Iowa Code § 249A.4A — IA Code / Title VI / Chapter 249A / Section 249A.4A
Health care coordination and intervention teams.
Status: in_force

(1) For purposes of this section, “health care provider” means a health care provider as defined in section 135.24, a mental health professional, or a substance use professional.

(2) The director may establish health care coordination and intervention teams as part of the state medical assistance program to conduct individual case reviews to determine whether additional health services or interventions may be appropriate for an individual’s care needs.

(3) (a) A health care coordination and intervention team shall review individual cases including but not limited to cases involving individuals with complex conditions who are in need of urgent placement and services.

(3) (b) A review of an individual case by a health care coordination and intervention team may be initiated by the department or by a health care provider.

(3) (c) In conducting an individual case review, a health care coordination and intervention team shall:

(3) (c) Review and analyze all relevant case information for the purpose of recommending additional health services, treatments, and interventions as appropriate to meet the individual’s needs and to ensure the protection of human health and safety.

(3) (c) Consult with the individual’s health care providers to assist and facilitate care coordination and treatment referral actions as appropriate.

(3) (c) Collect and review clinical records and other pertinent information, both confidential and nonconfidential, from hospitals and health care providers as necessary to review the individual’s health treatment needs.

(4) (a) Upon request of a health care coordination and intervention team, a hospital or health care provider shall provide records relating to an individual case being reviewed by the health care coordination and intervention team.

(4) (b) Upon request of a health care coordination and intervention team, a person in possession or control of medical, investigative, assessment, or other information pertaining to an individual case under review by the health care coordination and intervention team shall provide the information to the health care coordination and intervention team.

(4) (c) Confidential records and information provided to a health care coordination and intervention team under this subsection shall remain confidential and the health care coordination and intervention team shall not release the records or information to any person or entity without a court order.

(4) (d) A person or entity shall not be liable for providing records or information requested by a health care coordination and intervention team under this subsection to the health care coordination and intervention team or to the department.

(5) A health care coordination and intervention team member, and an agent of a health care coordination and intervention team member, shall be immune from any liability, civil or criminal, which might otherwise be incurred or imposed as a result of any act, omission, proceeding, decision, or determination undertaken or performed, or recommendation made provided that the team member or agent acted in good faith and without malice in carrying out official duties as a member of a health care coordination and intervention team or an agent of a health care coordination and intervention team member.

(6) Subject to federal law, individual case reviews conducted pursuant to this section shall be considered care coordination as defined in section 135D.2.

2024 Acts, ch 1075, §7, 8