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House File 1049 - Introduced HOUSE FILE 1049 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO HSB 342) A BILL FOR An Act 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;
House File 1049 - Enrolled House File 1049 AN ACT 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;
BEHAVIORAL HEALTH, PUBLIC HEALTH, COMMUNITY ACCESS AND ELIGIBILITY;
the medical assistance program, state supplementary assistance, Hawki, and other health-related programs;
THE MEDICAL ASSISTANCE PROGRAM, STATE SUPPLEMENTARY ASSISTANCE, HAWKI, AND OTHER HEALTH-RELATED PROGRAMS;
sex reassignment surgeries or associated procedures;
SEX REASSIGNMENT SURGERIES OR ASSOCIATED PROCEDURES;
family well-being and protection;
FAMILY WELL-BEING AND PROTECTION;
state-operated specialty care, administration and compliance;
STATE-OPERATED SPECIALTY CARE, ADMINISTRATION AND COMPLIANCE;
transfers, cash flows, and nonreversions;
TRANSFERS, CASH FLOWS, AND NONREVERSIONS;
prior appropriations;
PRIOR APPROPRIATIONS;
the beer and liquor control fund, and the behavioral health fund;
THE BEER AND LIQUOR CONTROL FUND, AND THE BEHAVIORAL HEALTH FUND;
report on nonreversion of moneys;
REPORT ON NONREVERSION OF MONEYS;
emergency rules;
EMERGENCY RULES;
and a hospital directed payment program;
AND A HOSPITAL DIRECTED PAYMENT PROGRAM;
and including effective date and retroactive applicability provisions.
AND INCLUDING EFFECTIVE DATE AND RETROACTIVE APPLICABILITY PROVISIONS.
TLSB 1004HV (1) 91 lh/ko H.F.
DIVISION I DEPARTMENT OF VETERANS AFFAIRS —— FY 2025-2026 Section 1.
1049 DIVISION I DEPARTMENT OF VETERANS AFFAIRS —— FY 2025-2026 Section 1.
1.
House File 1049, p.
2 1.
There is appropriated from the general fund of the state to the department of health and human LSB 1004HV (1) 91 -1- lh/ko 1/35 H.F.
There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
1049 services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
for the operation of the dependent adult abuse services program pursuant to chapter 235B;
for the operation House File 1049, p.
3 of the dependent adult abuse services program pursuant to chapter 235B;
Of the moneys appropriated in this section, $33,632 shall be used to build community capacity through the coordination LSB 1004HV (1) 91 -2- lh/ko 2/35 H.F.
Of the moneys appropriated in this section, $33,632 shall be used to build community capacity through the coordination and provision of training opportunities in accordance with the consent decree of Conner v.
1049 and provision of training opportunities in accordance with the consent decree of Conner v.
Activities shall align with accepted best practice guidance standards for behavioral health including those published by the centers for disease control and prevention of the United States department of health and human services, and the substance abuse and mental health services administration of the United States department of health and human services, for health promotion;
Activities shall align with accepted best practice House File 1049, p.
4 guidance standards for behavioral health including those published by the centers for disease control and prevention of the United States department of health and human services, and the substance abuse and mental health services administration of the United States department of health and human services, for health promotion;
LSB 1004HV (1) 91 -3- lh/ko 3/35 H.F.
2.
1049 2.
$ 1,750,000 DIVISION IV PUBLIC HEALTH —— FY 2025-2026 Sec.
$ 1,750,000 DIVISION IV PUBLIC HEALTH —— FY 2025-2026 House File 1049, p.
5 Sec.
LSB 1004HV (1) 91 -4- lh/ko 4/35 H.F.
..................................................
1049 ..................................................
c.
House File 1049, p.
6 c.
Moneys under this paragraph LSB 1004HV (1) 91 -5- lh/ko 5/35 H.F.
Moneys under this paragraph shall be distributed in their entirety on July 1, 2025, for the purpose specified.
1049 shall be distributed in their entirety on July 1, 2025, for the purpose specified.
There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
There is appropriated from the House File 1049, p.
