IA HF2053

Amends Iowa Code Section 249A.2 to define "managed care contract" as an agreement between the Department of Health and Human Services and a managed care organization to administer the Medicaid program, and defines "managed care organization" as a health maintenance organization acting under such contract.

Requires the Department of Health and Human Services to adopt rules establishing a standardized claim submission and reimbursement process for all medical and health services provided under the medical assistance program for services rendered on or after July 1, 2027.

Mandates that HHS amend all existing managed care contracts to require adherence to the new standardized claim submission and reimbursement process.

Requires all managed care contracts entered into, extended, or renewed on or after July 1, 2027 to include provisions requiring adherence to the standardized process.

Defines "claim" as a formal request by a provider for reimbursement for benefits received by or services rendered to a Medicaid recipient.