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H0202aa,aa...............................................by HEALTH AND WELFARE
MEDICAID COVERAGE - PREBORN CHILD - Amends existing law to include preborn
children within the definition of persons entitled to Medicaid coverage; to
require services to be provided for prenatal care and other health services
for unborn children; to direct the director of the Department of Health and
Welfare to seek necessary waivers to provide coverage; and to provide
legislative intent.
02/07 House intro - 1st rdg - to printing
02/10 Rpt prt - to Health/Wel
02/21 Rpt out - rec d/p - to 2nd rdg
02/24 2nd rdg - to 3rd rdg
03/06 Ret'd to Health/Wel
03/13 Rpt out - to Gen Ord
Rpt out amen - to engros
03/14 Rpt engros - 1st rdg - to 2nd rdg as amen
03/17 2nd rdg - to 3rd rdg as amen
03/21 Ret'd to Gen Ord
03/24 Rpt out amen - to engros
03/25 Rpt engros - 1st rdg - to 2nd rdg as amen
03/26 2nd rdg - to 3rd rdg as amen
03/31 3rd rdg as amen - FAILED - 33-37-0
AYES -- Barraclough, Barrett, Bauer, Bedke, Block, Bradford, Cannon,
Clark, Collins, Crow, Cuddy, Denney, Eberle, Ellsworth, Field(23),
Gagner, Harwood, Kellogg, Kulczyk, Lake, Langford, McGeachin, McKague,
Moyle, Nielsen, Roberts, Rydalch, Sali, Schaefer, Shirley, Snodgrass,
Wills, Wood
NAYS -- Andersen, Bell, Bieter, Black, Boe, Bolz, Campbell, Deal,
Douglas, Edmunson, Eskridge, Field(18), Garrett, Henbest, Jaquet, Jones,
Langhorst, Martinez, Meyer, Miller, Mitchell, Naccarato, Raybould,
Ridinger, Ring, Ringo, Robison, Sayler, Shepherd, Skippen, Smith(30),
Smith(24), Smylie, Stevenson, Tilman, Trail, Mr. Speaker
Absent and excused -- None
Floor Sponsors - Sali & McKague
Filed w/Office of the Chief Clerk
|||| LEGISLATURE OF THE STATE OF IDAHO ||||
Fifty-seventh Legislature First Regular Session - 2003
IN THE HOUSE OF REPRESENTATIVES
HOUSE BILL NO. 202
BY HEALTH AND WELFARE COMMITTEE
1 AN ACT
2 RELATING TO PROVISIONS OF STATE MEDICAID COVERAGE; AMENDING SECTION 56-203,
3 IDAHO CODE, TO INCLUDE PREBORN CHILDREN WITHIN THE DEFINITION OF PERSONS
4 ENTITLED TO COVERAGE; AMENDING SECTION 56-209d, IDAHO CODE, TO REQUIRE
5 SERVICES BE PROVIDED FOR PRENATAL CARE AND OTHER HEALTH SERVICES FOR
6 UNBORN CHILDREN; AND DIRECTING THE DIRECTOR OF THE DEPARTMENT OF HEALTH
7 AND WELFARE TO SEEK NECESSARY WAIVERS TO PROVIDE COVERAGE.
8 Be It Enacted by the Legislature of the State of Idaho:
9 SECTION 1. That Section 56-203, Idaho Code, be, and the same is hereby
10 amended to read as follows:
11 56-203. POWERS OF STATE DEPARTMENT. The state department shall have the
12 power to:
13 (a) Enter into contracts and agreements with the federal government
14 through its appropriate agency or instrumentality whereby the state of Idaho
15 shall receive federal grants-in-aid or other benefits for public assistance or
16 public welfare purposes under any act or acts of congress heretofore or here-
17 after enacted;
18 (b) Cooperate with the federal government in carrying out the purposes of
19 any federal acts pertaining to public assistance or welfare services, and in
20 other matters of mutual concern;
21 (c) Cooperate with county governments and other branches of government
22 and other agencies, public or private, in administering and furnishing public
23 welfare services;
24 (d) Enter into reciprocal agreements with other states relative to the
25 provisions of public assistance and welfare services to residents and nonresi-
26 dents;
27 (e) Initiate and administer public assistance and social services for
28 persons physically or mentally handicapped;
29 (f) Establish such requirements of residence for public assistance under
30 this act as may be deemed advisable, subject to any limitations imposed in
31 this act;
32 (g) Define persons entitled to medical assistance in such terms as will
