Bills You Need to Know – What's Impacting You on July 1 

The calendar year begins for the state of Iowa on July 1. That is the date that the majority of new legislation goes into effect. 

Here is what you need to know about new bills that will be impacting you on July 1: 

  • Nursing Facility Rebase Funding – The nursing facility rebase will technically go into effect on July 1, however, LAI members will not see it impact their rates until later this year. IME must submit a State Plan Amendment (SPA) to CMS to get full approval. IME will retro back your payments to reflect the changes.
    • Prospective payments – LAI members will also see their quarterly rate changes Nursing facilities are moving from a retrospective to a prospective payment system for rates. Therefore, beginning next year after the rebase has been approved, LAI members should receive their 4/1/20 rates at the end of January 2020. Moving forward, LAI members should receive their prospective rate notice on a similar timeframe. The exact timeframe is pending approval of CMS for the new NF rebase rates, but Medicaid anticipates that July and October rates will be distributed in December or January after federal approval.
  • QAAF Rate Increase - QAAF changes have been approved and will be implemented on July 1, 2019.  LAI members should see a change in QAAF add-on at that time. LAI members should also aspect to have to pay at the higher QAAF rate later this year.
  • Tiered Rates Funding – Entities using tiered rates should see a rate schedule reflecting their new rates in the next few months.
  • Mandatory Reporter Training Requirements – Please see the article “Mandatory Reporter Training Changes: Website and Key Points” for additional information. Mandatory reporter training for dependent adult will have changes to the frequency of the necessary training and will centralize the training to DHS. All other training programs will be invalid on July 1. For more information on the mandatory reporter training and to find where the new training materials will be housed, click on the following link:
  • IPOST Changes – Legally appointed guardians will now have the ability to fill out IPOST forms for individuals under their guardianship. This is a change from the past where only the individual, and not their guardians, could fill out an IPOST form.
  • Voluntary National Background Checks – See “Optional National Background Checks Now Available Through DPS" for more complete details. LAI members can now utilize national background checks on a voluntary basis through the Department of Public Safety
  • What is Not Going into Effect on July 1:
    • Hospice Room and Board Pass-Through - Ending the room in board pass through for Hospice residents residing in a nursing facility was one of the proactive pieces of legislation LAI worked on in the 2019 session. Popular among the members, the bill would allow the MCOs to pay the room and board for Hospice beneficiaries directly to the nursing facility. However, conversations with DHS state that due to a flaw in the legislation it may take up to 18 months to eliminate the passthrough and gain CMS approval.
    • Nursing Facility Quality of Care Rate Add-on (IGT) - The new nursing facility quality of care rate add will go into legal effect on July 1 but is months away from approval. LAI did an extensive analysis of the new program in a previous article. Medicaid stated a State Plan Amendment (SPA) for approval will be a lengthy process. The length of time is mainly due to federal requirements mandating an existing arrangement of non-state government owned (NSGO) nursing facilities before the submission of the SPA to CMS can take place. This differs from the past where IME could submit for approval of a SPA without any action needed by nursing facilities across the state.  LAI would highly recommend contacting Shannon Strickler or Matt Blake before entering into one of these agreements.