March 18, 2016  |  Issue 11  |  Volume 1
Medicaid e-News
Informational Letters:
New Provider Informational Letters
The Iowa Medicaid Enterprise has posted several important informational letters in preparation for the launch of the IA Health Link managed care program.

Informational letters are posted through the Iowa Medicaid Portal Application (IMPA) system and are available on the DHS website here. Recent informational letters are featured below. 

These letters communicate important policies and procedures for providers and their administrative staff. Providers should continue to watch closely for updates during the transition period. 

Updated - Managed Care Organization Pharmacy Provider Reimbursement Rate Floors
Informational Letter 1562-MC referenced provider reimbursement information under the IA Health Link program, specifically the establishment of rate floors by DHS. 

Informational Letter 1627-MC is intended to update the reimbursement rate floor established specific to covered outpatient drugs for pharmacy providers

To learn more see Informational Letter 1627-MC.

Prior Authorizations for Providers Participating with Managed Care Organizations
Informational Letter 1628-MC updates and replaces Informational Letters 1607 and 1591 which directed providers on the Prior Authorization (PA) process for the IA Health Link program for all other services that require a PA, including pharmacy drugs.

To learn more see Informational Letter 1628-MC.

Annual Restraint and Seclusion Attestation Letters and Incident Reporting
Informational Letter 1630 is to remind all Psychiatric Medical Institutions for Children (PMIC) providers of the requirement to adhere to federal regulations regarding the use of restraint and seclusion. Federal Regulations establish standards for the use of restraint and seclusion in psychiatric residential treatment facilities (PRTFs) providing inpatient psychiatric services to individuals under age 21. 

These rules apply to all PMIC providers enrolled with Iowa Medicaid and compliance with these standards for the use of restraints and seclusion in PRTFs regulations is a condition of participation in the Iowa Medicaid program. Please review these regulations closely.

To learn more see Informational Letter 1630.

Money Follows the Person Program
In 2007, Iowa received a $51 million dollar federal "Money Follows the Person" (MFP) grant to assist residents of Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/ID) to move into a community of their choice. 

Since 2014, Iowa has also been able to assist individuals living in nursing facilities with either an intellectual disability or brain injury diagnosis to move into a community of their choice. To date, Iowa has transitioned 513 individuals into the community. Iowa's MFP grant is authorized to continue through at least 2018.

To learn more see Informational Letter 1632-MC.

Update to Monthly Provider Assessment
Beginning with dates of service April 1, 2016, the IME will no longer be able to recoup the monthly provider assessment through claims offset. Providers will be required to remit the money for the assessment directly to the Iowa Medicaid Enterprise (IME) by check.

To learn more see Informational Letter 1636-MC.

Members: Please watch your mail!
Member ID cards will be arriving soon from the new health plans.

Members were asked to make a selection in health plan by February 17, 2016. Since that time, members have been sent a Confirmation of Coverage letter, and soon will receive their Amerigroup Iowa Inc., AmeriHealth Caritas Iowa Inc. or United Healthcare Plan of the River Valley Inc. member ID cards.

Please note : If a member's eligibility has changed since the selection date, or if they have made a different choice in health plan, they may not immediately receive a card, could receive a card in error, or receive duplicate cards. 

Members should call Iowa Medicaid Member Services, or their selected health plan, with any questions about changes in eligibility and choice in plan that may impact their receipt of member ID cards.

Resources and Tools:
Provider Search Portals
Managed Care Organization Provider Resource Pages Available
Comprehensive resource pages are available for each Managed Care Organization (MCO), featuring provider training manuals, webinars and important updates. You may view them below:

Looking for an Old Issue of the Medicaid e-News?
Each edition features useful tools and important updates. Now you can quickly access old issues to find what your looking for. Visit the Iowa Medicaid newsletter page 
where you'll find links to each issue.

IA Health Link coverage begins April 1, 2016.
Updated Communications Toolkit

The IA Health Link Communications Toolkit has been updated with the April 1, 2016, launch date and is full of resources including FAQs, social media posts, images, links and more. Download it below:

Managed Care Organizations:

Coverage Begins:
Coverage will begin for members transitioning to the IA Health Link on  April 1, 2016.
Member Choice Continues:
Members can continue to make changes in MCO selection for any reason until  June 16, 2016, and after for 'Good Cause.'
Iowa Medicaid Enterprise | |
100 Army Post Rd., Des Moines, IA 50315