33 meet requirements for federal financial participation in medical assistance
34 payments, including, but not limited to, preborn children as defined by 42 CFR
35 457 relating to the state children's health insurance program;
36 (h) Accept the legal custody of children committed to it by district
37 courts of this state under the Child Protective Act, to provide protective
38 supervision as defined therein, to place children for adoption when such chil-
39 dren are in the legal custody of the state department and are legally avail-
40 able for adoption and to exercise consent to adoption when the authority to do
41 so is vested in the department by court order or legally authorized parental
42 relinquishment;
43 (i) Determine the amount, duration and scope of care and services to be
2
1 purchased as medical assistance on behalf of needy eligible individuals;
2 (j) Manage and operate the Idaho state school and hospital at Nampa,
3 Idaho.
4 SECTION 2. That Section 56-209d, Idaho Code, be, and the same is hereby
5 amended to read as follows:
6 56-209d. MEDICAL ASSISTANCE PROGRAM -- SERVICES TO BE PROVIDED. Notwith-
7 standing any other provision of this chapter, medical assistance shall
8 increase:
9 (1) Payment as determined under rules established by the director from
10 forty (40) days per fiscal year to unlimited days of inpatient hospital care
11 per state fiscal year.
12 (2) Payment as determined under rules established by the director from
13 thirty dollars ($30.00) per month to an unlimited amount of prescribed drugs
14 for each recipient.
15 (3) Provision of eligibility for medical assistance for residents of
16 skilled and intermediate care facilities who meet the medical criteria for
17 medical assistance, from those with countable income of two hundred one and
18 two-tenths percent (201.2%) to those with countable income of three hundred
19 percent (300%) of the SSI standard.
20 (4) Payment, as authorized by title XIX of the social security act, as
21 amended, and as determined under rules established by the director for:
22 (a) Durable medical equipment.
23 (b) Soft organ transplants.
24 (c) Adult dental services.
25 (d) Adult vision services.
26 (e) Adult hearing services.
27 (f) Prosthetics.
28 (g) Assistive and augmentative communication devices.
29 (5) Payment for breast and cervical cancer-related treatment services for
30 persons who are eligible for screening for these cancers under the federal
31 centers for disease control and prevention's national breast and cervical can-
32 cer early detection program, and are eligible for medical assistance pursuant
33 to the provisions of the federal "Breast and Cervical Cancer Prevention and
34 Treatment Act of 2000" (Pub. L. 106-354).
35 (6) Payment, as authorized by title XXI of the social security act, as
36 amended, and as defined by 42 CFR 457, and as determined under rules estab-
37 lished by the director, for prenatal care and other health services for unborn
38 children.
39 SECTION 3. The director of the Department of Health and Welfare is hereby
40 directed to apply for a waiver or waivers of the federal Title XXI Children's
41 Health Insurance Program in order to amend the state's Medicaid plan to allow
42 coverage for services for preborn children.
|||| LEGISLATURE OF THE STATE OF IDAHO ||||
Fifty-seventh Legislature First Regular Session - 2003
Moved by Sali
Seconded by Kulczyk
IN THE HOUSE OF REPRESENTATIVES
HOUSE AMENDMENTS TO H.B. NO. 202
1 AMENDMENTS TO SECTION 3
2 On page 2 of the printed bill, in line 41, following "Program" insert: "or
3 other authorizations from the Secretary of Health and Human Services"; and in
4 line 42, following "children" insert: "and allow provision of services as set
5 out herein".
