1.A hospital health care access trust fund is created in the state treasury under the
authority of the department. Moneys received through the collection of the hospital health
care access assessment imposed under this chapter and any other moneys specified for
deposit in the trust fund shall be deposited in the trust fund.
2.Moneys in the trust fund shall be used, subject to their appropriation by the general
assembly, by the department to reimburse participating hospitals the medical assistance
program upper payment limit for inpatient and outpatient hospital services as calculated in
this section. Following payment of such upper payment limit to participating hospitals, any
remaining funds in the trust fund on an annual basis may be used for any of the following
purposes:
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1. A hospital health care access trust fund is created in the state treasury under the
authority of the department. Moneys received through the collection of the hospital health
care access assessment imposed under this chapter and any other moneys specified for
deposit in the trust fund shall be deposited in the trust fund.
2. Moneys in the trust fund shall be used, subject to their appropriation by the general
assembly, by the department to reimburse participating hospitals the medical assistance
program upper payment limit for inpatient and outpatient hospital services as calculated in
this section. Following payment of such upper payment limit to participating hospitals, any
remaining funds in the trust fund on an annual basis may be used for any of the following
purposes:
a. To support medical assistance program utilization shortfalls.
b. To maintain the state’s capacity to provide access to and delivery of services for
vulnerable Iowans.
c. Tofundthehealthcareworkforcesupportinitiativecreatedpursuanttosection135.175.
3 HOSPITAL HEALTH CARE ACCESS ASSESSMENT PROGRAM, §249M.5
d. To support access to health care services for uninsured Iowans.
e. To support Iowa hospital programs and services which expand access to health care
services for Iowans.
3. The trust fund shall be separate from the general fund of the state and shall not be
considered part of the general fund. The moneys in the trust fund shall not be considered
revenue of the state, but rather shall be funds of the hospital health care access assessment
program. The moneys deposited in the trust fund are not subject to section 8.33 and shall not
be transferred, used, obligated, appropriated, or otherwise encumbered, except to provide
for the purposes of this chapter. Notwithstanding section 12C.7, subsection 2, interest or
earnings on moneys deposited in the trust fund shall be credited to the trust fund.
4. The department shall adopt rules pursuant to chapter 17A to administer the trust fund
and reimbursements and expenditures as specified in this chapter made from the trust fund.
5. a. Beginning July 1, 2010, or the implementation date of the hospital health care access
assessment program as determined by receipt of approval from the centers for Medicare and
Medicaid services of the United States department of health and human services, whichever
is later, the department shall increase the diagnostic related groups and ambulatory patient
classificationsbaseratestoprovidepaymentstoparticipatinghospitalsattheMedicareupper
payment limit for the fiscal year beginning July 1, 2010, calculated as of July 31, 2010. Each
participating hospital shall receive the same percentage increase, but the percentage may
differ depending on whether the basis for the base rate increase is the diagnostic related
groups or ambulatory patient classifications.
b. The percentage increase shall be calculated by dividing the amount calculated under
subparagraph (1) by the amount calculated under subparagraph (2) as follows:
(1) The amount under the Medicare upper payment limit for the fiscal year beginning July
1, 2010, for participating hospitals.
(2) The projected expenditures for participating hospitals for the fiscal year beginning
July 1, 2010, as determined by the department, plus the amount calculated under
subparagraph (1).
6. For the fiscal year beginning July 1, 2011, and for each fiscal year beginning July 1,
thereafter, the payments to participating hospitals shall continue to be calculated based on
the upper payment limit as calculated for the fiscal year beginning July 1, 2010.
7. Reimbursement of participating hospitals shall incorporate the rebasing process for
inpatient and outpatient services for state fiscal year 2012. However, the total amount of
increased funding available for reimbursement attributable to rebasing shall not exceed four
million five hundred thousand dollars for state fiscal year 2012 and six million dollars for
state fiscal year 2013.
8. Any payments to participating hospitals under this section shall result in budget
neutrality to the general fund of the state.