To be used for salaries, support, maintenance, and miscellaneous purposes and for family investment program (FIP) assistance in accordance with chapter 239B, and for other costs LSB 1004HV (1) 91 -6- lh/ko 6/35 H.F.
7 general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
1049 associated with providing needs-based benefits or assistance including but not limited to maternal and child health, oral health, obesity prevention, the promoting independence and self-sufficiency through employment, job opportunities and the basic skills (PROMISE JOBS) program, supplemental nutrition assistance program (SNAP) employment and training, the FIP diversion program, family planning, rent reimbursement, and eligibility determinations for medical assistance, food assistance, and the children’s health insurance program, and for not more than the following full-time equivalent positions:
To be used for salaries, support, maintenance, and miscellaneous purposes and for family investment program (FIP) assistance in accordance with chapter 239B, and for other costs associated with providing needs-based benefits or assistance including but not limited to maternal and child health, oral health, obesity prevention, the promoting independence and self-sufficiency through employment, job opportunities and the basic skills (PROMISE JOBS) program, supplemental nutrition assistance program (SNAP) employment and training, the FIP diversion program, family planning, rent reimbursement, and eligibility determinations for medical assistance, food assistance, and the children’s health insurance program, and for not more than the following full-time equivalent positions:
The moneys shall be used first to fully fund the current participating counties to ensure that those counties are fully operational, with the remaining moneys to be used for expanding participation to additional counties.
The moneys shall be used first to fully fund the current participating counties House File 1049, p.
Full implementation and expansion LSB 1004HV (1) 91 -7- lh/ko 7/35 H.F.
8 to ensure that those counties are fully operational, with the remaining moneys to be used for expanding participation to additional counties.
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1049 shall include enhancing the scope of the initiative through collaboration with child health specialty clinics to promote the use of developmental surveillance and screening to support healthy child development through early identification and response to both biomedical and social determinants of healthy development by providing practitioner consultation and continuous improvement through training and education, particularly for children with behavioral conditions and needs.
Full implementation and expansion shall include enhancing the scope of the initiative through collaboration with child health specialty clinics to promote the use of developmental surveillance and screening to support healthy child development through early identification and response to both biomedical and social determinants of healthy development by providing practitioner consultation and continuous improvement through training and education, particularly for children with behavioral conditions and needs.
FTEs 464.00 LSB 1004HV (1) 91 -8- lh/ko 8/35 H.F.
FTEs 464.00 1.
1049 1.
Federal access and visitation grant moneys shall be used House File 1049, p.
Federal access and visitation grant moneys shall be used for services designed to increase compliance with the child access provisions of court orders, including but not limited to neutral visitation sites and mediation services.
9 for services designed to increase compliance with the child access provisions of court orders, including but not limited to neutral visitation sites and mediation services.
Grants shall be awarded to pregnancy prevention programs developed after July 1, 2025, if the programs are based on existing models that have LSB 1004HV (1) 91 -9- lh/ko 9/35 H.F.
Grants shall be awarded to pregnancy prevention programs developed after July 1, 2025, if the programs are based on existing models that have demonstrated positive outcomes.
1049 demonstrated positive outcomes.
Priority in the awarding of grants shall be given to programs that serve areas of the state which demonstrate the highest percentage of unplanned pregnancies of females of childbearing age within the geographic area to be served by the grant.
Priority in the awarding of grants shall be given to programs House File 1049, p.
10 that serve areas of the state which demonstrate the highest percentage of unplanned pregnancies of females of childbearing age within the geographic area to be served by the grant.
There LSB 1004HV (1) 91 -10- lh/ko 10/35 H.F.
There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
1049 is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
For medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies in effect on June 30, 2025, except as otherwise expressly authorized by law, consistent with options under House File 1049, p.
For medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies in effect on June 30, 2025, except as otherwise expressly authorized by law, consistent with options under federal law and regulations, and contingent upon receipt of approval from the office of the governor of reimbursement for each abortion performed under the medical assistance program;
11 federal law and regulations, and contingent upon receipt of approval from the office of the governor of reimbursement for each abortion performed under the medical assistance program;
Of the moneys allocated in this subsection, $3,050,000 shall be used to expand the capacity of intermittent community-based services that allow an individual to remain in the community and that provide support to the individual, including employment services, hourly supported community living services, respite services, and day habilitation LSB 1004HV (1) 91 -11- lh/ko 11/35 H.F.
Of the moneys allocated in this subsection, $3,050,000 shall be used to expand the capacity of intermittent community-based services that allow an individual to remain in the community and that provide support to the individual, including employment services, hourly supported community living services, respite services, and day habilitation services.
1049 services.
Of the moneys appropriated in this section, $61,266,871 is allocated for maintenance of the Hawki program pursuant to chapter 514I, including supplemental dental services, for receipt of federal financial participation under Tit.
Of the moneys appropriated in this section, $61,266,871 is allocated for maintenance of the Hawki program pursuant to chapter 514I, including supplemental dental services, for House File 1049, p.
12 receipt of federal financial participation under Tit.
Of the moneys appropriated in this section, a sufficient LSB 1004HV (1) 91 -12- lh/ko 12/35 H.F.
Of the moneys appropriated in this section, a sufficient amount shall be allocated for the administration of the health insurance premium payment program, including salaries, support, maintenance, and miscellaneous purposes.
1049 amount shall be allocated for the administration of the health insurance premium payment program, including salaries, support, maintenance, and miscellaneous purposes.
Unless otherwise provided by law, if a contract for services provided under this section initially entered into during the fiscal year beginning July 1, 2025, and ending June 30, 2026, provides for an annual increase of the cost of services provided under the contract, the annual increase shall not exceed the amount by which the consumer price index for all urban consumers increased during the immediately preceding calendar year.
Unless otherwise provided by law, if a contract for services provided under this section initially entered into during the fiscal year beginning July 1, 2025, and ending House File 1049, p.
13 June 30, 2026, provides for an annual increase of the cost of services provided under the contract, the annual increase shall not exceed the amount by which the consumer price index for all urban consumers increased during the immediately preceding calendar year.
Notwithstanding any provision of law to the contrary, to supplement the appropriation made in this Act from the general fund of the state for health program operations under the LSB 1004HV (1) 91 -13- lh/ko 13/35 H.F.
Notwithstanding any provision of law to the contrary, to supplement the appropriation made in this Act from the general fund of the state for health program operations under the medical assistance program for the same fiscal year:
1049 medical assistance program for the same fiscal year:
Notwithstanding any provision of law to the contrary, and subject to the availability of moneys, there is appropriated from the hospital health care access trust fund created in section 249M.4 to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount, or so much thereof as is necessary, for the purposes designated:
Notwithstanding any provision of law to the contrary, and subject to the availability of moneys, there is appropriated from the hospital health care access trust fund created in section 249M.4 to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following House File 1049, p.
14 amount, or so much thereof as is necessary, for the purposes designated:
Moneys appropriated from the general fund of the state to the department for the medical assistance program shall not be used for reimbursement for sex reassignment surgery or associated procedures, including hormone therapy or other medical interventions intended to alter primary or secondary LSB 1004HV (1) 91 -14- lh/ko 14/35 H.F.
Moneys appropriated from the general fund of the state to the department for the medical assistance program shall not be used for reimbursement for 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.
1049 sex characteristics related to an individual’s gender dysphoria diagnosis.
Of the moneys appropriated for medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies June 30, 2025, the following amounts, or so much thereof as is necessary, are allocated to the department of health and human services to be used for the following purposes:
Of the moneys appropriated for medical assistance program reimbursement and associated costs as specifically provided in the reimbursement methodologies June 30, 2025, the following amounts, or so much thereof as is necessary, are allocated to the department of health and human services to be House File 1049, p.
15 used for the following purposes:
LSB 1004HV (1) 91 -15- lh/ko 15/35 H.F.
(2) The department of health and human services shall calculate each nursing facility’s case-mix index for the period beginning July 1, 2024, using weighting based on the current patient-driven payment model schedule.
