Government : Iowa Medicaid Prepares to Transition Members

Last Friday, the Governor and DHS announced that UnitedHealthcare has decided to leave the Iowa Medicaid program after demanding more money for less accountability. House Republicans support Governor Reynolds decision and commitment to get the best deal possible for Medicaid members, providers, and taxpayers.

House Republicans are focused on ensuring a smooth transition and no gaps in service to vulnerable Iowans. DHS is actively working on a transition plan with Amerigroup and Iowa Total Care to match members with their current case managers, credentialing out of network providers throughout the transition, ensuring comprehensive data file transfers for care coordination, and honoring existing prior authorizations. The call center is prepared to assist members and providers with any questions during the transition.

During the transition, Medicaid members will have a choice between the two remaining MCOs and will be able to switch plans for 90 days from the date they are moved from United. Even after that 90-day choice period, members will be able to change MCOs at any time for “good cause”, which includes their provider not being in their current MCO’s network.

Providers should also be reassured that even after United leaves the Medicaid program, they are required to maintain claims processing for 12 months to complete adjudication of all claims.

This week, the House Appropriations Committee passed the Health and Human Services Budget, which includes actuarially sound Medicaid rates based on actual experience to ensure a sustainable program for the future. For the last 3 years, the legislature has passed, in a bipartisan manner, some of the strongest managed care oversight in the country.

Please reach out to me if you are a provider or member experiencing a specific issue, and I will do my best to resolve the problem.

House GOP Continues Steady Pace Moving Budget Bills

As committee work on policy bills winds down this week, attention is turning to the budget process as both the House and Senate begin to move appropriation bills setting the FY 2020 spending plan.

In the House, three budget bills have moved to the House floor for consideration – Administration and Regulation, Education, and Federal Block Grants. And two more bills – Health and Human Services and Rebuild Iowa Infrastructure Fund – will be considered by the House Appropriations Committee by Friday. These bills contain some of the key priorities that House Republicans have been working on during the 2019 legislative session.

In the House GOP Education budget bill, higher education students are the biggest winners under House File 758. The bill provides an additional $7 million to the state’s share of funding to Iowa’s fifteen community colleges.

Additionally, community college students in certain job training programs will be able to get additional financial aid through Future Ready Iowa’s last dollar scholarship program. House File 758 provider $14.7 million for the first year of this ambitious effort to increase the number of Iowans with the job skills needed in Iowa’s economy.

For Iowans getting degrees at four-year institutions, House File 758 is also addressing their needs. The three state universities would receive an increase of $15.9 million under the House plan, which would be distributed by the Board of Regents. Additionally, the All Iowa Opportunity Scholarship program – which provides additional financial assistance to state university students based on need – will see its first increase in a number of years.

Those Iowans who attend one of the state’s independent colleges will see an increase in funding to the Iowa Tuition Grant program. The students who were unable to finish their schooling in certain fields will be able to get assistance through the Future Ready Iowa Scholarship program, which will receive $1 million in FY 2020 under House File 758.

Another key priority of House Republicans is to address health care provider reimbursement issues. The Health and Human Services budget – House Study Bill 253 - proposes to restore Medicaid payment rates to Iowa’s eighty-two critical access hospitals to 101% of costs, with a cost settlement process at the end of the year. To help ensure Iowans have access to nursing homes in their local communities, House Study Bill 253 provides an additional $19 million of General Fund dollars to Iowa’s Medicaid program to increase the daily nursing home payment rate.

Addressing children’s mental health is a key priority this year for many Iowans of all political persuasion. House Republicans are committed to this and have dedicated additional resources in the FY 2020 budget for this purpose. This includes funding the $3 million in House File 758 to help schools train their personnel to identify and work with kids having mental health issues. In the Health and Human Services budget, $1.2 million is provided to expand access to the children’s mental health waiver in the Medicaid program and another $1.1 million to increase the number of assertive community treatment teams throughout Iowa. To increase access, additional funding is provided in the Health and Human Services budget to train and retain mental health providers.

