March 19, 2020  |  Issue 2 |  Volume 5

Medicaid e-News
News and Announcements:


Iowa Medicaid COVID-19 Updates
In response to the COVID-19 outbreak and the President's issuance of an emergency declaration for all states, the Department of Human Services (DHS) has taken action to ensure Medicaid members have continued access to services.

Member co-pays, premiums, and contributions waived
Effective March 13, 2020, DHS is waiving all co-pays, premiums, and contributions for Iowa Health and Wellness Plan (IHAWP), Medicaid for Employed People with Disabilities (MEPD), Healthy and Well Kids in Iowa (Hawki), and Dental Wellness Plan (DWP) members until the emergency declaration is lifted.

Members of these medical assistance programs will not receive billing statements during the emergency declaration and services will continue uninterrupted.

Billing statements from DHS received by members with March, April, May, or June due dates are waived. Members who already paid their co-pay, premium or contribution for a waived month will receive a credit on their account when billing resumes. Hawki members who have automatic reoccurring payments setup, will receive a credit balance on their account when billing resumes.

Additionally, DHS has put a pause on all dis-enrollments for medical assistance programs until the emergency declaration is lifted. Members who are past due on their payment will not be dis-enrolled during this time.

Covered services available
The Iowa Medicaid Enterprise (IME) has published  Informational Letter 2115-MC-FFS-CVD that addresses the covered services available and provides guidance for claims billing regarding coronavirus and COVID-19.

Additionally, the IME seeks authority to allow telehealth services to be provided, regardless of the recipient's location, for all Medicaid-covered benefits if provision of the service via telehealth is clinically feasible and appropriate. As part of this announcement, members will now be able to access their service providers using a wider range of communication tools including telephones that have audio and video capabilities, making it easier for members and providers to connect.

Frequently asked questions
The following are the answers to frequently asked questions regarding Medicaid and COVID-19:
  • Is the COVID-19 test a covered Medicaid/Hawki benefit? / How much does the COVID-19 test cost? IA Health Link, Fee-for-Service and Hawki members do not have to pay anything for the COVID-19 test.
  • Do I have to get prior authorization for a COVID-19 test? No, prior authorization is not required for COVID-19 testing.
  • Are there limits to care or services I can get during a pandemic? No.
DHS submitting federal waivers to ensure continued access to medical assistance
DHS is exploring all opportunities for flexibility to provide public assistance. Medical Assistance will continue for current recipients.  DHS will be submitting §1115, §1915(c) and §1135 waivers to the Centers for Medicare and Medicaid Services (CMS) to ensure continuous coverage for recipients of Medical Assistance in Iowa and to ensure providers are able to provide much needed services during this emergency. More information can be found on the DHS website.

Additional COVID-19 DHS resources
 
Retroactive Coverage for Children at Application
Effective for applications filed on or after January 1, 2020, a 3-month retroactive Medicaid coverage period is now available to children under age 19 at the time of application and who are otherwise Medicaid eligible.

A 3-month retroactive Medicaid coverage period will continue for pregnant women (and during the 60-day period beginning on the last day of the pregnancy), infants under one year of age and applications who are residents of a nursing facility at the time of application.

The effective date of coverage for Medicaid remains unchanged and begins on the first of the month in which the application is received.

For more information, see Informational Letter 2085-MC-FFS-D.

New Print Vendor for Medicaid ID Cards
Effective January 1, 2020, a new vendor is printing and mailing Medical Assistance Eligibility Cards ( Form 470-1911) on behalf of DHS to all newly eligible Medicaid members as well as existing members who request a replacement card.

How the Medicaid ID card looks is not changing. The front of the card will continue to show the state of Iowa logo along with the member's name, date of birth and State ID number.

However, going forward the ID cards will feel different as they will be printed on different paper.

Providers should verify the eligibility status of the cardholder before providing services. Providers can get current eligibility status of the cardholder by calling the Eligibility Verification System (ELVS) at 1-800-338-7752 or 515-323-9639 in the Des Moines area.

Latest MCO Quarterly Report Available
The latest quarterly report for the Iowa Medicaid Managed Care Organizations (MCOs) is now available on the DHS  website.

This report, which was released February 7, 2020, includes performance data from July through September 2019 for Amerigroup Iowa and Iowa Total Care.

Final Draft Statewide Transition Plan for HCBS Settings Available on Department Website
In March 2014, the Centers for Medicare and Medicaid Services (CMS) issued regulations that define the settings in which it is permissible for states to pay for Medicaid Home- and Community-Based Services (HCBS).

The purpose of these regulations are to ensure that individuals receive Medicaid HCBS in settings that are integrated in and support full access to the greater community. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources, and receive services in the community, to the same degree as individuals who do not receive HCBS.

On December 19, 2019, the Iowa Medicaid Enterprise (IME) submitted a final draft statewide transition plan (STP) to CMS. The final draft STP is available on the Department's  website

The final STP will be posted on the DHS website when approved by CMS.

Reminders:
Changing Your MCO
Members requesting to change their MCO due to good cause first 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 at 1-800-338-8366. The final decision for disenrollment will be determined by DHS. More information can be found on the DHS website .

Provider Tools and Resources:
Providers are Encouraged to Verify Eligibility
The 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. 

If you currently do not have access to the ELVS web portal, you can register your provider at https://connect.edissweb.com. Each additional user that would like access to the provider's information can complete an Additional Access Request Form. If you have any questions regarding EDISS registration, call 1-800-967-7902.
 
Provider Resource Pages
Comprehensive provider resource pages are available for each MCO, featuring provider training manuals, webinars and important updates. View them below:


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

1-800-600-4441

1-833-404-1061

PROVIDER SERVICES

1-800-454-3730

1-833-404-1061
Dental Wellness Plan Contacts
MEMBER SERVICES

1-888-472-2793

1-855-247-6262
PROVIDER SERVICES

1-888-472-1205

1-855-856-6262

Iowa Medicaid Contacts
1-800-338-8366

PROVIDER SERVICES

1-800-338-7909

Success Stories
IA Health Link Success Stories
IA Health Link is a managed care program that works to make sure members get the health care that they need. Click the image above to read success stories.
 


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Iowa Medicaid Enterprise | IMECommunications@dhs.state.ia.us | dhs.iowa.gov
611 Fifth Ave., Des Moines, IA 50309