2005 Legislation
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HOUSE BILL NO. 189 – Medical assist/services not covered

HOUSE BILL NO. 189

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Bill Status



H0189.................................................by HEALTH AND WELFARE
MEDICAL ASSISTANCE - Amends existing law to provide that the costs of
physician and hospital services for lung, pancreas or other organ
transplants considered experimental procedures and multiple organ
transplants are excluded from the medical assistance program; and to
provide that treatments and procedures used solely to gain further evidence
or knowledge or to test the usefulness of a drug or type of therapy are not
covered for payment by the medical assistance program.
                                                                        
02/11    House intro - 1st rdg - to printing
02/14    Rpt prt - to Health/Wel

Bill Text


                                                                        
                                                                        
  ]]]]              LEGISLATURE OF THE STATE OF IDAHO             ]]]]
 Fifty-eighth Legislature                   First Regular Session - 2005
                                                                        
                                                                        
                              IN THE HOUSE OF REPRESENTATIVES
                                                                        
                                     HOUSE BILL NO. 189
                                                                        
                              BY HEALTH AND WELFARE COMMITTEE
                                                                        
  1                                        AN ACT
  2    RELATING TO THE STATE MEDICAL ASSISTANCE PROGRAM;  AMENDING  SECTION  56-209d,
  3        IDAHO  CODE,  TO PROVIDE THAT THE COSTS OF PHYSICIAN AND HOSPITAL SERVICES
  4        FOR LUNG, PANCREAS OR OTHER ORGAN TRANSPLANTS CONSIDERED EXPERIMENTAL PRO-
  5        CEDURES AND MULTIPLE ORGAN TRANSPLANTS ARE EXCLUDED  FROM  MEDICAL  ASSIS-
  6        TANCE PAYMENT AND TO PROVIDE THAT TREATMENTS AND PROCEDURES USED SOLELY TO
  7        GAIN  FURTHER EVIDENCE OR KNOWLEDGE OR TO TEST THE USEFULNESS OF A DRUG OR
  8        TYPE OF THERAPY ARE NOT COVERED FOR PAYMENT BY THE MEDICAL ASSISTANCE PRO-
  9        GRAM.
                                                                        
 10    Be It Enacted by the Legislature of the State of Idaho:
                                                                        
 11        SECTION 1.  That Section 56-209d, Idaho Code, be, and the same  is  hereby
 12    amended to read as follows:
                                                                        
 13        56-209d.  MEDICAL  ASSISTANCE  PROGRAM  -- SERVICES TO BE PROVIDED -- SER-
 14    VICES AND TREATMENTS NOT COVERED. Notwithstanding any other provision of  this
 15    chapter, medical assistance shall increase:
 16        (1)  Payment  as  determined  under rules established by the director from
 17    forty (40) days per fiscal year to unlimited days of inpatient  hospital  care
 18    per state fiscal year.
 19        (2)  Payment  as  determined  under rules established by the director from
 20    thirty dollars ($30.00) per month to an unlimited amount of  prescribed  drugs
 21    for each recipient.
 22        (3)  Provision  of  eligibility  for  medical  assistance for residents of
 23    skilled and intermediate care facilities who meet  the  medical  criteria  for
 24    medical  assistance,  from  those with countable income of two hundred one and
 25    two-tenths percent (201.2%) to those with countable income  of  three  hundred
 26    percent (300%) of the SSI standard.
 27        (4)  Payment,  as  authorized  by title XIX of the social security act, as
 28    amended, and as determined under rules established by the director for:
 29        (a)  Durable medical equipment.
 30        (b)  Soft organ transplants.
 31        (c)  Adult dental services.
 32        (d)  Adult vision services.
 33        (e)  Adult hearing services.
 34        (f)  Prosthetics.
 35        (g)  Assistive and augmentative communication devices.
 36        (5)  Payment for breast and cervical cancer-related treatment services for
 37    persons who are eligible for screening for these  cancers  under  the  federal
 38    centers for disease control and prevention's national breast and cervical can-
 39    cer  early detection program, and are eligible for medical assistance pursuant
 40    to the provisions of the federal "Breast and Cervical  Cancer  Prevention  and
 41    Treatment Act of 2000" (Pub. L. 106-354).
 42        (6)  The  costs of physician and hospital services for the following types
 43    of treatments and procedures are excluded  from  medical  assistance  payment:
                                                                        
                                           2
                                                                        
  1    lung,  pancreas or other organ transplants considered  experimental procedures
  2    and multiple organ transplants.  This includes both the procedure itself,  and
  3    the  costs for all follow-up medical treatment directly associated with such a
  4    procedure.
  5        (7)  Treatments and procedures used solely to  gain  further  evidence  or
  6    knowledge  or to test the usefulness of a drug or type of therapy are not cov-
  7    ered for payment by the medical assistance program.  This  includes  both  the
  8    treatment  or  procedure itself and the costs for all follow-up medical treat-
  9    ment directly associated with such a procedure.

Statement of Purpose / Fiscal Impact



                       STATEMENT OF PURPOSE

                            RS 14886

The purpose of this legislation is to specify services and
treatments not covered under Idaho's state medical assistance
program.


                           FISCAL NOTE

The fiscal impact to the general fund is positive to the extent
that certain services are not covered.



Contact
Name:  Rep. Janice McGeachin 
Phone: 332-1000


STATEMENT OF PURPOSE/FISCAL NOTE                       H 189