House Passes Commercial Establishments Personal Identification Requirements

On Thursday, March 28, the Iowa House passed House File 311 by a nearly partisan 55 -aye to 42-nay vote. The bill eliminates a Code provision that requires a person applying for a commercial establishment authorization to provide a personal identification number (social security or taxpayer i.d.). The House adopted an amendment requiring that a person applying for a commercial establishment license must present a government issue photo i.d. or similar identification approved by Iowa Department of Agriculture and Land Stewardship (IDALS). In addition, a person must sign the application under penalty perjury. Upon completing the initial inspection, IDALS shall issue a unique identification number that is a public record. Other IDALS licenses (such pesticide applicator, grain dealers) and age-related environmental permits and livestock regulatory licenses issued by the Department of Natural Resources (DNR) do not require personal identity or taxpayer numbers, but instead usually assign a unique number to the person to track the license and permit and that number is usually a public record.

The House turned down an amendment that required an applicant for a commercial establishment to submit a date of birth, last four digits of a person’s social security number, and a fingerprint to enable national-wide criminal background check. The legislation cleared the Senate Agriculture Committee on Tuesday, April 2, with an amendment to remove the House adopted an amendment from the bill.

IDALS Secretary Naig Issues Statement of Support of Governor Reynolds at EPA Hearing

On Friday, March 29, 2019, the Iowa Department of Agriculture and Land Stewardship (IDALS) published a press release in which Iowa Secretary of Agriculture Mike Naig issued comments in support of Governor Reynolds’ comments at the EPA public hearing today in Michigan. The proposed rules allow the year-round use of E-15 and reform to the RINS credits program. Secretary Naig noted-- “We share the Governor’s concerns about the economic pressures facing rural Iowans, which are intensified by the recent flooding. We echo her support of the biofuels industry, which is essential to the success of Iowa farmers and the ag economy. We call on the EPA to end the unjust practice of issuing small refinery exemptions that continue to undermine the intent of the RFS.”

Iowa is the number one producer of corn, ethanol, and biodiesel. The renewable fuels industry accounts for nearly $5 billion of Iowa’s GDP, generates over $2.4 billion of income for Iowa households, and supports almost 47,000 jobs in the state.” Click here to view Gov. Reynold's full news release.

Customers Save $630M Under Plans Approved by IUB

The Iowa Utilities Board (IUB) issued three orders last week approving the proposed five-year energy efficiency plans by Alliant Energy - Interstate Power and Light Company (docket EEP-2018-0003), Black Hills Energy Company (EEP-2018-0004), and Liberty Utilities (EEP-2018-0005). Earlier this year, the IUB approved the proposed five-year energy efficiency plan by MidAmerican Energy (EEP-2018-0002). The IUB's final orders, are available under each docket number in the IUB's electronic filing system at efs.iowa.gov.

Last year, the legislature capped the fees charged to consumers for energy efficiency plans managed by the utilities. Beginning in April or May, customers of these rate-regulated utilities should see a decrease in the energy efficiency charge on their monthly bill. As a result, these new plans have projected savings to customers of over $635 million dollars.

New Energy Assistance Programs within IEDA

Last week, the Iowa Economic Development Authority (IEDA) and the Iowa Energy Center (IEC) board, launched two financial assistance programs that support projects and initiatives that align with the Iowa Energy Plan and IEC’s activities. The IEC Grant Program and Alternate Energy Revolving Loan Program (AERLP) have been designed to facilitate energy-related economic development in Iowa.

The IEC Grant Program is funded by gas and electric utilities across Iowa and is open to Iowa businesses, colleges, and universities, and private nonprofit agencies and foundations. The program provides grants to eligible applicants for projects that provide a benefit to Iowa's electric and natural gas utility customers. Projects must also aid in the implementation of at least one of seven key focus areas of the Iowa Energy Plan. Grant awards will range from $10,000 to $1,000,000; however, most grants awarded will be in the $150,000-to-$300,000 range. Pre-applications for the program are due April 19, 2019, and accepted through IowaGrants.gov.