6 CORRECTION TO TITLE
7 On page 1, in line 6, following "CHILDREN;" delete "AND"; and in line 7,
8 following "COVERAGE" insert: "; AND PROVIDING A STATEMENT OF LEGISLATIVE
9 INTENT".
Moved by Sali
Seconded by Kulczyk
IN THE HOUSE OF REPRESENTATIVES
HOUSE AMENDMENT TO H.B. NO. 202, As Amended
10 AMENDMENT TO THE BILL
11 On page 2 of the engrossed bill, following line 45, insert:
12 "SECTION 4. It is legislative intent that this enactment will save funds
13 and reduce human suffering within the amounts budgeted in the effective and
14 future fiscal years. To that end it is legislative intent that, subject to
15 the authorization of such program by federal Health and Human Services offi-
16 cials, a 2-year pilot project be implemented by the Department of Health and
17 Welfare where CHIP funds currently being spent on neonatal intensive care
18 expenses will be redirected to prenatal care for unborn children with the fol-
19 lowing limitations:
20 1. The services described below will be available for unborn children,
21 and their mothers, for households between 133% and 150% of federal poverty
22 level.
23 2. Antepartum care will be available pursuant to CPT codes 59425 and
24 59426, as applicable and will be available for qualified persons, including
25 eligible residents and ineligible aliens, who would not qualify for services
26 under the current requirements for Pregnant Women and Children services.
27 3. The mother of each qualifying unborn child shall receive prenatal
28 vitamins up to $48.00 and for a program total of $84,960 for fiscal year 2004
29 and with up to an additional 1.8% increase for population growth for each
30 future year.
31 4. Mothers of qualifying unborn children may receive medications up to
32 $300 during the pregnancy for up to a program total of $53,100 for fiscal year
33 2004 and with up to an additional 1.8% increase for population growth for each
34 future year.
|||
2
1 5. Mothers of qualifying unborn children may receive ultrasounds up to
2 $300 during the pregnancy for up to a program total of $53,100 for fiscal year
3 2004 and with up to an additional 1.8% increase for population growth for each
4 future year.
5 6. Mothers of qualifying unborn children may receive lab services up to
6 $120 during the pregnancy for up to a program total of $212,400 for fiscal
7 year 2004 and with up to an additional 1.8% increase for population growth for
8 each future year.
9 7. It is intended that the Department of Health and Welfare seek authori-
10 zation to process claims and payments in the most cost-efficient manner feasi-
11 ble, including use of existing CPT codes for services, use of existing com-
12 puter programming, use of mother's name with an assumed number to identify the
13 unborn child and, if needed, processing of claims and payments off-line from
14 the department's main computers.
15 8. The Department of Health and Welfare may expend additional amounts
16 from avoided costs to provide administration of the program and to provide
17 additional pregnancy-related services to accomplish the goals of avoiding
18 neonatal intensive care costs and reducing human suffering of children before
19 and after they are born.".
