Healthcare (Medicaid)

in committee · Iowa · House Feb 17, 2025

HF 426: A bill for an act relating to the provision of durable medical equipment to Medicaid recipients with a permanent disability.

HF 426 requires Iowa's Department of Health and Human Services to mandate that Medicaid managed care organizations continue approving coverage for durable medical equipment (like wheelchairs or oxygen equipment) that Medicaid recipients with permanent disabilities were previously approved for. It directly affects Medicaid recipients whose conditions meet federal or state definitions of permanent disability (lasting 12+ months or resulting in death) and who haven't experienced significant health changes. The key provision ensures ongoing coverage for existing equipment without requiring new approvals, preventing sudden termination of essential support. This policy change aims to provide stability for vulnerable Medicaid beneficiaries relying on critical medical devices.

Topics ✓ HealthcareSupports HealthcareMandates continued Medicaid coverage for durable medical equipment, expanding access to essential health services for disabled recipients without restricting benefits.95% confidence

Sub-Topics Medicaid

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in committee · Iowa · Senate Feb 25, 2025

SF 417: A bill for an act relating to insurance coverage and Medicaid coverage for annual lung cancer screenings for at-risk individuals.

SF 417 requires both Medicaid and most private health insurance plans to cover annual low-dose CT lung cancer screenings for at-risk individuals aged 50 or older. It defines "at-risk" as people with a history of regular smoking or secondhand smoke exposure, a family member diagnosed with lung cancer, or occupational exposure to certain carcinogens like asbestos or radon. The bill mandates that insurers cannot impose copays, deductibles, or other out-of-pocket costs for these screenings and requires Medicaid to provide coverage once a federal waiver is approved. This applies to most health insurance plans but excludes specialized coverages like accident-only or dental insurance.

Topics ✓ HealthcareSupports HealthcareMandates coverage for lung cancer screenings without cost-sharing for at-risk groups, expanding access to preventative care and aligning with healthcare coverage protections.95% confidence

Sub-Topics Insurance Medicaid

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in committee · Iowa · House Feb 26, 2025

HF 607: A bill for an act relating to eligibility of pregnant women and infants for the Medicaid program.

HF 607 increases Iowa's Medicaid eligibility income threshold for pregnant women and infants from 215% to 375% of the federal poverty level. It directly affects low-income pregnant individuals and infants whose families earn up to 375% of the federal poverty level, expanding access to coverage. The bill requires Iowa's Department of Health and Human Services to submit state plan amendments to the federal government by January 2026, enabling 12 months of continuous postpartum Medicaid coverage for eligible pregnant women and updating infant eligibility rules. This change aligns with federal provisions under the American Rescue Plan Act and aims to improve healthcare continuity for this population.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid eligibility for pregnant women and infants to 375% FPL, increasing healthcare access and enabling 12-month postpartum coverage.95% confidence

Sub-Topics Medicaid

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in committee · Iowa · House Feb 26, 2025

HF 337: A bill for an act relating to reimbursement rates under the Medicaid dental wellness plan.

HF 337 requires Iowa's Medicaid dental wellness plan to align reimbursement rates for dental providers with those paid under the Healthy and Well Kids in Iowa (Hawki) program. This change aims to increase dental provider participation in Medicaid by ensuring they receive the same payment rates as in the Hawki program. The bill directly affects dental providers who serve Medicaid members and Medicaid beneficiaries seeking dental care. By matching reimbursement rates, the policy seeks to improve access to dental services for Medicaid enrollees without altering eligibility or coverage. The bill is currently under review in the Health and Human Services committee.

Topics ✓ HealthcareSupports HealthcareAligns Medicaid dental reimbursement with Hawki program to increase provider participation and access for beneficiaries, directly improving dental care access under Medicaid.85% confidence

Sub-Topics Medicaid

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in committee · Iowa · House Feb 28, 2025

HF 663: A bill for an act relating to provision of the state family planning services under the Medicaid program, and including effective date and repeal provisions.

This bill (HF 663) seeks to continue Iowa's Medicaid-funded family planning services by requiring the state to request federal approval for a new "Iowa Family Planning Network." It would replace the current state program (Section 217.41B of the Iowa Code) with a network operating under the same benefits and rules as a federal waiver approved in 2017. The repeal of the old program takes effect only after the federal Centers for Medicare and Medicaid Services (CMS) approves the new state plan amendment. This change directly affects Iowans who use Medicaid for family planning services and the state program providing those services.

