Healthcare (Medicaid)

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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in committee · Iowa · Senate Mar 10, 2025

SF 484: A bill for an act relating to Hawki coverage for applied behavior analysis services including a state plan amendment waiver for the children’s health insurance program.

This bill requires Iowa's children's health insurance program (CHIP) to cover applied behavior analysis (ABA) services for eligible children. It directs the Department of Health and Human Services to seek federal approval for this coverage expansion by submitting a state plan amendment to Medicare and Medicaid services. The change would directly affect children enrolled in CHIP who require ABA therapy, commonly used for developmental conditions like autism. The bill mandates that the medical assistance advisory council adopt rules to include ABA as a covered benefit in qualifying health plans under federal guidelines. It does not create new funding but modifies existing CHIP coverage to add this service.

Topics ✓ HealthcareSupports HealthcareExpands CHIP coverage for ABA therapy (mental health service), improving access for children with autism under public health program.95% confidence

Sub-Topics Children's Health Medicaid Medicare

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in committee · Iowa · House Mar 13, 2025

HF 959: A bill for an act relating to ventilator-dependent recipients who receive services under the medical assistance program.

HF 959 requires Iowa's Medicaid program (medical assistance program) to provide ventilator services based on medical need, not age, for people who rely on ventilators. The bill mandates that the Department of Health and Human Services adopt rules ensuring any qualified medical provider can deliver these services to eligible Medicaid enrollees. This directly affects ventilator-dependent Medicaid recipients by removing age-based barriers to care and expanding provider options. The rules aim to standardize access to necessary ventilator services regardless of the recipient's age or current provider network.

Topics ✓ HealthcareSupports HealthcareRemoves age-based barriers for ventilator-dependent Medicaid recipients, mandates care based on medical need, and expands provider options - directly improving access and protecting patient rights in healthcare coverage.92% confidence

Sub-Topics Medicaid

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in committee · Iowa · Senate Feb 20, 2025

SF 339: A bill for an act relating to eligibility of pregnant women and infants for the Medicaid program.

SF 339 raises Iowa's Medicaid income eligibility threshold for pregnant women and infants from 215% to 375% of the federal poverty level. This change directly affects low-income pregnant women and infants whose families earn up to 375% of the federal poverty guideline, making them eligible for Medicaid coverage. The bill also requires Iowa to implement 12 months of continuous postpartum Medicaid coverage for qualifying pregnant women starting January 2026, and update infant eligibility rules accordingly. These changes align with federal requirements under the American Rescue Plan Act and aim to expand access to healthcare for this population.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid eligibility for pregnant women/infants to 375% FPL and mandates 12-month postpartum coverage, directly increasing healthcare access and coverage for low-income families.95% confidence

Sub-Topics Children's Health Medicaid Women's Health

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in committee · Iowa · Senate Feb 20, 2025

SF 327: A bill for an act relating to dental provider reimbursement under the dental wellness plan and the dental wellness plan kids.

SF 327 aligns reimbursement rates for dental providers participating in Iowa's Dental Wellness Plan and Dental Wellness Plan Kids with the Healthy and Well Kids in Iowa (Hawki) program. It requires providers to be paid at the higher of either the usual, customary, and reasonable fee percentage or the commercial dental insurance billing percentage. This change aims to increase provider participation and improve access for plan members by making reimbursement rates more competitive. The bill directly affects dentists and dental practices enrolled in these specific Medicaid programs.

Topics ✓ HealthcareSupports HealthcareAligns dental reimbursement rates with commercial insurance to increase provider participation and improve access to dental care under healthcare programs.95% confidence

Sub-Topics Medicaid

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in committee · Iowa · Senate Feb 20, 2025

SF 324: A bill for an act relating to provision of the state family planning services under the Medicaid program, and including effective date provisions.

SF 324 establishes the Iowa Family Planning Network under Medicaid by requiring the state to submit a plan amendment to federal authorities (CMS) for approval, using the same benefits and rules as the existing 2017 waiver. It repeals the current state family planning program, but this repeal only takes effect after CMS approves the new Medicaid amendment. The bill also directs state funds to increase awareness of the network's services in areas with high sexually transmitted infection rates, subject to legislative funding.

Topics ✓ HealthcareSupports HealthcareEstablishes Medicaid family planning network, directs state funds for awareness in high-STI areas, expanding access to healthcare services under existing waiver structure.95% confidence

Sub-Topics Medicaid

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in committee · Iowa · House Apr 3, 2025

HF 701: A bill for an act relating to a review of anti-obesity medications by the department of health and human services for purposes of the medical assistance program.

HF 701 requires Iowa's Department of Health and Human Services to review anti-obesity medications for potential inclusion in the state's Medicaid program (medical assistance program). The review must assess medication effectiveness, impact on related health conditions (comorbidities), cost savings from avoiding other treatments, and recommended eligibility rules. The department must submit a report with findings and proposed eligibility requirements to the legislature by December 1, 2025. This bill does not change current coverage but sets a process for evaluating these medications for future Medicaid inclusion. It directly affects Medicaid beneficiaries and the state's healthcare spending on obesity-related treatments.

Topics ✓ HealthcareSupports HealthcareRequires review of anti-obesity meds for Medicaid inclusion, aiming to expand coverage and improve access to obesity treatment under medical assistance program.95% confidence

Sub-Topics Medicaid

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