Iowa 2023-2024 Regular Session

Iowa Senate Bill SF567

Introduced

4/10/23

Introduced

4/10/23

Caption

A bill for an act relating to health care services and financing including nursing facility licensing and financing and the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums, and providing for licensee discipline.(Formerly SF 462, SSB 1167.)

Impact

The bill imposes significant changes to the financial responsibilities and operational frameworks of HMOs within the state. By taxing premiums and creating a designated fund, it aims to bolster the state's Medicaid funding. Furthermore, the bill's provisions regarding third-party recoveries ensure that the Medicaid payors act as a payor of last resort, compelling recipients to repay the Medicaid program if they recover benefits from third parties. This promotes accountability among recipients and reinforces the state's financial interests in the medical assistance program.

Summary

Senate File 567 amends various provisions related to health care services and financing in Iowa, focusing primarily on the Medicaid program, third-party recovery processes, and the taxation of Health Maintenance Organizations (HMOs). The bill introduces a new tax framework for HMOs that contract with the Department of Health Services (HHS) to administer the medical assistance program, mandating that these organizations remit a tax of 2.5% on their premiums. Additionally, it establishes a Medicaid managed care organization premiums fund to support the medical assistance program, emphasizing the importance of timely tax payments by HMOs under threat of license revocation.

Contention

Debate surrounding SF 567 has highlighted concerns from stakeholders regarding its implications for healthcare access and financial equity. Supporters argue that the new tax structure will enhance funding for vital medical assistance programs, thereby improving service delivery. However, critics express fears that the increased financial burdens on HMOs may lead to higher insurance premiums and, consequently, less affordable healthcare access for low-income individuals. The moratorium on new nursing home constructions raises additional concerns regarding the adequacy of long-term care resources in the state, with advocates urging for more flexible regulatory measures to meet community needs.

Latest IA SF567 Activity

View All Events: IA 2023-2024 Regular Session SF567

Companion Bills

IA SF462

Similar To A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(Formerly SSB 1167; See SF 567.)

IA HF525

Similar To A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(Formerly HSB 177; See HF 685.)

IA HF685

Similar To A bill for an act relating to health care services and financing, including nursing facility licensing and financing and the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums. (Formerly HF 525, HSB 177.) Effective date: 07/01/2023.

IA HSB177

Related A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(See HF 525, HF 685.)

IA SSB1167

Related A bill for an act relating to the Medicaid program including third-party recovery and taxation of Medicaid managed care organization premiums.(See SF 462, SF 567.)

Previously Filed As

IA SF2202

A bill for an act relating to subacute mental health care facilities and services, and including effective date provisions.(Formerly SSB 3083.)

IA HB4615

Relating to the regulation of certain nursing facilities, including licensing requirements and Medicaid participation requirements.

IA HB5183

Relating to contracts with managed care organizations, including the procurement of managed care contracts, under Medicaid and the child health plan program.

IA SB457

Relating to the regulation of certain nursing facilities, including licensing requirements and Medicaid participation and reimbursement requirements.

IA HB5185

Relating to contracts with managed care organizations, including the procurement of managed care contracts, under Medicaid and the child health plan program.

IA SF2422

A bill for an act relating to public assistance programs under the purview of the department of health and human services, including the supplemental nutrition assistance program, Medicaid, and the Iowa health and wellness plan, and including effective date provisions. (Formerly SSB 3140.) Effective date: Enactment, 01/01/2027.

IA HF2641

A bill for an act relating to the Medicaid home and community-based services elderly waiver program, including transition planning and assisted living services.(Formerly HSB 739.)

IA SF575

A bill for an act relating to health care including a funding model for the rural health care system; the elimination of several health care-related award, grant, residency, and fellowship programs; establishment of a health care professional incentive program; Medicaid graduate medical education; the health facilities council; and the Iowa health information network, making appropriations, and including effective date provisions.(Formerly SSB 1163; See SF 618.)

IA SF618

IA SF2419

A bill for an act relating to third-party litigation funding and including applicability provisions.(Formerly SF 586, SF 54.)