reglab/housing_qa huggingface dataset:
IA Code § 249A.34 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.34 - Medical assistance crisis intervention team.

249A.34 Medical assistance crisis intervention team. Repealed by  2005 Acts, ch 167, §40, 66  .
IA Code § 249A.35 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.35 - Purchase of qualified long-term care insurance policy — computation under medical assistance program.

249A.35 Purchase of qualified long-term care insurance policy — computation under medical assistance program.   A computation for the purposes of determining eligibility under this chapter concerning an individual who is the beneficiary of a qualified long-term care insurance policy under chapter 514H shall include consideration of the asset disregard provided in section 514H.5.  2005 Acts, ch 166, §1, 13; 2009 Acts, ch 145, §1  Referred to in §514H.5
IA Code § 249A.36 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.36 - Medical assistance quality improvement council.

249A.36 Medical assistance quality improvement council. Repealed by 2012 Acts, ch 1138, §111.
IA Code § 249A.37 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.37 - Health care information sharing.

249A.37 Health care information sharing.   1. As a condition of doing business in the state, health insurers including self-insured plans, group health plans as defined in the federal Employee Retirement Income Security Act of 1974, Pub. L. No. 93-406, service benefit plans, managed care organizations, pharmacy benefits managers, and other parties that are, by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service, shall do all of the following:   a. Provide, with respect to individuals who are eligible for or are provided medical assistance under the state’s medical assistance state plan, upon the request of the state, information to determine during what period the individual or the individual’s spouse or dependents may be or may have been covered by a health insurer and the nature of the coverage that is or was provided by the health insurer, including the name, address, and identifying number of the plan, in accordance with section 505.25, in a manner prescribed by the department of human services or as agreed upon by the department and the entity specified in this section.   b. Accept the state’s right of recovery and the assignment to the state of any right of an individual or other entity to payment from the party for an item or service for which payment has been made under the medical assistance state plan.   c. Respond to any inquiry by the state regarding a claim for payment for any health care item or service that is submitted no later than three years after the date of the provision of such health care item or service.   d. Agree not to deny any claim submitted by the state solely on the basis of the date of submission of the claim, the type or format of the claim form, or a failure to present proper documentation at the point-of-sale that is the basis of the claim, if all of the following conditions are met:   (1) The claim is submitted to the entity by the state within the three-year period beginning on the date on which the item or service was furnished.   (2) Any action by the state to enforce its rights with respect to such claim is commenced within six years of the date that the claim was submitted by the state.   2. The department of human services may adopt rules pursuant to chapter 17A as necessary to implement this section. Rules governing the exchange of information under this section shall be consistent with all laws, regulations, and rules relating to the confidentiality or privacy of personal information or medical records, including but not limited to the federal Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, and regulations promulgated in accordance with that Act and published in  45 C.F.R. pts. 160 – 164  .  2008 Acts, ch 1187, §124
IA Code § 249A.38 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.38 - Inmates of public institutions — suspension of medical assistance.

249A.38 Inmates of public institutions — suspension of medical assistance.   1. Following the first thirty days of commitment, the department shall suspend, but not terminate, the eligibility of an individual who is an inmate of a public institution as defined in  42 C.F.R. §435.1010  , who is enrolled in the medical assistance program at the time of commitment to the public institution, and who remains eligible for medical assistance as an individual except for the individual’s institutional status, during the entire period of the individual’s commitment to the public institution.   2. a. A public institution shall provide the department and the social security administration with a monthly report of the individuals who are committed to the public institution and of the individuals who are discharged from the public institution. The monthly report to the department shall include the date of commitment or the date of discharge, as applicable, of each individual committed to or discharged from the public institution during the reporting period. The monthly report shall be made through the reporting system created by the department for public, nonmedical institutions to report inmate populations. Any medical assistance expenditures, including but not limited to monthly managed care capitation payments, provided on behalf of an individual who is an inmate of a public institution but is not reported to the department in accordance with this subsection, shall be the financial responsibility of the respective public institution.   b. The department shall provide a public institution with the forms necessary to be used by the individual in expediting restoration of the individual’s medical assistance benefits upon discharge from the public institution.   3. The department may adopt rules pursuant to chapter 17A to implement this section.  2011 Acts, ch 98, §13, 15; 2012 Acts, ch 1038, §1; 2018 Acts, ch 1165, §127; 2019 Acts, ch 81, §1
IA Code § 249A.39 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.39 - Reporting of overpayment.

