrangement,
with
Medicaid
acting
as
the
third-party
payor
for
13
such
services.
The
eligible
Medicaid
member
categories
shall
14
include
childless
adults,
children
under
seven
years
of
age,
15
children
seven
years
of
age
through
eighteen
years
of
age,
16
parents,
pregnant
women,
the
elderly,
and
individuals
with
17
disabilities.
18
EXPLANATION
19
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
20
the
explanation’s
substance
by
the
members
of
the
general
assembly.
21
This
bill
requires
the
department
of
human
services
(DHS)
22
to
submit
any
Medicaid
state
plan
amendment
or
waiver
request
23
necessary
to
the
centers
for
Medicare
and
Medicaid
services
24
of
the
United
States
department
of
health
and
human
services
25
for
approval
to
implement
a
pilot
program
relating
to
direct
26
primary
care
agreements
as
specified
in
the
bill.
The
request
27
shall
authorize
DHS
to
develop
and
oversee
a
pilot
program
28
beginning
January
1,
2021,
and
ending
December
31,
2026,
to
29
allow
Medicaid
members
in
specified
categories
to
receive
30
primary
care
health
services
through
a
direct
primary
care
31
arrangement
with
Medicaid
acting
as
the
third-party
payor
for
32
such
services.
The
eligible
Medicaid
member
categories
shall
33
include
childless
adults,
children
under
seven
years
of
age,
34
children
seven
years
of
age
through
18
years
of
age,
parents,
35
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pregnant
women,
the
elderly,
and
individuals
with
disabilities.
1
Direct
primary
care
agreements
are
authorized
under
Code
2
chapter
135N.
Such
agreements
are
agreements
between
a
3
direct
provider
and
a
direct
patient,
or
the
direct
patient’s
4
representative,
in
which
the
direct
provider
agrees
to
provide
5
primary
care
health
services
for
a
specified
period
of
time
to
6
the
direct
patient
for
a
direct
service
charge.
Code
chapter
7
135N
authorizes
a
direct
provider
to
accept
payment
of
a
8
direct
service
charge
for
a
direct
patient
either
directly
or
9
indirectly
from
a
third
party.
Under
the
bill,
the
Medicaid
10
program
would
act
as
the
third-party
payor.
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