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House
File
2518
-
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HOUSE
FILE
2518
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
HSB
621)
(As
Amended
and
Passed
by
the
House
February
25,
2026
)
A
BILL
FOR
An
Act
relating
to
the
department
of
health
and
human
services
1
and
reporting
requirements
for
shelter
care,
residential
2
treatment,
and
Medicaid
provider
reimbursement
rates,
and
3
establishing
provider
reimbursement
rates
for
Medicaid
home
4
and
community-based
waiver
services.
5
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
6
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2518
Section
1.
Section
235.2,
Code
2026,
is
amended
by
adding
1
the
following
new
subsection:
2
NEW
SUBSECTION
.
9.
Upon
implementation
by
the
department
3
of
a
uniform
cost
report
for
shelter
care
and
qualified
4
residential
treatment
providers,
the
department
shall
5
biennially
conduct
a
review
of
shelter
care
and
qualified
6
residential
treatment
provider
costs
compared
to
current
7
shelter
care
and
qualified
residential
treatment
provider
8
rates.
On
or
before
October
1
of
the
calendar
year
immediately
9
succeeding
the
calendar
year
in
which
the
review
is
conducted,
10
the
department
shall
submit
a
report
to
the
governor
and
the
11
general
assembly
detailing
the
results
of
the
department’s
12
review
and
recommendations
for
rate
adjustments.
13
Sec.
2.
Section
249A.4,
Code
2026,
is
amended
by
adding
the
14
following
new
subsection:
15
NEW
SUBSECTION
.
15.
a.
Conduct
an
annual
review
of
16
provider
reimbursement
rates
for
medical
and
health
services
17
provided
under
this
chapter
that
are
reimbursed
by
a
statewide
18
fee
schedule
and
that
are
not
periodically
updated
or
rebased
19
pursuant
to
federal
or
state
law
or
rule.
The
department
shall
20
compare
each
provider
reimbursement
rate
in
the
following
21
manner:
22
(1)
For
all
medical
and
health
services
other
than
dental
23
services,
to
reimbursement
rates
under
the
federal
Medicare
24
program.
25
(2)
For
dental
services,
to
reimbursement
rates
for
26
Medicaid
programs
in
states
contiguous
to
Iowa.
27
b.
On
or
before
January
15
of
each
calendar
year,
the
28
department
shall
submit
to
the
general
assembly
a
report
29
summarizing
the
department’s
review
under
paragraph
“a”
.
30
Sec.
3.
NEW
SECTION
.
249A.32C
Home
and
community-based
31
service
waivers
——
provider
rate
limits.
32
1.
For
purposes
of
this
section:
33
a.
“Consumer”
means
the
same
as
defined
in
section
249A.29.
34
b.
“Provider”
means
the
same
as
defined
in
section
249A.29.
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c.
“Waiver”
means
the
same
as
defined
in
section
249A.29.
1
2.
On
or
before
July
1
of
each
fiscal
year,
providers
2
shall
submit
actual
cost
of
service
and
supply
data
to
the
3
department.
Upon
request
by
the
department,
a
provider
shall
4
submit
to
reasonable
review
of
the
actual
cost
of
service
and
5
supply
data
submitted.
6
3.
a.
Upon
the
required
submission
of
annual
cost
reports
7
by
providers
and
implementation
by
the
department
of
a
waiver
8
fee
schedule,
the
department,
with
input
from
the
public,
9
consumers,
providers,
and
other
stakeholders,
shall
develop
a
10
proposed
cost-based
reimbursement
system
and
related
changes
to
11
department
policies
and
procedures
for
all
services
rendered
12
under
a
waiver
during
the
period
of
review
specified
by
13
the
department.
The
cost-based
reimbursement
system
shall
14
be
developed
using
information
provided
to
the
department
15
including
but
not
limited
to
all
of
the
following:
16
(1)
Provider
cost
data.
17
(2)
Provider
claims
data.
18
(3)
Consumer
needs
assessment
data.
19
(4)
Other
relevant
regional
and
national
data.
20
b.
The
department
shall,
with
input
from
providers
and
21
other
relevant
stakeholders,
develop
a
uniform
and
streamlined
22
provider
cost
reporting
mechanism
for
home
and
community-based
23
services.
24
4.
At
least
once
every
four
years,
the
department
shall
25
establish
a
new
base
period
to
be
used
in
calculating
proposed
26
rate
models
and
related
changes
to
department
policies
and
27
procedures.
On
or
before
October
1
of
each
year
that
a
new
base
28
period
is
established,
the
department
shall
submit
a
report
29
to
the
general
assembly
that
includes
proposed
rate
models,
30
the
projected
fiscal
impact
of
implementing
the
proposed
rate
31
models,
including
documentation
supporting
the
actuarial
32
soundness
of
the
proposed
rate
models,
and
the
proposed
changes
33
to
department
policies
and
procedures.
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