1049 (2) The department of health and human services shall calculate each nursing facility’s case-mix index for the period beginning July 1, 2024, using weighting based on the current patient-driven payment model schedule.
For the fiscal year beginning July 1, 2026, and for each fiscal year thereafter, the department shall review the reimbursement rates for home health agencies and pharmacy dispensing fees.
For the fiscal year beginning July 1, 2026, and for each fiscal year thereafter, the department shall review the House File 1049, p.
16 reimbursement rates for home health agencies and pharmacy dispensing fees.
LSB 1004HV (1) 91 -16- lh/ko 16/35 H.F.
NURSING FACILITIES —— MEDICAID REIMBURSEMENT METHODOLOGY PROPOSAL Sec.
1049 NURSING FACILITIES —— MEDICAID REIMBURSEMENT METHODOLOGY PROPOSAL Sec.
On or before July 1, 2026, the department of health and human services, in consultation with appropriate stakeholders, shall develop and implement a nursing bed facility forecasting formula utilizing the recommendations for improvement to the nursing facility bed need formula developed by the workgroup convened pursuant to 2023 Iowa Acts, chapter 158, section 11, to ensure the availability of sufficient nursing facility beds to meet future demand for nursing facility beds.
On or before July 1, 2026, the department of health and human services, in consultation with appropriate stakeholders, shall develop and implement a nursing bed facility forecasting formula utilizing the recommendations for improvement to the nursing facility bed need formula developed by the workgroup convened pursuant to 2023 Iowa Acts, chapter 158, section 11, to ensure the availability of sufficient nursing facility beds House File 1049, p.
LSB 1004HV (1) 91 -17- lh/ko 17/35 H.F.
17 to meet future demand for nursing facility beds.
1049 2.
2.
There is appropriated from the general fund of the state to the department of health LSB 1004HV (1) 91 -18- lh/ko 18/35 H.F.
There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount, or so much thereof as is necessary, to be used for the purposes House File 1049, p.
1049 and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount, or so much thereof as is necessary, to be used for the purposes designated:
18 designated:
Of the moneys appropriated in this section, not more than $734,000 shall be used for the healthy opportunities for parents to experience success (HOPES)-healthy families Iowa LSB 1004HV (1) 91 -19- lh/ko 19/35 H.F.
Of the moneys appropriated in this section, not more than $734,000 shall be used for the healthy opportunities for parents to experience success (HOPES)-healthy families Iowa (HFI) program established pursuant to section 135.106.
1049 (HFI) program established pursuant to section 135.106.
Of the moneys appropriated in this section, $29,256,799 shall be deposited in the early childhood Iowa fund created in section 256I.11.
Of the moneys appropriated in this section, $29,256,799 shall be deposited in the early childhood Iowa fund created in House File 1049, p.
19 section 256I.11.
LSB 1004HV (1) 91 -20- lh/ko 20/35 H.F.
4.
1049 4.
5.
House File 1049, p.
20 5.
Of the moneys appropriated in this section, $4,359,500 LSB 1004HV (1) 91 -21- lh/ko 21/35 H.F.
Of the moneys appropriated in this section, $4,359,500 is allocated for the preparation for adult living program established pursuant to section 234.46.
1049 is allocated for the preparation for adult living program established pursuant to section 234.46.
Of the moneys appropriated in this section, $39,823,955 is allocated for adoption subsidy payments and related costs.
Of the moneys appropriated in this section, House File 1049, p.
21 $39,823,955 is allocated for adoption subsidy payments and related costs.
Of the moneys appropriated in this section, $308,765 shall be allocated to increase the foster care reimbursement LSB 1004HV (1) 91 -22- lh/ko 22/35 H.F.
Of the moneys appropriated in this section, $308,765 shall be allocated to increase the foster care reimbursement rates pursuant to section 234.38, not to exceed the maximum reimbursement rate established in section 234.38.
1049 rates pursuant to section 234.38, not to exceed the maximum reimbursement rate established in section 234.38.
2.
House File 1049, p.
22 2.
LSB 1004HV (1) 91 -23- lh/ko 23/35 H.F.
