2/4/2021. –  IMHCA Week 4 

Bill of the week

1. 1. 1. SF 178/HF 372-Non-Medical Switching: Support

         1. The bill provides that during a covered person’s eligibility under a health benefit plan inclusive of any open enrollment periods, a health plan carrier, health benefit plan, or utilization review organization shall not limit or exclude coverage of a prescription drug for the covered person if the covered person is medically stable on the drugs 

Need to know

1. 1. 1. HF 294-Telehealth: 

         1. Reimbursement with telehealth at the same rate and on the same basis as would be in the office

• Fiscal Note: https://www.legis.iowa.gov/docs/publications/FN/1211014.pdf 

Bills to watch/new bills

• HSB 169/SSB1164-Medicaid Program and Oversight: Support
  • The bill directs the DHS to require that a MCO organization process and pay participating provider claims for each district provider type in accordance with the following: 
    • 90% of clean claims shall be accurately paid or denied within 14 calendar day, 95% of clean claims shall be accurately paid or denied within 21 calendar days and 100% of clean claims shall be accurately paid or denied within 30 calendar days of receipt by the MCO
  • https://www.legis.iowa.gov/legislation/BillBook?ga=89&ba=HSB%20169 
• HSB 172-Non-certified Staff: Undecided
  • Non-licensed practitioners providing such services may include, in addition to noncertified staff with a bachelor’s degree in education, psychology, social work, occupational therapy, physical therapy, or speech language pathology, those non licensed practitioners who hold a registered behavior technician certification from a nationally recognized accrediting body including but not limited to the behavior analyst certification board
    • Services include preventative services for early and periodic screening, diagnosis, and treatment benefits
  • We are watching to make sure that it does not impact our license
  • https://www.legis.iowa.gov/legislation/BillBook?ga=89&ba=HSB%20172