249J.19 - HEALTH CARE SERVICES PRICING AND REIMBURSEMENT OF PROVIDERS. - Iowa Statutes

249J.19 HEALTH CARE SERVICES PRICING AND REIMBURSEMENT OF PROVIDERS. The department shall annually collect data on third-party payor rates in the state and, as appropriate, the usual and customary charges of health care providers, including the reimbursement rates paid to providers and by third-party payors participating in the medical assistance program and through the expansion population. The department shall consult with the division of insurance of the department of commerce in adopting administrative rules specifying the reporting format and guaranteeing the confidentiality of the information provided by the providers and third-party payors. The department shall review the data and make recommendations to the governor and the general assembly regarding pricing changes and reimbursement rates annually by January 1. Any recommended pricing changes or changes in reimbursement rates shall not be implemented without express authorization by the general assembly.          Section History: Recent Form 2005 Acts, ch 167, §20, 66