Section 249N.1 – Title.
249N.1 Title. This chapter shall be known and may be cited as the “Iowa Health and Wellness Plan”. 2013 Acts, ch 138, §166, 187
Section 249N.2 – Definitions.
249N.2 Definitions. As used in this chapter, unless the context otherwise requires: 1. “Accountable care organization” means a risk-bearing, integrated health care organization characterized by a payment and care delivery model that ties provider reimbursement to quality metrics and reductions in the total cost of care for an attributed population of patients. 2. “Affordable Care […]
Section 249N.3 – Purpose — establishment of Iowa health and wellness plan — limitation.
249N.3 Purpose — establishment of Iowa health and wellness plan — limitation. 1. The purpose of this chapter is to establish and provide for the administration of an Iowa health and wellness plan to promote all of the following: a. Increased access to health care through a patient-centered, integrated health care system. b. Improved quality […]
Section 249N.4 – Iowa health and wellness plan — eligibility.
249N.4 Iowa health and wellness plan — eligibility. 1. Except as otherwise provided in this chapter, an individual may participate in the Iowa health and wellness plan if the individual meets all of the following criteria: a. Is an eligible individual. b. Meets the citizenship or alienage requirements of the medical assistance program, is a […]
Section 249N.5 – Iowa health and wellness plan — covered benefits — administration.
249N.5 Iowa health and wellness plan — covered benefits — administration. 1. Iowa health and wellness plan members shall receive coverage for benefits as specified in section 249A.3, subsection 1, paragraph “v”. 2. a. For members whose household income is at or below one hundred percent of the federal poverty level, the plan shall be […]
Section 249N.6 – Iowa health and wellness plan provider network.
249N.6 Iowa health and wellness plan provider network. 1. The Iowa health and wellness plan provider network shall include all providers enrolled in the medical assistance program and all participating accountable care organizations. Reimbursement under this chapter shall only be made to such Iowa health and wellness plan providers for covered benefits. 2. a. Upon […]
Section 249N.7 – Member financial participation.
249N.7 Member financial participation. 1. Membership in the Iowa health and wellness plan shall require payment of monthly contributions for members whose household income is at or above fifty percent of the federal poverty level. Members shall be subject to copayment amounts applicable only to nonemergency use of a hospital emergency department. Total member cost-sharing, […]
Section 249N.8 – Mental health services reports.
249N.8 Mental health services reports. The department shall submit all of the following to the governor and the general assembly: 1. Biennially, a report of the results of a review, by county and region, of mental health services previously funded through taxes levied by counties pursuant to section 331.424A, Code 2021, or funds administered by […]