249A.39 Reporting of overpayment.   1. A provider who has received an overpayment shall notify in writing, and return the overpayment to, the department, the department’s agent, or the department’s contractor, as appropriate. The notification shall include the reason for the return of the overpayment.   2. Notification and return of an overpayment under this section shall be provided by no later than the later of either of the following, as applicable:   a. The date which is sixty days after the date on which the overpayment was identified by the provider.   b. The date any corresponding cost report is due.   3. A violation of this section is a violation of chapter 685.  2013 Acts, ch 24, §3  Referred to in §249A.47, 249A.49
IA Code § 249A.40 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.40 - Involuntarily dissolved providers — overpayments or incorrect payments.

249A.40 Involuntarily dissolved providers — overpayments or incorrect payments.   Medical assistance paid to a provider following involuntary administrative dissolution of the provider pursuant to chapter 490, subchapter XIV, part B, shall be considered incorrectly paid for the purposes of section 249A.53 and the provider shall be considered to have received an overpayment for the purposes of this subchapter. For the purposes of this section, the overpayment shall not accrue until after a grace period of ninety days following receipt of notice by the provider of the dissolution from the department. Notwithstanding section 490.1422, or any other similar retroactive provision for reinstatement, the director shall recoup any medical assistance paid to a provider while the provider was dissolved if the provider is not retroactively reinstated within the ninety-day grace period. The principals of the provider shall be personally liable for the incorrect payment or overpayment.  2013 Acts, ch 24, §4; 2019 Acts, ch 24, §104
IA Code § 249A.41 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.41 - Overpayment — interest.

249A.41 Overpayment — interest.   1. Interest may be collected upon any overpayment determined to have been made and shall accrue at the rate and in the manner specified in this section.   2. Prior to the provision of a notice of overpayment to the provider, interest shall accrue at the statutory rate for prejudgment interest applicable in civil actions.   3. After the provision of a notice of overpayment to the provider and after all of the provider’s administrative and judicial review remedies under  441 IAC ch. 7   and chapter 17A have been exhausted, interest shall accrue at the statutory rate for prejudgment interest applicable in civil actions plus five percent per annum, or the maximum legal rate, whichever is lower.   4. At the discretion of the director, interest on an overpayment may be waived in whole or in part when the department determines the imposition of interest would produce an unjust result, would unduly burden the provider, or would substantially delay the prompt and efficient resolution of an outstanding audit or investigation.  2013 Acts, ch 24, §5  Referred to in §249A.2  Interest on judgments, see §535.3 and 668.13
IA Code § 249A.42 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.42 - Overpayment — limitations periods.

249A.42 Overpayment — limitations periods.   1. An administrative action to recover an overpayment to a provider shall be commenced within five years of the date the overpayment was incurred. For the purposes of this subsection, “incurred” means the date the medical assistance claim was paid, or the date any applicable reconciliation was completed, whichever is later.   2. An administrative action to impose a sanction related to an overpayment to a provider shall be commenced within five years of the date the conduct underlying the sanction concluded, or the director discovered such conduct, whichever is later.  2013 Acts, ch 24, §6
IA Code § 249A.43 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.43 - Provider overpayment — notice — judgment.

249A.43 Provider overpayment — notice — judgment.   1. Any overpayment to a provider under this chapter shall become a judgment against the provider, by operation of law, ninety days after a notice of overpayment is personally served upon the enrolled provider as required in the Iowa rules of civil procedure or by certified mail, return receipt requested, by the director or the attorney general or, if applicable, upon exhaustion of the provider’s administrative and judicial review remedies under  441 IAC ch. 7   or chapter 17A, whichever is later. The judgment is entitled to full faith and credit in all states.   2. The notice of overpayment shall include the amount and cause of the overpayment, the provider’s appeal rights, and a disclaimer that a judgment may be established if an appeal is not timely filed or if an appeal is filed and at the conclusion of the administrative process under chapter 17A a determination is made that there is an overpayment.   3. An affidavit of service of a notice of entry of judgment shall be made by first class mail at the address where the debtor was served with the notice of overpayment. Service is completed upon mailing as specified in this subsection.   4. On or after the date an unpaid overpayment becomes a judgment by operation of law, the director or the attorney general may file all of the following with the district court:   a. A statement identifying, or a copy of, the notice of overpayment.   b. Proof of service of the notice of overpayment.   c. An affidavit of default, stating the full name, occupation, place of residence, and last known post office address of the debtor; the name and post office address of the department; the date or dates the overpayment was incurred; the program under which the debtor was overpaid; and the total amount of the judgment.   5. Nothing in this section shall be construed to impede or restrict alternative methods of recovery of the overpayments specified in this section or of overpayments which do not meet the requirements of this section.  2013 Acts, ch 24, §7; 2013 Acts, ch 140, §59
IA Code § 249A.44 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.44 - Overpayment — emergency relief.