For salaries, support, maintenance, and miscellaneous purposes at institutions under the jurisdiction of the department of health and human services, and for not more than the following full-time equivalent positions:
1049 For salaries, support, maintenance, and miscellaneous purposes at institutions under the jurisdiction of the department of health and human services, and for not more than the following full-time equivalent positions:
..................................................
House File 1049, p.
23 ..................................................
For accountability, compliance, and program integrity, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time LSB 1004HV (1) 91 -24- lh/ko 24/35 H.F.
For accountability, compliance, and program integrity, including salaries, support, maintenance, and miscellaneous purposes, and for not more than the following full-time equivalent positions:
1049 equivalent positions:
Notwithstanding any provision of law to the contrary, the department of health and human services may transfer moneys appropriated in this Act to support continuing alignment efforts, to maximize federal support in accordance with the department’s federal costs allocation plan, and for resources necessary to implement and administer the services for which moneys are appropriated.
Notwithstanding any provision of law to the contrary, the department of health and human services may transfer moneys appropriated in this Act to support continuing alignment efforts, to maximize federal support in accordance with the department’s federal costs allocation plan, and for resources necessary to implement and administer the services for which House File 1049, p.
24 moneys are appropriated.
If, due to ongoing cost management efforts, the appropriations under this Act for the Medicaid program exceed the associated costs for the Medicaid program for the fiscal year, the department may transfer any savings to the appropriations made in this Act for health program operations, LSB 1004HV (1) 91 -25- lh/ko 25/35 H.F.
If, due to ongoing cost management efforts, the appropriations under this Act for the Medicaid program exceed the associated costs for the Medicaid program for the fiscal year, the department may transfer any savings to the appropriations made in this Act for health program operations, or for accountability, compliance, and program integrity, to defray the costs associated with ongoing cost management efforts.
1049 or for accountability, compliance, and program integrity, to defray the costs associated with ongoing cost management efforts.
Notwithstanding section 8.33, moneys appropriated under this Act from the general fund of the state and the temporary assistance for needy families block grant to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, for the purposes of the FaDSS grant program that remain unencumbered or unobligated at the close of the fiscal year shall not revert, but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
Notwithstanding section 8.33, moneys appropriated under this Act from the general fund of the state and the temporary assistance for needy families block grant to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, for the purposes of the FaDSS grant program that remain unencumbered or unobligated at the House File 1049, p.
25 close of the fiscal year shall not revert, but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
Notwithstanding section 8.33, of the moneys appropriated LSB 1004HV (1) 91 -26- lh/ko 26/35 H.F.
Notwithstanding section 8.33, of the moneys appropriated under this Act from the general fund of the state, the quality assurance trust fund, and the hospital health care access trust fund to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, for the purposes of the medical assistance program, the amount in excess of actual expenditures for the medical assistance program that remains unencumbered or unobligated at the close of the fiscal year shall not revert, but shall remain available for expenditure for the medical assistance program until the close of the succeeding fiscal year.
1049 under this Act from the general fund of the state, the quality assurance trust fund, and the hospital health care access trust fund to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, for the purposes of the medical assistance program, the amount in excess of actual expenditures for the medical assistance program that remains unencumbered or unobligated at the close of the fiscal year shall not revert, but shall remain available for expenditure for the medical assistance program until the close of the succeeding fiscal year.
Notwithstanding section 8.33, moneys appropriated under this Act from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, and allocated for rural psychiatric residencies that remain unencumbered or unobligated at the close of the fiscal year shall not revert, but shall remain available for expenditure for the purposes designated LSB 1004HV (1) 91 -27- lh/ko 27/35 H.F.
Notwithstanding section 8.33, moneys appropriated under this Act from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, and allocated for rural psychiatric residencies that remain unencumbered or unobligated at the close of the fiscal year shall not revert, but shall remain available for expenditure for the purposes designated House File 1049, p.
1049 until the close of the succeeding fiscal year.
26 until the close of the succeeding fiscal year.
LSB 1004HV (1) 91 -28- lh/ko 28/35 H.F.