|||| LEGISLATURE OF THE STATE OF IDAHO ||||
Fifty-seventh Legislature First Regular Session - 2003
IN THE HOUSE OF REPRESENTATIVES
HOUSE BILL NO. 202, As Amended
BY HEALTH AND WELFARE COMMITTEE
1 AN ACT
2 RELATING TO PROVISIONS OF STATE MEDICAID COVERAGE; AMENDING SECTION 56-203,
3 IDAHO CODE, TO INCLUDE PREBORN CHILDREN WITHIN THE DEFINITION OF PERSONS
4 ENTITLED TO COVERAGE; AMENDING SECTION 56-209d, IDAHO CODE, TO REQUIRE
5 SERVICES BE PROVIDED FOR PRENATAL CARE AND OTHER HEALTH SERVICES FOR
6 UNBORN CHILDREN; DIRECTING THE DIRECTOR OF THE DEPARTMENT OF HEALTH AND
7 WELFARE TO SEEK NECESSARY WAIVERS TO PROVIDE COVERAGE; AND PROVIDING A
8 STATEMENT OF LEGISLATIVE INTENT.
9 Be It Enacted by the Legislature of the State of Idaho:
10 SECTION 1. That Section 56-203, Idaho Code, be, and the same is hereby
11 amended to read as follows:
12 56-203. POWERS OF STATE DEPARTMENT. The state department shall have the
13 power to:
14 (a) Enter into contracts and agreements with the federal government
15 through its appropriate agency or instrumentality whereby the state of Idaho
16 shall receive federal grants-in-aid or other benefits for public assistance or
17 public welfare purposes under any act or acts of congress heretofore or here-
18 after enacted;
19 (b) Cooperate with the federal government in carrying out the purposes of
20 any federal acts pertaining to public assistance or welfare services, and in
21 other matters of mutual concern;
22 (c) Cooperate with county governments and other branches of government
23 and other agencies, public or private, in administering and furnishing public
24 welfare services;
25 (d) Enter into reciprocal agreements with other states relative to the
26 provisions of public assistance and welfare services to residents and nonresi-
27 dents;
28 (e) Initiate and administer public assistance and social services for
29 persons physically or mentally handicapped;
30 (f) Establish such requirements of residence for public assistance under
31 this act as may be deemed advisable, subject to any limitations imposed in
32 this act;
33 (g) Define persons entitled to medical assistance in such terms as will
34 meet requirements for federal financial participation in medical assistance
35 payments, including, but not limited to, preborn children as defined by 42 CFR
36 457 relating to the state children's health insurance program;
37 (h) Accept the legal custody of children committed to it by district
38 courts of this state under the Child Protective Act, to provide protective
39 supervision as defined therein, to place children for adoption when such chil-
40 dren are in the legal custody of the state department and are legally avail-
41 able for adoption and to exercise consent to adoption when the authority to do
42 so is vested in the department by court order or legally authorized parental
43 relinquishment;
|||| LEGISLATURE OF THE STATE OF IDAHO ||||
Fifty-seventh Legislature First Regular Session - 2003
1 (i) Determine the amount, duration and scope of care and services to be
2 purchased as medical assistance on behalf of needy eligible individuals;
3 (j) Manage and operate the Idaho state school and hospital at Nampa,
4 Idaho.
5 SECTION 2. That Section 56-209d, Idaho Code, be, and the same is hereby
6 amended to read as follows:
7 56-209d. MEDICAL ASSISTANCE PROGRAM -- SERVICES TO BE PROVIDED. Notwith-
8 standing any other provision of this chapter, medical assistance shall
9 increase:
10 (1) Payment as determined under rules established by the director from
11 forty (40) days per fiscal year to unlimited days of inpatient hospital care
12 per state fiscal year.
13 (2) Payment as determined under rules established by the director from
14 thirty dollars ($30.00) per month to an unlimited amount of prescribed drugs
15 for each recipient.
16 (3) Provision of eligibility for medical assistance for residents of
17 skilled and intermediate care facilities who meet the medical criteria for
18 medical assistance, from those with countable income of two hundred one and
19 two-tenths percent (201.2%) to those with countable income of three hundred
20 percent (300%) of the SSI standard.
21 (4) Payment, as authorized by title XIX of the social security act, as
22 amended, and as determined under rules established by the director for:
23 (a) Durable medical equipment.
24 (b) Soft organ transplants.
25 (c) Adult dental services.
26 (d) Adult vision services.
27 (e) Adult hearing services.
28 (f) Prosthetics.
29 (g) Assistive and augmentative communication devices.
30 (5) Payment for breast and cervical cancer-related treatment services for
31 persons who are eligible for screening for these cancers under the federal
32 centers for disease control and prevention's national breast and cervical can-
33 cer early detection program, and are eligible for medical assistance pursuant
34 to the provisions of the federal "Breast and Cervical Cancer Prevention and
35 Treatment Act of 2000" (Pub. L. 106-354).
36 (6) Payment, as authorized by title XXI of the social security act, as
37 amended, and as defined by 42 CFR 457, and as determined under rules estab-
38 lished by the director, for prenatal care and other health services for unborn
39 children.
40 SECTION 3. The director of the Department of Health and Welfare is hereby
41 directed to apply for a waiver or waivers of the federal Title XXI Children's
42 Health Insurance Program or other authorizations from the Secretary of Health
43 and Human Services in order to amend the state's Medicaid plan to allow cover-
44 age for services for preborn children and allow provision of services as set
45 out herein.
