Relating to and making appropriations to the department of veterans affairs and the department of health and human services, and related provisions and appropriations, including aging and disability services; behavioral health, public health, community access and eligibility; the medical assistance program, state supplementary assistance, Hawki, and other health-related programs; sex reassignment surgeries or associated procedures; family well-being and protection; state-operated specialty care, administration and compliance; transfers, cash flows, and nonreversions; prior appropriations; the beer and liquor control fund, and the behavioral health fund; report on nonreversion of moneys; emergency rules; and a hospital directed payment program; and including effective date and retroactive applicability provisions

This bill makes appropriations from the general fund of the state to the department of veterans affairs and to the department of health and human services (HHS) for fiscal year 2025-2026. The appropriations from the general fund of the state to the department of veterans affairs include appropriations for administration, the Iowa veterans home, and the home ownership assistance program. The appropriations from the general fund of the state to HHS include appropriations for aging and disability services; behavioral health; public health; community access and eligibility including for child support services; the medical assistance program, state supplementary assistance, the healthy and well kids in Iowa (Hawki) program, and other specified health-related programs including health program operations; reimbursement rates; family well-being and protection including state child care assistance, early intervention and supports, and child protective services; state-operated specialty care; and administration and compliance. The bill also makes appropriations to HHS from the sports wagering receipts fund, the pharmaceutical settlement account, the quality assurance trust fund, and the hospital health care access trust fund. The bill transfers money from the beer and liquor control fund to the behavioral health fund. The bill requires HHS to develop a reimbursement methodology proposal for reimbursement of nursing facilities under the medical assistance program. The bill prohibits HHS from using moneys appropriated for the medical assistance program to reimburse sex reassignment surgery or associated procedures, including hormone therapy or other medical interventions intended to alter primary or secondary sex characteristics related to an individual’s gender dysphoria diagnosis. The bill requires HHS to submit documentation to the federal centers for Medicare and Medicaid services for approval to administer a hospital directed payment program. Upon receipt of approval, the bill permits HHS to administer a hospital directed payment program. HHS may impose an assessment on a hospital. The bill includes transfer, cash flow, and nonreversion provisions, emergency rulemaking authority, and reporting requirements.