Notwithstanding section 8.33, any moneys utilized for this purpose shall not revert but shall remain available for expenditure for the purposes designated.
1049 Notwithstanding section 8.33, any moneys utilized for this purpose shall not revert but shall remain available for expenditure for the purposes designated.
COMMUNITY ACCESS AND ELIGIBILITY House File 1049, p.
COMMUNITY ACCESS AND ELIGIBILITY Sec.
27 Sec.
NEW SUBSECTION.
NEW SUBSECTION .
Notwithstanding section 8.33, moneys appropriated under this 2024 Iowa Act from the general fund of LSB 1004HV (1) 91 -29- lh/ko 29/35 H.F.
Notwithstanding section 8.33, moneys appropriated under this 2024 Iowa Act from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, for child protective services that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
1049 the state to the department of health and human services for the fiscal year beginning July 1, 2024, and ending June 30, 2025, for child protective services that remain unencumbered or unobligated at the close of the fiscal year shall not revert but shall remain available for expenditure for the purposes designated until the close of the succeeding fiscal year.
Sec.
House File 1049, p.
28 Sec.
Of the amounts transferred, two one million dollars, plus an additional amount determined by the general assembly, shall be appropriated to the department of health and human services for LSB 1004HV (1) 91 -30- lh/ko 30/35 H.F.
Of the amounts transferred, two one million dollars, plus an additional amount determined by the general assembly, shall be appropriated to the department of health and human services for use by the staff who administer the comprehensive substance use disorder program under chapter 125 for substance use disorder treatment and prevention programs shall be transferred to the behavioral health fund established under section 225A.7.
1049 use by the staff who administer the comprehensive substance use disorder program under chapter 125 for substance use disorder treatment and prevention programs shall be transferred to the behavioral health fund established under section 225A.7.
This division of this Act applies retroactively to July 1, 2024.
This division of this House File 1049, p.
29 Act applies retroactively to July 1, 2024.
If the department of health and human services adopts emergency rules in accordance with this section, or as LSB 1004HV (1) 91 -31- lh/ko 31/35 H.F.
If the department of health and human services adopts emergency rules in accordance with this section, or as otherwise directed or authorized by state law, and the rules will result in an increase in expenditures beyond the amount anticipated in the budget for the fiscal year, or if the expenditures were not addressed in the budget for the fiscal year, the department shall notify the general assembly and the department of management concerning the rules and the increase in expenditures.
1049 otherwise directed or authorized by state law, and the rules will result in an increase in expenditures beyond the amount anticipated in the budget for the fiscal year, or if the expenditures were not addressed in the budget for the fiscal year, the department shall notify the general assembly and the department of management concerning the rules and the increase in expenditures.
“Centers for Medicare and Medicaid services” means the centers for Medicare and Medicaid services of the United States department of health and human services.
“Centers for Medicare and Medicaid services” means the House File 1049, p.
30 centers for Medicare and Medicaid services of the United States department of health and human services.
Upon receipt of approval from the centers for Medicare and Medicaid services, the department LSB 1004HV (1) 91 -32- lh/ko 32/35 H.F.
Upon receipt of approval from the centers for Medicare and Medicaid services, the department shall administer the hospital directed payment program during the specified fiscal year.
1049 shall administer the hospital directed payment program during the specified fiscal year.
4.
House File 1049, p.
31 4.
EXPLANATION The inclusion of this explanation does not constitute agreement with the explanation’s substance by the members of the general assembly.
______________________________ ______________________________ PAT GRASSLEY AMY SINCLAIR Speaker of the House President of the Senate I hereby certify that this bill originated in the House and is known as House File 1049, Ninety-first General Assembly.
LSB 1004HV (1) 91 -33- lh/ko 33/35 H.F.
______________________________ MEGHAN NELSON Chief Clerk of the House Approved _______________, 2025 ______________________________ KIM REYNOLDS Governor
1049 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 LSB 1004HV (1) 91 -34- lh/ko 34/35 H.F.
1049 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.
LSB 1004HV (1) 91 -35- lh/ko 35/35
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