All Roll Calls
Yes: 238 • No: 0
IowaHF 91991st General Assembly (2025–2026)HouseWALLET
A bill for an act relating to children’s specialty hospital designations for certain nonprofit organizations, and including effective date provisions. (Formerly HSB 268.) Effective date: 05/01/2025.
Sponsored By: COMMITTEE ON HEALTH AND HUMAN SERVICES
Signed by Governor
health and human services
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Bill Overview
Analyzed Economic Effects
4 provisions identified: 4 benefits, 0 costs, 0 mixed.
Easier rules so kids' hospitals can open
Starting 05/01/2025, DIAL waives some hospital rules so licensed entities can keep operating during the transition. Waivers can cover lab, pathology, and emergency services not already offered. Each waiver lasts up to 24 months or until a permanent license. Entities may keep using earlier nursing‑facility building standards and are exempt from FGI hospital design rules. They are exempt from certificate‑of‑need for new or changed services to convert or revert, for up to 24 months.
Medicaid pay rules for kids' hospitals
Beginning 05/01/2025, Iowa sets Medicaid payment methods for children's specialty hospitals. Inpatient pay uses average allowable per‑day costs, adjusted for inflation (441 IAC 79.1(5)(k)). Outpatient pay uses the hospital's cost‑to‑charge ratio with later adjustments (441 IAC 79.1(1)(g)). The law sets methods, not exact dollar amounts.
New specialty hospital care for kids
Beginning 05/01/2025, Iowa creates a children's specialty hospital license. A qualifying nonprofit serves only people age 30 or younger, with over 60% on Medicaid. It specializes in pediatric rehab and complex or behavioral health needs, has no more than 200 beds, and offers outpatient care. It also must have been a 'special population nursing facility' before 07/01/2025. Within 30 days, DIAL issues a provisional license for up to 24 months to pursue federal certification and reimbursement. DIAL sets statewide licensure standards, and hospitals must keep clear medical rules for admission, discharge, and continued care.
State help to speed federal approval
From 05/01/2025, DIAL and Health and Human Services must help licensed entities seek federal certification and reimbursement. DIAL can adopt emergency rules that take effect when filed, and must also publish them as intended actions.
Sponsors & Cosponsors
Sponsor
COMMITTEE ON HEALTH AND HUMAN SERVICES
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
House vote • 4/15/2025
Passed House
Yes: 94 • No: 0
Senate vote • 4/9/2025
Passed Senate
Yes: 47 • No: 0
House vote • 3/25/2025
Passed House
Yes: 97 • No: 0
Actions Timeline
Signed by Governor.
5/1/2025GovernorReported correctly enrolled, signed by Speaker and President, and sent to Governor.
5/1/2025SenateExplanation of vote.
4/24/2025legislatureExplanation of vote.
4/22/2025legislatureMessage from House.
4/15/2025HouseImmediate message.
4/15/2025legislaturePassed House, yeas 94, nays 0.
4/15/2025HouseHouse concurred in Senate amendment H-1225.
4/15/2025SenateSenate amendment H-1225 filed.
4/10/2025SenateMessage from Senate.
4/10/2025SenateImmediate message.
4/9/2025legislaturePassed Senate, yeas 47, nays 0.
4/9/2025SenateAmendment S-3070 adopted.
4/9/2025legislaturePlaced on calendar.
4/7/2025legislatureAmendment S-3070 filed.
4/7/2025legislatureCommittee report, recommending amendment and passage.
4/7/2025legislatureSubcommittee recommends amendment and passage.
4/1/2025legislatureSubcommittee Meeting: 03/31/2025 4:00PM Senate Lounge.
3/27/2025SenateSubcommittee: Klimesh, Pike, and Trone Garriott.
3/27/2025legislatureReferred to Health and Human Services.
3/26/2025legislatureRead first time, passed on file.
3/25/2025legislatureMessage from House.
3/25/2025HouseImmediate message.
3/25/2025legislaturePassed House, yeas 97, nays 0.
3/25/2025HouseAmendment H-1163 adopted.
3/25/2025legislature
Bill Text
As Introduced
Enrolled
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