IA
Iowa Senate Bill SF462

Iowa 2023-2024 Regular Session

Iowa Senate Bill SF462

Introduced
2/28/23  
Refer
3/2/23  
Introduced
2/28/23  

Caption

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.)

Impact

The bill introduces new requirements for HMOs contracting with the Iowa Department of Health and Human Services to pay a premium tax of 2.5 percent on premiums received for administering Medicaid services. This new tax structure is aimed at ensuring that funds are available to support the Medicaid managed care organization premiums fund, which is dedicated to supporting the medical assistance program. These provisions are intended to enhance state revenue while simultaneously ensuring that Medicaid recipients continue to receive necessary services. It establishes a clear timeline for when HMOs must remit taxes and further encourages compliance by threatening the suspension or revocation of HMO licenses for non-compliance.

Summary

Senate File 462 (SF462) addresses important aspects of the Medicaid program in Iowa, focusing on the recovery rights of Medicaid payors and the taxation of health maintenance organizations (HMOs) participating in the Medicaid managed care program. The bill amends existing statutes to clarify and strengthen the authority of Medicaid payors to seek reimbursement from third parties responsible for medical expenses incurred by Medicaid recipients. It establishes that Medicaid payors are to be considered the payor of last resort, ensuring that all other potential sources of payment must first be exhausted before Medicaid funds are utilized.

Contention

One notable point of contention surrounding SF462 involves the balance between ensuring effective recovery of Medicaid funds and protecting the rights of Medicaid recipients. The bill includes provisions that impose stringent requirements on recipients regarding the disclosure of any third-party benefits, leading to potential concerns about how these obligations may impact beneficiaries. Critics may argue that the requirements could create a barrier for individuals seeking to access their medical benefits or recover costs associated with third-party liabilities. Additionally, the bill's stipulations regarding the taxation of HMOs may face pushback from healthcare stakeholders who may view the new tax as an additional financial burden on organizations already operating under tight margins.

Latest SF462 Activity

Companion Bills

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 SF567

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.)

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.)

Similar Bills

IA HF525

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 SSB1167

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.)

IA HSB177

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 HF685

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 SF567

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.)

NC S600

Medicaid Agency Omnibus

LA HB814

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

MS HB467

Division of Medicaid; apply for waivers to eliminate waiting period for certain services.