The AERLP provides zero-interest loans to eligible borrowers for alternate energy production projects, including but not limited to solar, wind, biomass and combined heat and power. The AERLP can improve the feasibility of energy projects for businesses, farmers, individuals, water and wastewater utilities, and rural water and sanitary districts. Loan amounts may range from $25,000 to $1 million and cover up to 50 percent of eligible project costs. The first deadline for applications is May 31, 2019, and applications are accepted through IowaGrants.gov.

New PE and Health Academic Standards Adopted for Iowa Schools

The State Board of Education adopted new Physical Education and Health standards last week for students in kindergarten through high school.

This effort on these standards is part of a process the Department of Education has been working on for all of Iowa since 2013. Former Governor Branstad issued an Executive Order directing the Department to review all of Iowa’s standards.

This most recent action by the board will provide a foundation for Iowa school districts to implement high-quality health and physical education programs. The standards are optional for Iowa schools.

FDA Takes Closer Look at Cannabis Products

The FDA issued a press release this week addressing new steps it is taking to evaluate regulatory pathways for cannabis containing and derived products. In many parts of Iowa, stores are selling CBD products, and these products are currently illegal under state law. The only way for a person to have CBD is to have a Medical CBD Card and to purchase the product at an approved dispensary. However, even though the products are illegal, they remain very popular.

House Considers Use of Electronic Notary

HF 736 allows a remotely located individual to comply with section 9B.6 by using communication technology to appear before a notary public. A notary public may use communication technology for a remotely located individual if all of the following apply:

· Personal knowledge under section 9B.7(1) of the identity of the individual.

· Satisfactory evidence of the identity of the remotely located individual by oath or affirmation from a credible witness appearing before the notary public under section 9B.7(2) or this section.

· Obtained satisfactory evidence of the identity of the remotely located individual by using at least two different types of identity proofing.

Property Taxes: The Basics of the Budget Limitation Legislation—House Study Bill 165

House Study Bill 165 has cleared a House subcommittee and is eligible to be considered in the House Ways and Means Committee. The legislation has been diligently worked on for the last several weeks and a strike-after amendment will be offered that takes into account the suggestions of many legislators, taxpayers, and interest groups.

The legislation seeks to limit the growth of city and county budgets to two percent per year. That two percent represents a reasonable growth rate that taxpayers can understand the necessity of. It takes away the ability of local governments –intentionally or not - to deceive taxpayers by telling them their tax rate was not increased, which while true, is not the whole story. There seems to be a growing trend by local governments to ride large increases in valuations (causing tax collections even at a steady rate to increase greatly). Taxpayers hear “I didn’t raise your tax rate” and think the local government must be acting extremely responsibly with their taxpayer dollars—and then are shocked to receive a property tax bill with a giant increase. This legislation ends that behavior.

Under the bill, to figure out what a local budget can be (and therefore what needs to be levied) for the next year, local governments will have to start with their prior year’s budget. To explain it simply—they would be able to levy up to two percent more than last year’s budget. When they receive their property valuations—the Department of Management will assist in calculating what the levy needs to be in order to collect the correct amount of property tax.

The legislation recognizes that there are some funds, levies, pots of money, whatever you want to call it—that need to be outside of this calculation of up to 102 percent. The legislation leaves all net new property out of the limitation. If a city had a new development built one year—the legislation would not include that value in the calculation that first year. Additionally—any bonding, mental health, EMS, capital funds, or voted upon levies (symphonies, libraries, etc.) live outside of this limitation calculation. The things that are included in the limitation calculation are the emergency, trust and agency, transit, utility replacement transfers, anything under the city 8.10 levy or the county general or supplemental levies. These are things taxpayers would generally think of as “general fund” pots of money.