249A.44 Overpayment — emergency relief.   1. Concurrently with a withholding of payment, the imposition of a sanction, or the institution of a criminal, civil, or administrative proceeding against a provider or other person for overpayment, the director or the attorney general may bring an action for a temporary restraining order or injunctive relief to prevent a provider or other person from whom recovery may be sought, from transferring property or otherwise taking action to protect the provider’s or other person’s business inconsistent with the recovery sought.   2. To obtain such relief, the director or the attorney general shall demonstrate all necessary requirements for the relief to be granted.   3. If an injunction is granted, the court may appoint a receiver to protect the property and business of the provider or other person from whom recovery may be sought. The court shall assess the costs of the receiver to the provider or other person.   4. The director or the attorney general may file a lis pendens on the property of the provider or other person during the pendency of a criminal, civil, or administrative proceeding.   5. When requested by the court, the director, or the attorney general, a provider or other person from whom recovery may be sought shall have an affirmative duty to fully disclose all property and liabilities to the requester.   6. An action brought under this section may be brought in the district court for Polk county or any other county in which a provider or other person from whom recovery may be sought has its principal place of business or is domiciled.  2013 Acts, ch 24, §8
IA Code § 249A.45 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.45 - Provider’s third-party submissions.

249A.45 Provider’s third-party submissions.   1. The department may refuse to accept a financial and statistical report, cost report, or any other submission from any third party acting under a provider’s authority or direction to prepare or submit such documents or information, for good cause shown. For the purposes of this section, “good cause” includes but is not limited to a pattern or practice of submitting unallowable costs on cost reports; making a false statement or certification to the director or any representative of the department; professional negligence or other demonstrated lack of knowledge of the cost reporting process; conviction under a federal or state law relating to the operation of a publicly funded program; or submission of a false claim under chapter 685.   2. If the department refuses to accept a cost report from a third party for good cause under this section, the third party shall be strictly liable to the provider for all fees incurred in preparation of the cost report, as well as reasonable attorney fees and costs. The department shall not take any adverse action against a provider that results from the unintentional delay in the submission of a new cost report or other submission necessitated by the department’s refusal to accept a cost report or other submission under this section. The department shall notify an affected provider within seven business days of any refusal to accept a cost report.  2013 Acts, ch 24, §9
IA Code § 249A.46 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.46 - Liability of other persons — repayment of claims.

249A.46 Liability of other persons — repayment of claims.   1. The department may require repayment of medical assistance paid from the person submitting an incorrect or improper claim, the person causing the claim to be submitted, or the person receiving payment for the claim.   2. Nothing in this section shall be construed to impede or restrict alternative recovery methods for claims specified in this section or claims which do not meet the requirements of this section.  2013 Acts, ch 24, §10
IA Code § 249A.48 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.48 - Temporary moratoria.

249A.48 Temporary moratoria.   1. The Iowa Medicaid enterprise shall impose a temporary moratorium on the enrollment of new providers or provider types identified by the centers for Medicare and Medicaid services of the United States department of health and human services as posing an increased risk to the medical assistance program.   a. This section shall not be interpreted to require the Iowa Medicaid enterprise to impose a moratorium if the Iowa Medicaid enterprise determines that imposition of a temporary moratorium would adversely affect access of recipients to medical assistance services.   b. If the Iowa Medicaid enterprise makes a determination as specified in paragraph “a”, the Iowa Medicaid enterprise shall notify the centers for Medicare and Medicaid services of the United States department of health and human services in writing.   2. The Iowa Medicaid enterprise may impose a temporary moratorium on the enrollment of new providers, or impose numerical caps or other limits that the Iowa Medicaid enterprise and the centers for Medicare and Medicaid services identify as having a significant potential for fraud, waste, or abuse.   a. Before implementing the moratorium, caps, or other limits, the Iowa Medicaid enterprise shall determine that its action would not adversely impact access by recipients to medical assistance services.   b. The Iowa Medicaid enterprise shall notify, in writing, the centers for Medicare and Medicaid services, if the Iowa Medicaid enterprise seeks to impose a moratorium under this subsection, including all of the details of the moratorium. The Iowa Medicaid enterprise shall receive approval from the centers for Medicare and Medicaid services prior to imposing a moratorium under this subsection.   3. a. The Iowa Medicaid enterprise shall impose any moratorium for an initial period of six months.   b. If the Iowa Medicaid enterprise determines that it is necessary, the Iowa Medicaid enterprise may extend the moratorium in six-month increments. Each time a moratorium is extended, the Iowa Medicaid enterprise shall document, in writing, the necessity for extending the moratorium.  2013 Acts, ch 24, §12
IA Code § 249A.49 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.49 - Internet site — providers found in violation of medical assistance program.

