This bill aims to standardize the claim submission and reimbursement processes for managed care organizations (MCOs) that administer the medical assistance program in Iowa. It introduces definitions for "managed care contract" and "managed care organization" and mandates the Department of Health and Human Services (HHS) to establish a standardized process for claims related to benefits received or services rendered to recipients, effective from July 1, 2027. The bill emphasizes the need for HHS to consider various factors, including efficient service delivery and compliance with federal regulations, when establishing these rules.

Additionally, the bill requires HHS to amend existing managed care contracts to ensure adherence to the new standardized process. It stipulates that all managed care contracts entered into, extended, or renewed on or after July 1, 2027, must comply with this standardized claim submission and reimbursement process. The bill aims to enhance the efficiency and consistency of the reimbursement system for medical and health services provided under the medical assistance program.

Statutes affected:
Introduced: 249A.2, 514B.1