2003 Legislation
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HOUSE BILL NO. 202 – Medicaid coverage, preborn children

HOUSE BILL NO. 202

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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

Bill Text


                                                                        
                                                                        
  ||||              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.

Amendment


                                                                        
                                                                        
  ||||              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.".

Engrossed Bill (Original Bill with Amendment(s) Incorporated)


                                                                        
                                                                        
  ||||              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 / Fiscal Impact



                       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