249A.49 Internet site — providers found in violation of medical assistance program.   1. The director shall maintain on the department’s internet site, in a manner readily accessible by the public, all of the following:   a. A list of all providers that the department has terminated, suspended, or placed on probation.   b. A list of all providers that have failed to return an identified overpayment of medical assistance within the time frame specified in section 249A.39.   c. A list of all providers found liable for a false claims law violation related to the medical assistance program under chapter 685.   2. The director shall take all appropriate measures to safeguard the protected health information, social security numbers, and other information of the individuals involved, which may be redacted or omitted as provided in  rule of civil procedure 1.422  . A provider shall not be included on the internet site until all administrative and judicial remedies relating to the violation have been exhausted.  2013 Acts, ch 24, §13; 2014 Acts, ch 1092, §153, 197, 199
IA Code § 249A.50 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.50 - Fraudulent practices — investigations and audits — Medicaid fraud fund.

249A.50 Fraudulent practices — investigations and audits — Medicaid fraud fund.   1. A person who obtains assistance or payments for medical assistance under this chapter by knowingly making or causing to be made, a false statement or a misrepresentation of a material fact or by knowingly failing to disclose a material fact required of an applicant for aid under the provisions of this chapter and a person who knowingly makes or causes to be made, a false statement or a misrepresentation of a material fact or knowingly fails to disclose a material fact concerning the applicant’s eligibility for aid under this chapter commits a fraudulent practice.   2. The department of inspections and appeals shall conduct investigations and audits as deemed necessary to ensure compliance with the medical assistance program administered under this chapter. The department of inspections and appeals shall cooperate with the department of human services on the development of procedures relating to such investigations and audits to ensure compliance with federal and state single state agency requirements.   3. a. A Medicaid fraud fund is created in the state treasury under the authority of the department of inspections and appeals. Moneys from penalties, investigative costs recouped by the Medicaid fraud control unit, and other amounts received as a result of prosecutions involving the department of inspections and appeals investigations and audits to ensure compliance with the medical assistance program that are not credited to the program shall be credited to the fund.   b. Notwithstanding section 8.33, moneys credited to the fund from any other account or fund shall not revert to the other account or fund. Moneys in the fund shall only be used as provided in appropriations from the fund and shall be used in accordance with applicable laws, regulations, and the policies of the office of inspector general of the United States department of health and human services.   c. For the purposes of this subsection, “investigative costs” means the reasonable value of a Medicaid fraud control unit investigator’s, auditor’s or employee’s time, any moneys expended by the Medicaid fraud control unit, and the reasonable fair market value of resources used or expended by the Medicaid fraud control unit in a case resulting in a criminal conviction of a provider under this chapter or chapter 714 or 715A.  [C62, 66, §249A.15; C71, 73, 75, 77, 79, 81, §249A.7]  90 Acts, ch 1204, §63; 97 Acts, ch 56, §3; 2009 Acts, ch 136, §10; 2011 Acts, ch 52, §1; 2011 Acts, ch 127, §49, 89; 2013 Acts, ch 24, §14  C2014, §249A.50  Referred to in §910.1  Fraudulent practices, see §714.8 – 714.14
IA Code § 249A.51 (2021)
2021 Iowa Code|Title VI - HUMAN SERVICES|Chapter 249A - MEDICAL ASSISTANCE|Section 249A.51 - Fraudulent practice.

249A.51 Fraudulent practice.   A person who knowingly makes or causes to be made false statements or misrepresentations of material facts or knowingly fails to disclose material facts in application for payment of services or merchandise rendered or purportedly rendered by a provider participating in the medical assistance program under this chapter commits a fraudulent practice.  91 Acts, ch 107, §12  CS91, §249A.8  97 Acts, ch 56, §4; 2013 Acts, ch 24, §14  C2014, §249A.51  Referred to in §249A.47  Fraudulent practices, see §714.8 – 714.14