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This week in the Iowa Senate we primarily focused on committee work and approving gubernatorial appointments; also the Governor signed a number of bills that have come out of the legislature. Our 100th day of session is April 19, and with the decision on education funding behind us we hope to get through budget bills and appropriations quickly and adjourn on time.
The fireworks bill is still making its way through the legislative process, and was scheduled to go before the Senate Ways and Means committee on Thursday morning. This bill would legalize the sale, use and regulation of consumer fireworks designated to meet standards of the American Pyrotechnics Association.
Approximately 40 other states allow for the use of some or all consumer fireworks. The proposed legislation would place the regulation duties within the office of the state fire marshal to enforce all laws dealing with the use and sale of fireworks. Under provisions in the bill, individuals would get licenses to sell, with revocation of licensure for violations of the law. The bill also restricts the use of consumer fireworks to those 18 years or older and provides designated use times.
This week the Senate Human Resources Committee again had a meeting with Department of Human Services for an update on the transition from state run to managed care for Medicaid. This is the third of these meetings with a panel of MCO (Managed Care Organizations) representatives focused on CMS (Centers for Medicare & Medicaid Services) Readiness Criteria. This new approach will be implemented on April 1.
More than 560,000 Iowans are covered by Medicaid, and total spending on Medicaid in Iowa has gone from $2.5 billion in FY 07 to $4.5 billion today. Despite the dramatic growth in spending, Medicaid members’ health outcomes have failed to improve. The rising Medicaid costs prompted the state to explore modernizing how it delivers services to Iowans utilizing the program through managed care organizations. The intent of Medicaid modernization is to contract on a statewide basis with companies which have a demonstrated capacity to coordinate care and provide quality outcomes for the Medicaid patients.
Under the terms of the state contracts, the MCO’s cannot immediately cut services or pay providers less than a base rate in order for those companies to earn profits. Those Iowans currently in a nursing home will see no change for at least two years.
Under the proposed system, access to care and quality patient outcomes are two important goals set forth by the state. Since Governor Branstad’s announcement about moving to managed care there have been more than 350 public meetings, training and listening sessions with members, providers and stakeholders. All stakeholders were involved including the Departments of Human Services, Public Health, Aging, Inspections and Appeals, Insurance Division, and Office of the Long-Term Care Ombudsman. When the average Medicaid patient has more than four chronic conditions, sees five different physicians, and uses six different prescribers, continuity of care can be a challenge. By going to a managed care model for its Medicaid program, Iowa is utilizing nationally-experienced companies to coordinate care in a way that makes Medicaid members healthier and fits individual needs.
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