Topics ✓ HealthcareSupports HealthcareBill continues Medicaid family planning services via new network structure, maintaining access to public health programs under federal waiver framework.95% confidence

Sub-Topics Medicaid Medicare

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in committee · Iowa · Senate Mar 3, 2025

SF 478: A bill for an act relating to Medicaid and children’s health insurance program coverage for mental health services provided in school-based settings.

This bill requires Iowa's Department of Health and Human Services to seek federal approval to expand Medicaid and CHIP coverage for mental health services provided in schools. It ensures all children enrolled in Iowa's Medicaid or CHIP programs - regardless of whether they have a special education plan - can access covered services without needing a formal mental health diagnosis. Covered services include individual, group, and family therapy, prevention services, evaluation, and case management. The bill also mandates collaboration with schools and federal technical assistance to implement these changes, particularly in rural and under-resourced districts.

Topics ✓ EducationSupports EducationExpands school-based mental health access for all students in Medicaid/CHIP, enhancing student support services without diagnostic barriers.90% confidence ✓ HealthcareSupports HealthcareExpands Medicaid/CHIP coverage for school-based mental health services without diagnosis requirement, improving access for all enrolled children.95% confidence

Sub-Topics Special Education Student Health Children's Health Medicaid Mental Health

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in committee · Iowa · Senate Mar 3, 2025

SF 433: A bill for an act relating to direct acting antiviral medications, including prior authorization requirements, and the Iowa medical assistance drug utilization review commission.

This bill (SF 433) removes a prior authorization requirement for direct-acting antiviral medications treating hepatitis C that are already on Iowa's preferred drug list for Medicaid. It directly affects Medicaid patients seeking hepatitis C treatment by simplifying access to these specific medications. The bill also requires the Iowa Medical Assistance Drug Utilization Review Commission to review the drug Vosevi for potential inclusion on the preferred formulary by July 1, 2026, per federal guidelines.

Topics ✓ HealthcareSupports HealthcareRemoves prior authorization for hepatitis C meds on Medicaid formulary, improving patient access to treatment without added barriers.95% confidence

Sub-Topics Medicaid

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in committee · Iowa · House Mar 5, 2025

HF 739: A bill for an act relating to reimbursement rates under the Medicaid dental wellness plan for adults.

HF 739 requires Iowa's Medicaid dental plan contractors to set payment rates for dental providers equal to those paid under the Healthy and Well Kids in Iowa (Hawki) program for children. This change directly affects dental providers who treat Medicaid-eligible adults in Iowa, aiming to increase their participation in the Medicaid dental wellness plan. The bill mandates that reimbursement rates for adult dental services align with Hawki rates to improve access to dental care for Medicaid members. The goal is to address current low provider participation by making the Medicaid dental program more financially attractive.

Topics ✓ HealthcareSupports HealthcareBill aligns Medicaid adult dental reimbursement with Hawki program to improve access to dental care for Medicaid members, enhancing patient access.95% confidence

Sub-Topics Medicaid

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in committee · Iowa · House Mar 6, 2025

HF 815: A bill for an act relating to annual automatic increases in Medicaid provider reimbursement rates.

HF 815 requires Iowa's Medicaid program to automatically increase reimbursement rates for healthcare providers by 2.5% each July 1, regardless of other inflation adjustments. This applies to all providers enrolled in Medicaid as of July 1 of the prior year, directly affecting hospitals, clinics, and other medical service providers who bill Medicaid. The bill overrides existing laws about inflation indexing, mandating this specific percentage increase annually without additional legislative action. It ensures providers receive predictable, annual payment adjustments tied solely to this fixed rate.

Topics ✓ Budget & TaxesSupports Budget & TaxesMandates annual 2.5% Medicaid reimbursement increases, directly increasing state budget expenditure on healthcare services and public program funding.92% confidence ✓ HealthcareSupports HealthcareMandates annual 2.5% Medicaid reimbursement increases for providers, strengthening funding for healthcare services and improving provider access to Medicaid patients.95% confidence

Sub-Topics Medicaid

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in committee · Iowa · Senate Mar 10, 2025

SF 501: A bill for an act relating to medical assistance program and Hawki program coverage for standard fertility preservation services.

SF 501 requires Iowa's health department to seek federal approval to add coverage for standard fertility preservation services under Medicaid (medical assistance program) and the Hawki program. It directly affects Iowans facing fertility risks from medical treatments like cancer care, including procedures such as egg retrieval and embryo transfers. The bill mandates coverage for up to three completed egg retrievals with unlimited embryo transfers, following American Society for Reproductive Medicine guidelines. Upon federal approval, these programs must immediately provide this coverage to eligible individuals.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid/Hawki coverage for fertility preservation services, increasing access for cancer patients facing fertility risks from medical treatments.95% confidence

Sub-Topics Medicaid

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