514I.4 - DIRECTOR AND DEPARTMENT -- DUTIES -- POWERS.
514I.4 DIRECTOR AND DEPARTMENT -- DUTIES -- POWERS. 1. The director, with the approval of the hawk-i board, shall implement this chapter. The director shall do all of the following: a. At least every six months, evaluate the scope of the program currently being provided under this chapter, project the probable cost of continuing the program, and compare the probable cost with the remaining balance of the state appropriation made for payment of assistance under this chapter during the current appropriation period. The director shall report the findings of the evaluation to the board and shall annually report findings to the governor and the general assembly by January 1. b. Establish premiums to be paid to participating insurers for provision of health insurance coverage. c. Contract with participating insurers to provide health insurance coverage under this chapter. d. Recommend to the board proposed rules necessary to implement the program. e. Recommend to the board individuals to serve as members of the clinical advisory committee. 2. a. The director, with the approval of the board, may contract with participating insurers to provide dental-only services. b. The director, with the approval of the board, may contract with participating insurers to provide the supplemental dental-only coverage to otherwise eligible children who have private health care coverage as specified in the federal Children's Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111-3. 3. The director, with the concurrence of the board, shall enter into a contract with an administrative contractor. Such contract shall be entered into in accordance with the criteria established by the board. 4. The department may enter into contracts with other persons whereby the other person provides some or all of the functions, pursuant to rules adopted by the board, which are required of the director or the department under this section. All contracts entered into pursuant to this section shall be made available to the public. 5. The department shall do or shall provide for all of the following: a. Develop a joint program application form which is easy to understand, complete, and concise, supplemental forms, and the same application and renewal verification process for both the hawk-i and medical assistance programs. b. (1) Establish the family cost sharing amounts for children of families with incomes of one hundred fifty percent or more but not exceeding two hundred percent of the federal poverty level, of not less than ten dollars per individual and twenty dollars per family, if not otherwise prohibited by federal law, with the approval of the board. (2) Establish for children of families with incomes exceeding two hundred percent but not exceeding three hundred percent of the federal poverty level, family cost sharing amounts, and graduated premiums based on a rationally developed sliding fee schedule, in accordance with federal law, with the approval of the board. c. Perform annual, random reviews of enrollee applications to ensure compliance with program eligibility and enrollment policies. Quality assurance reports shall be made to the board and the department based upon the data maintained by the administrative contractor. d. Perform other duties as determined by the department with the approval of the board.
Section History: Recent Form 98 Acts, ch 1196, §5, 16; 2003 Acts, ch 108, §131; 2003 Acts, ch 124, §1; 2003 Acts, ch 175, §38; 2009 Acts, ch 118, §26, 27