IMS Advocate: 2021 Session - Week Seven

Saturday, February 27, 2021 7:30 AM | Sydney Maras (Administrator)

With just one week to go until the March 5 first legislative funnel deadline – the date by which the majority of policy bills must have passed out of a committee in their chamber of origin to remain eligible for consideration this session – it’s been another busy week for subcommittee and committee work. Equally important, efforts to halt dangerous legislation continue as opponents work to keep bills from clearing this first procedural hurdle.

Tort Reform

We saw continued movement this week on our top legislative priority – a hard cap on noneconomic damages. On Wednesday, the Senate introduced its companion bill to the House hard cap legislation, which was introduced last week. SSB 1225 has been assigned to a subcommittee, with subcommittee and committee discussion expected next week.

Last week, IMS issued an Action Alert to help drive a record number of pro-tort reform messages into the Iowa House. On Wednesday, we issued a second Action Alert to ensure the same is true for the Iowa Senate. While the Senate has a strong record on the issue – having previously passed hard cap legislation in 2017 and 2019 – there are several new members this year and the trial attorneys have been contacting legislators in force to oppose this needed reform.

It is vital that legislators in both chambers hear from Iowa physicians, residents, and medical students about the need for tort reform. If you haven’t already, please take a moment to contact your State Senator and your State Representative in support of HF 592 and SSB 1225.

Medicaid Payment Adjustments

On Tuesday, a House subcommittee took up HSB 225, which would enact a twelve-month limitation on recoupment of Medicaid overpayments. The bill was brought forward by the Iowa Behavioral Health Association following multiple instances where member facilities recently received substantial recoupment requests from the MCOS, in some cases stretching back the maximum five years allowed by the MCOs’ contracts with the state. In Tuesday’s subcommittee, DHS blamed this spike in recoupment requests on recently-obtained Department of Corrections (DOC) data showing individuals who became incarcerated and as a resulted ceased being eligible for Medicaid benefits.

In 2018, the legislature enacted legislation to suspend, rather than terminate, Medicaid eligibility for individuals who enter the correctional system. This recent transfer of DOC records is part of the attempt to better align departmental records to implement this statutory change. DHS is now receiving monthly DOC reports to allow for more real-time reconciliation, however, that fails to address the potential for other lengthy retroactive recoupments.

The bill failed to advance out of subcommittee on Tuesday over concerns that it was more narrowly written than federal recoupment regulations and did not allow sufficient time for the MCOs to meet the federal requirements to ensure Medicaid benefits are not provided to ineligible individuals. Proponents of the bill are working with DHS and the MCOs on a potential amendment to shorten the current five year look-back period to a period longer than the twelve months currently in the bill.

Scope of Practice

Multiple scope expansion bills continue to move forward at the capitol. On Tuesday, the House took up and overwhelmingly passed HF 528, which would allow dentists to administer the flu and COVID-19 vaccines to patients of any age. As we have noted in previous weeks, IMS has raised multiple concerns with the proposal and recommended scaling back this authority if the legislation is to become law. The bill now moves to the Senate where there is no companion bill and the proposal’s future remains uncertain.

Also on Tuesday, the House Human Resources Committee took up and passed HF 686, which would allow podiatrists to administer any CDC-recommended immunizations to patients of any age. The bill does not require additional vaccine-specific education as is the case with the other vaccine expansion proposals that have been put forward this year and it does not require that vaccines administered by a podiatrist be reported into IRIS. The bill is now eligible for consideration by the full House. It too does not have a companion bill in the Senate and it’s future in that chamber remains uncertain.

Tort Reform Action Alerts

It is absolutely critical that Iowa physicians, residents, medical students, and clinic administrators contact their legislators to urge support for a hard cap on noneconomic damages. If you haven’t already, please take a minute to reach out via the IMS Action Alert System. We have sample messages that you can edit as you see fit, enter your information to be matched to your local legislators, and hit send. It takes two minutes to make your voice heard. Take action today!

Senate Action Alert

House Action Alert

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