January 23, 2018  |  Issue 2  |  Volume 3
Medicaid e-News
Important Update:
Integrated Health Homes (IHH) 
The Department will be conducting a review of the State's Health Home programs, and associated State Plan Amendments. The Department will work collaboratively with both Managed Care Organizations (MCOs) through this process. Given the potential for program changes to occur as a result of such a review, both MCOs are delaying IHH member transitions. The Department is committed to ensuring there is no duplication in services. 
There are approximately 200 UnitedHealthcare members who have been enrolled in an IHH yet do not have claims evidence of any substantive care coordination activities. These members will have their future care coordination needs met through their ACO or internally through UnitedHealthcare. All other IA Health Link members with care coordination needs enrolled with an IHH will be transitioned later this year. Providers and members will receive additional information and training in the coming months.

Good Cause
Remember, members  requesting to change their Managed Care Organization (MCO) due to 'Good Cause,' f irst must contact their current MCO to go through their grievance process for resolution. If the issue has not been resolved following the decision of the grievance, the member may call Iowa Medicaid Member Services. The final decision for disenrollment will be determined by the Department of Human Services (DHS). For more information click here.

Retroactive Medicaid Coverage
The Centers for Medicare and Medicaid Services (CMS) has approved Iowa's request to eliminate the three month retroactive eligibility period, except for pregnant women (and during the 60-day period beginning on the last day of the pregnancy) and infants under one year of age, for applications filed on or after November 1, 2017. This includes initial applications and applications to add new household members. 

The elimination of retroactive coverage does NOT impact presumptive eligibility, annual renewals/reviews, or the 90-day reconsideration period.

For more information view Informational Letter 1847-MC-FFS-D.

Provider Tools and Resources:
Providers are Encouraged to Verify Eligibility
The Eligibility and Verification Information System (ELVS) line is very busy during the first of the month. The ELVS web portal  is another option for providers in lieu of calling the ELVS line but each provider must enroll through the Electronic Data Interchange Support Services (EDISS). The ELVS web portal allows for multiple eligibility checks and batch submission, where as the ELVS phone system only allows for one at a time.

Login ID and password may be obtained through EDISS by submitting the following Access Request Form to EDISS or calling EDISS at 1-800-967-7902. 
Provider Resource Pages
Comprehensive provider resource pages are available for each Managed Care Organization (MCO), featuring provider training manuals, webinars and important updates. View them below:

Member Choice Guidelines for Providers
All health care providers delivering services to Iowa's Medicaid population in the IA Health Link managed care program are welcome to inform their patients of the health plans in which they have chosen to participate. However, there are strict prohibitions against patient steering, which all providers must observe.

Learn more here.
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Iowa Medicaid Contacts
Iowa Medicaid Provider Services
IA Health Link Member Services

IA Health Link Provider Services

Dental Wellness Plan Member Services

Dental Wellness Plan Provider Services


Informational Letters
Informational letters are posted through the Iowa Medicaid Portal Application (IMPA) system and are available on the DHS website  here These letters communicate important policies and procedures for providers and their administrative staff. 

Iowa Medicaid Enterprise | IMECommunications@dhs.state.ia.us | dhs.iowa.gov
100 Army Post Rd., Des Moines, IA 50315
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