Establishing the healthy Iowa program and including effective date provisions

The bill prohibits health care providers participating in the healthy Iowa program from refusing to provide services to a member on the basis of certain protected categories. The bill establishes the healthy Iowa board and public advisory committee. The bill provides that health care coverage under the healthy Iowa program shall not be subject to coinsurance, deductibles, or copayments. The bill prohibits certain insurers, nonprofit health service plans, and health maintenance organizations from offering benefits that duplicate the services covered by the program. The bill prohibits health insurers from offering health benefits covering any health care service for which coverage is offered to individuals under the healthy Iowa program, except as otherwise provided, and prohibits a participating health care provider from imposing charges directly on healthy Iowa members. The bill provides for approval of participating health care providers and care coordinators under the program and provides for enrollment of residents in the program. The bill also provides that healthy Iowa program members may choose a participating health care provider and requires that members select a care coordinator. The bill specifies healthy Iowa program standards and payment for health care services and care coordination, and requires that the program provide reimbursements to certain members. The bill establishes a health benefit credit for certain employers and residents. The bill establishes the healthy Iowa trust fund as a special fund for the purpose of implementing the program and its purposes. The bill requires the board and the department of human services to apply to the federal government for waivers and other approvals relating to federally regulated health care programs.F. The bill also creates new Code chapter 135F providing for collective negotiations between health care providers and the healthy Iowa program. The bill authorizes health care providers to collectively negotiate with the program for rates of payment for health care services, rates of payment for prescription and nonprescription drugs, and payment methodologies using a third-party representative. The bill takes effect upon enactment but implementation of the bill is contingent upon sufficient revenue in the healthy Iowa trust fund to bear the costs of implementing the healthy Iowa program as determined by the director of human services.