Print Friendly HOUSE BILL NO. 189 – Medical assist/services not covered
HOUSE BILL NO. 189
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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
]]]] 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-
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:
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
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
The purpose of this legislation is to specify services and
treatments not covered under Idaho's state medical assistance
The fiscal impact to the general fund is positive to the extent
that certain services are not covered.
Name: Rep. Janice McGeachin
STATEMENT OF PURPOSE/FISCAL NOTE H 189