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.
Impact
The implementation of HF685 will enforce new financial obligations on Medicaid managed care organizations, requiring them to remit specific taxes on healthcare premiums, with the expectation that these changes will generate increased funding for the Medicaid program. Additionally, provisions for third-party recovery will be more stringent, placing heightened responsibility on individuals and third parties to reimburse Medicaid for services provided when other insurance or benefits are available. Furthermore, the bill introduces a moratorium on the construction of new nursing facilities until mid-2026, aiming to stabilize the nursing home bed capacity amidst changing state demographics and healthcare needs.
Summary
House File 685 (HF685) is a legislative measure aimed at reforming several aspects of healthcare service financing and nursing facility regulation in Iowa. The bill significantly revises the state's approach to Medicaid managed care organization (MCO) taxation and introduces new provisions for third-party recovery processes. Among its notable components, it establishes a dedicated fund for MCO premiums collected by the Department of Health and Human Services, which is intended to enhance the management and financing of Medicaid services in the state. The bill seeks to streamline the taxation process for health maintenance organizations and mandate reporting on nursing facility bed availability, thereby addressing both fiscal and operational transparency in healthcare services.
Sentiment
Discussions surrounding HF685 indicate a mix of support and concern among lawmakers and healthcare advocates. Supporters argue that the bill's provisions will bolster Iowa's Medicaid program and improve service access and management. However, there are apprehensions regarding the implications of such taxation on healthcare providers and the potential burdens it may create. Critics also raise concerns about the moratorium on nursing facility construction, fearing it could exacerbate existing shortages in long-term care services, particularly as the population ages.
Contention
A prominent point of contention in HF685 revolves around the balance between enhancing Medicaid funding and managing the operational impacts on healthcare providers. While the increase in premium taxes is positioned as a means to improve care quality and access, opponents emphasize that additional financial obligations on managed care organizations can lead to higher costs for consumers and could reduce the availability of services. The bill also reflects broader themes in current healthcare policy debates, particularly around the role of state-level regulation versus the autonomy of healthcare facilities and the potential consequences of centralized fiscal management.
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.)
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.)
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, and providing for licensee discipline.(Formerly SF 462, SSB 1167.)
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.)
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.)
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.)
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.)
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.)
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.)
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.)
A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions. (Formerly SSB 1074.) Effective date: 07/01/2025. Applicability date: 07/01/2025.
A bill for an act relating to eligibility for pregnant women and infants under the Medicaid program, and including effective date provisions.(Formerly HSB 643.)
A bill for an act relating to eligibility for pregnant women and infants under the Medicaid program, and including effective date provisions. (Formerly SSB 3140.) Effective date: 01/01/2025.
A bill for an act relating to the health and well-being of children and families including provisions for regional centers of excellence, a state-funded family medicine obstetrical fellowship program, self-administered hormonal contraceptives, maternal support and fatherhood initiatives, adoption expenses under the adoption subsidy program, and accessibility to the all Iowa scholarship program; making appropriations; and including effective date and applicability provisions.(Formerly HSB 91.)
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.)
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.)
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.)
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.)
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.)
Extends right of Medicaid recovery in cases of third party liability for injury, illness, or death to Medicaid managed care organizations that provide covered services to Medicaid enrollees