249J.9 - FUTURE EXPANSION POPULATION, BENEFITS, AND PROVIDER NETWORK GROWTH.
249J.9 FUTURE EXPANSION POPULATION, BENEFITS, AND
PROVIDER NETWORK GROWTH.
1. Population. The department shall contract with the
division of insurance of the department of commerce or another
appropriate entity to track, on an annual basis, the number of
uninsured and underinsured Iowans, the cost of private market
insurance coverage, and other barriers to access to private insurance
for Iowans. Based on these findings and available funds, the
department shall make recommendations, annually, to the governor and
the general assembly regarding further expansion of the expansion
population.
2. Benefits.
a. The department shall not provide services to expansion
population members that are in addition to the services originally
designated by the department pursuant to section 249J.6, without
express authorization provided by the general assembly.
b. The department, upon the recommendation of the clinicians
advisory panel established pursuant to section 249J.18, may change
the scope and duration of any of the available expansion population
services, but this subsection shall not be construed to authorize the
department to make expenditures in excess of the amount appropriated
for benefits for the expansion population.
3. Expansion population provider network.
a. The department shall not expand the expansion population
provider network unless the department is able to pay for expansion
population services provided by such providers at the full benefit
recipient rates.
b. The department may limit access to the expansion
population provider network by the expansion population to the extent
the department deems necessary to meet the financial obligations to
each provider under the expansion population provider network. This
subsection shall not be construed to authorize the department to make
any expenditure in excess of the amount appropriated for benefits for
the expansion population. Section History: Recent Form
2005 Acts, ch 167, §9, 66