IN THE HOUSE OF REPRESENTATIVES
HOUSE BILL NO. 202, As Amended, As Amended
3
BY HEALTH AND WELFARE COMMITTEE
1 AN ACT
2 RELATING TO PROVISIONS OF STATE MEDICAID COVERAGE; AMENDING SECTION 56-203,
3 IDAHO CODE, TO INCLUDE PREBORN CHILDREN WITHIN THE DEFINITION OF PERSONS
4 ENTITLED TO COVERAGE; AMENDING SECTION 56-209d, IDAHO CODE, TO REQUIRE
5 SERVICES BE PROVIDED FOR PRENATAL CARE AND OTHER HEALTH SERVICES FOR
6 UNBORN CHILDREN; DIRECTING THE DIRECTOR OF THE DEPARTMENT OF HEALTH AND
7 WELFARE TO SEEK NECESSARY WAIVERS TO PROVIDE COVERAGE; AND PROVIDING A
8 STATEMENT OF LEGISLATIVE INTENT.
9 Be It Enacted by the Legislature of the State of Idaho:
10 SECTION 4. That Section 56-203, Idaho Code, be, and the same is hereby
11 amended to read as follows:
12 56-203. POWERS OF STATE DEPARTMENT. The state department shall have the
13 power to:
14 (a) Enter into contracts and agreements with the federal government
15 through its appropriate agency or instrumentality whereby the state of Idaho
16 shall receive federal grants-in-aid or other benefits for public assistance or
17 public welfare purposes under any act or acts of congress heretofore or here-
18 after enacted;
19 (b) Cooperate with the federal government in carrying out the purposes of
20 any federal acts pertaining to public assistance or welfare services, and in
21 other matters of mutual concern;
22 (c) Cooperate with county governments and other branches of government
23 and other agencies, public or private, in administering and furnishing public
24 welfare services;
25 (d) Enter into reciprocal agreements with other states relative to the
26 provisions of public assistance and welfare services to residents and nonresi-
27 dents;
28 (e) Initiate and administer public assistance and social services for
29 persons physically or mentally handicapped;
30 (f) Establish such requirements of residence for public assistance under
31 this act as may be deemed advisable, subject to any limitations imposed in
32 this act;
33 (g) Define persons entitled to medical assistance in such terms as will
34 meet requirements for federal financial participation in medical assistance
35 payments, including, but not limited to, preborn children as defined by 42 CFR
36 457 relating to the state children's health insurance program;
37 (h) Accept the legal custody of children committed to it by district
38 courts of this state under the Child Protective Act, to provide protective
39 supervision as defined therein, to place children for adoption when such chil-
40 dren are in the legal custody of the state department and are legally avail-
41 able for adoption and to exercise consent to adoption when the authority to do
42 so is vested in the department by court order or legally authorized parental
43 relinquishment;
44 (i) Determine the amount, duration and scope of care and services to be
45 purchased as medical assistance on behalf of needy eligible individuals;
46 (j) Manage and operate the Idaho state school and hospital at Nampa,
47 Idaho.
48 SECTION 5. That Section 56-209d, Idaho Code, be, and the same is hereby
49 amended to read as follows:
4
1 56-209d. MEDICAL ASSISTANCE PROGRAM -- SERVICES TO BE PROVIDED. Notwith-
2 standing any other provision of this chapter, medical assistance shall
3 increase:
4 (1) Payment as determined under rules established by the director from
5 forty (40) days per fiscal year to unlimited days of inpatient hospital care
6 per state fiscal year.
7 (2) Payment as determined under rules established by the director from
8 thirty dollars ($30.00) per month to an unlimited amount of prescribed drugs
9 for each recipient.
10 (3) Provision of eligibility for medical assistance for residents of
11 skilled and intermediate care facilities who meet the medical criteria for
12 medical assistance, from those with countable income of two hundred one and
13 two-tenths percent (201.2%) to those with countable income of three hundred
14 percent (300%) of the SSI standard.
15 (4) Payment, as authorized by title XIX of the social security act, as
16 amended, and as determined under rules established by the director for:
17 (a) Durable medical equipment.
18 (b) Soft organ transplants.
19 (c) Adult dental services.
20 (d) Adult vision services.
21 (e) Adult hearing services.
22 (f) Prosthetics.
23 (g) Assistive and augmentative communication devices.
