Amendment H-8036 to HF 2518
Relating to the department of health and human services and reporting requirements for shelter care, residential treatment, and Medicaid provider reimbursement rates, and establishing provider reimbursement rates for Medicaid home and community-based waiver services
Adopted · February 25, 2026
Filed February 24, 2026 in the House by
What it changes
AI summary This amendment changes how the department reviews payment rates by requiring them to compare most medical services to Medicare and dental services to neighboring states. It also requires providers to submit their actual service and supply costs to the department every year. Additionally, it requires the department to develop a new cost-based reimbursement system for waiver services and establish a new base period for calculating rate models at least once every four years.1
Read the amendment’s wording
- Page 1, by striking lines 16 through 28 and inserting: “NEW SUBSECTION .
- a. Conduct an annual review of provider reimbursement rates for medical and health services provided under this chapter that are reimbursed by a statewide fee schedule and that are not periodically updated or rebased pursuant to federal or state law or rule. The department shall compare each provider reimbursement rate in the following manner: (1) For all medical and health services other than dental services, to reimbursement rates under the federal Medicare program. (2) For dental services, to reimbursement rates for Medicaid programs in states contiguous to Iowa. b. On or before January 15 of each calendar year, the department shall submit to the general assembly a report summarizing the department’s review under paragraph “a” .”
- By striking page 1, line 35, through page 2, line 21, and inserting: “
- On or before July 1 of each fiscal year, providers shall submit actual cost of service and supply data to the department. Upon request by the department, a provider shall submit to reasonable review of the actual cost of service and supply data submitted.
- a. Upon the required submission of annual cost reports by providers and implementation by the department of a waiver fee schedule, the department, with input from the public, consumers, providers, and other stakeholders, shall develop a proposed cost-based reimbursement system and related changes to department policies and procedures for all services rendered under a waiver during the period of review specified by the department. The cost-based reimbursement system shall be developed using information provided to the department including but not limited to all of the following: (1) Provider cost data. (2) Provider claims data. (3) Consumer needs assessment data. (4) Other relevant regional and national data. b. The department shall, with input from providers and other relevant stakeholders, develop a uniform and streamlined provider cost reporting mechanism for home and community-based services.
- At least once every four years, the department shall establish a new base period to be used in calculating proposed rate models and related changes to department policies and procedures. On or before October 1 of each year that a new base period is established, the department shall submit a report to the general assembly that includes proposed rate models, the projected fiscal impact of implementing the proposed rate models, including documentation supporting the actuarial soundness of the proposed rate models, and the proposed changes to department policies and procedures.”
- Title page, by striking lines 1 through 4 and inserting “An Act relating to the department of health and human services and reporting requirements for shelter care, residential treatment, and Medicaid provider reimbursement rates, and establishing provider reimbursement rates for Medicaid home and community-based waiver services.”
- By renumbering as necessary.