A bill for an act relating to Medicaid program improvements, making an appropriation, and providing penalties.

SF 558 updates Iowa's Medicaid program to improve service delivery and provider rights. It requires Medicaid managed care organizations (MCOs) to provide conflict-free case management and independent assessments for long-term care members, and allows them to opt into a fee-for-service program. The bill creates a new external review process for providers denied services or reimbursement, mandating MCOs to clearly notify providers of their appeal rights and pay a $1,000 penalty if they fail to comply with notification requirements. Providers automatically win reviews if MCOs miss deadlines for documentation or notifications. These changes directly affect Medicaid providers, MCOs, and long-term care recipients in Iowa.