249J.19 - HEALTH CARE SERVICES PRICING AND REIMBURSEMENT OF PROVIDERS.
249J.19 HEALTH CARE SERVICES PRICING AND
REIMBURSEMENT OF PROVIDERS.
The department shall annually collect data on third-party payor
rates in the state and, as appropriate, the usual and customary
charges of health care providers, including the reimbursement rates
paid to providers and by third-party payors participating in the
medical assistance program and through the expansion population. The
department shall consult with the division of insurance of the
department of commerce in adopting administrative rules specifying
the reporting format and guaranteeing the confidentiality of the
information provided by the providers and third-party payors. The
department shall review the data and make recommendations to the
governor and the general assembly regarding pricing changes and
reimbursement rates annually by January 1. Any recommended pricing
changes or changes in reimbursement rates shall not be implemented
without express authorization by the general assembly. Section History: Recent Form
2005 Acts, ch 167, §20, 66