Iowa 2025-2026 Regular Session

Iowa House Bill HF808

Introduced

3/6/25

Refer

3/6/25

Caption

A bill for an act relating to managed care organization chargebacks and third-party auditors.

Impact

One significant effect of HF808 is the introduction of a standardized timeframe for chargebacks, which may reduce financial uncertainties for healthcare providers. By limiting the chargeback period to twelve months, providers can better manage their finances and avoid potential disputes over older claims. Furthermore, this legislation emphasizes ensuring that MCOs engage third-party auditors under fair conditions, promoting transparency and accountability in the auditing process.

Summary

House File 808 aims to regulate chargebacks issued by managed care organizations (MCOs) that administer the medical assistance program in Iowa. The bill stipulates that an MCO cannot issue a chargeback to a healthcare provider more than twelve months after reimbursement has been provided. This provision is intended to provide clarity and assurance to healthcare providers regarding their financial transactions with MCOs, ensuring timely and fair practices in chargeback processes.

Conclusion

Overall, HF808 represents a significant step toward enhancing the operational standards for chargebacks within Iowa's managed care sector. By establishing clear protocols and timelines, the bill aims to foster a more transparent relationship between MCOs and healthcare providers, which could ultimately benefit patients by ensuring more stable healthcare delivery systems.

Contention

While the intention of HF808 is to protect healthcare providers, there may be some contention around how these restrictions could impact MCO operations. Critics might argue that the bill could limit MCOs' abilities to manage their financial risk effectively, potentially leading to higher costs or reduced services for beneficiaries. Moreover, there may be concerns regarding the fees negotiated with third-party auditors and the implications these regulations have for the overall efficiency of audits.

Companion Bills

No companion bills found.

Previously Filed As

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 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 SF462

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

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

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.)

Similar Bills

No similar bills found.