24 (5) Payment for breast and cervical cancer-related treatment services for
25 persons who are eligible for screening for these cancers under the federal
26 centers for disease control and prevention's national breast and cervical can-
27 cer early detection program, and are eligible for medical assistance pursuant
28 to the provisions of the federal "Breast and Cervical Cancer Prevention and
29 Treatment Act of 2000" (Pub. L. 106-354).
30 (6) Payment, as authorized by title XXI of the social security act, as
31 amended, and as defined by 42 CFR 457, and as determined under rules estab-
32 lished by the director, for prenatal care and other health services for unborn
33 children.
34 SECTION 6. The director of the Department of Health and Welfare is hereby
35 directed to apply for a waiver or waivers of the federal Title XXI Children's
36 Health Insurance Program or other authorizations from the Secretary of Health
37 and Human Services in order to amend the state's Medicaid plan to allow cover-
38 age for services for preborn children and allow provision of services as set
39 out herein.
40 SECTION 7. It is legislative intent that this enactment will save funds
41 and reduce human suffering within the amounts budgeted in the effective and
42 future fiscal years. To that end it is legislative intent that, subject to the
43 authorization of such program by federal Health and Human Services officials,
44 a 2-year pilot project be implemented by the Department of Health and Welfare
45 where CHIP funds currently being spent on neonatal intensive care expenses
46 will be redirected to prenatal care for unborn children with the following
47 limitations:
48 1. The services described below will be available for unborn children,
49 and their mothers, for households between 133% and 150% of federal poverty
50 level.
51 2. Antepartum care will be available pursuant to CPT codes 59425 and
52 59426, as applicable and will be available for qualified persons, including
53 eligible residents and ineligible aliens, who would not qualify for services
5
1 under the current requirements for Pregnant Women and Children services.
2 3. The mother of each qualifying unborn child shall receive prenatal
3 vitamins up to $48.00 and for a program total of $84,960 for fiscal year 2004
4 and with up to an additional 1.8% increase for population growth for each
5 future year.
6 4. Mothers of qualifying unborn children may receive medications up to
7 $300 during the pregnancy for up to a program total of $53,100 for fiscal year
8 2004 and with up to an additional 1.8% increase for population growth for each
9 future year.
10 5. Mothers of qualifying unborn children may receive ultrasounds up to
11 $300 during the pregnancy for up to a program total of $53,100 for fiscal year
12 2004 and with up to an additional 1.8% increase for population growth for each
13 future year.
14 6. Mothers of qualifying unborn children may receive lab services up to
15 $120 during the pregnancy for up to a program total of $212,400 for fiscal
16 year 2004 and with up to an additional 1.8% increase for population growth for
17 each future year.
18 7. It is intended that the Department of Health and Welfare seek authori-
19 zation to process claims and payments in the most cost-efficient manner feasi-
20 ble, including use of existing CPT codes for services, use of existing com-
21 puter programming, use of mother's name with an assumed number to identify the
22 unborn child and, if needed, processing of claims and payments off-line from
23 the department's main computers.
24 8. The Department of Health and Welfare may expend additional amounts
25 from avoided costs to provide administration of the program and to provide
26 additional pregnancy-related services to accomplish the goals of avoiding
27 neonatal intensive care costs and reducing human suffering of children before
28 and after they are born.
STATEMENT OF PURPOSE
RS 12791
The purpose of this legislation is to take advantage of President
Bush's Executive Order expanding eligibility for the Children's
Health Insurance Program to include pre-born children. Published
research demonstrates tremendous health benefits associated with
prenatal care for both the baby and the pregnant woman. This
legislation will, thereby, improve public health and lower
expenditures in Medicaid by helping to prevent post-birth
difficulties associated with low birth weight, malnutrition,
infections and chemical abuse.
FISCAL IMPACT
This legislation will have no negative fiscal impact on the
State. All expenditures associated with expanding coverage of
CHIP to include pre-born children will be contained within the
upper appropriation limit set by the Legislature. Since all pre-
born children receiving benefits under this legislation will be
eligible for benefits after birth, it is anticipated that cost
savings associated with improved prenatal care will actually
allow more Idaho children to receive benefits under CHIP.
Contact
Name: Sen. Skip Brandt, Rep. Bill Sali, Rep. Shirley McKague
Phone: 332-1000
STATEMENT OF PURPOSE/FISCAL NOTE H 202