April 24, 2024

The Fry Times - HHS Funnel Survivors

Feb. 22, 2024 - Last week marked the end of “first funnel” – a legislative deadline where bills need to be out of the committee level to move forward. The House Health and Human Services Committee advanced 26 bills, with the vast majority receiving bipartisan support. Below are some of the bills that expand access to health care, including mental health.

HF 2391 – Temp Staffing Cap - This bill establishes a statewide allowable charge schedule for nursing services and prohibits temp staffing agencies from charging over 150% of the charge schedule. This bill also brings technology platforms involved in temp staffing into state regulation. DHHS will establish the charge schedule through cost reports, and DIAL will establish an annual report and issue penalties.

HF 2402 – PMICs - This bill provides for an enhanced rate for psychiatric medical institutions for children that care for children with specialized needs and makes regulatory changes to PMICs based on feedback from providers.

HF 2397 – Access Center Transportation - This bill requires DHHS to authorize payments to ambulances transporting mental health patients in crisis to an access center at a similar amount to when transporting to an ER.

HF 2271 – Parent Access to Minor Health Care Records - This bill requires parents to have access to electronic health care records of their minor children, unless the minor has the legal ability to consent to the health care service or prohibited by state or federal law. Allows for health care providers to provide parents with a printed copy of the minor’s health records, with the exceptions redacted, at no charge to the parent, if they cannot comply with the electronic health records requirements of this bill.

HF 2509 – Behavioral Health System - This bill comes from the Governor to transition the current county run mental health and disability services regional system to a state behavioral health service system with state contracted administrative service organizations governed by the Iowa Department of Health and Human Services.

HF 2268 – Medicaid Look-Back Period - This bill requires Iowa Medicaid Enterprise and the managed care companies (MCOs) to identify overpayments to providers within two years and prohibits them from recouping funds after the two-year window unless there was fraud or misrepresentation by the provider.

HF 2507 – EMS Physician Exception - This bill allows physicians to be EMS providers if they have documented ability to deliver out-of-hospital emergency care. This bill is modeled after exceptions already allowed for registered nurses and physician assistants.

HF 2267 – MOMS Program Updates - This bill makes updates to the More Options for Maternal Support (MOMS) program. This bill allows DHHS to administer the program directly through pregnancy resource centers or through a 3rd party, strikes the requirement that the 3rd party have 3 years of experience managing pregnancy support service subcontractors, and allows for additional pregnancy support services be provided to pregnant women beyond counseling.

HF 2512 – Social Work Compact - This bill establishes an interstate license for social workers after 7 states have joined the compact. Two states currently have enacted this compact (Missouri and South Dakota). 24 states have pending legislation. The compact is effective upon 7 states joining.

HF 2585 – Nursing Facility Regulation - This bill requires DIAL to hold trainings with inspectors and nursing facilities twice a year, updates when an on-site inspection is needed of a nursing home, and requires a process for citations that involves feedback from the nursing home.

HF 2583 – Postpartum Coverage - This bill comes from the Governor to extend Medicaid postpartum coverage eligibility to one year after birth. This bill also lowers eligibility from 300% FPL to 215% FPL. However, eligibility has actually been at 375%, even though that is not what was set in code. This bill also transfers infants that were formerly covered up to 375% FPL to the hawk-i program, which sets eligibility at 302% FPL.

  • 47 states have passed postpartum coverage extensions at varying eligibility thresholds. 10 states have also not expanded Medicaid coverage, like Iowa. This bill places Iowa at the 13th highest in the nation for eligibility for pregnant women.

    138%-146% FPL - 8 states (including South Dakota)

    159%-171% - 6 states

    190%-200% - 9 states

    201%-205% - 9 states (Nebraska)

    213%-217% - 5 states (Illinois)

    220%-305% - 11 states (Missouri, Minnesota)
  • There are dozens of plan options available on the insurance marketplace that vary in terms of deductibles, copays, and premiums. Preventative services on the marketplace are free, and most check-ups after birth for women and infants are considered preventative.