|
Having trouble viewing this email? View it in your browser here. |
|
Medicaid news for members, providers and stakeholders.
|
|
Unwinding COVID-19 Medical Assistance Eligibility
On April 20, 2021, the Department of Human Services (DHS) resumed some of the Medicaid eligibility processes for many members currently enrolled in Medicaid and Hawki. This roll out is the first of five phases of resuming back to normal operations. DHS will continue resuming the rest of the processes in future months. Many of the regular processes had been put on hold for more than a year due to the COVID-19 public health emergency (PHE).
Most members will still maintain medical assistance eligibility throughout the PHE.
- Members may be dis-enrolled if the member: requests disenrollment, dies, is no longer a resident of Iowa, is erroneously approved, or has aged out of the Hawki program.
- Hawki members who have turned 19 years old, or will soon turn 19, will transition to Medicaid or will be referred to the federal marketplace for health care.
- Some members may transition to a different Medicaid program with different benefits.
- Members may be transitioned from full Medicaid coverage to a Medicare Savings Program.
- In future phases, some members currently receiving Long Term Services and Supports, such as Home- and Community-Based Services (HCBS) waivers and Habilitation services, Program for All-Inclusive Care for the Elderly (PACE), and facility coverage may be transitioned to a different Medicaid coverage group based on a review of circumstances.
To help complete the review of eligibility, DHS may need additional information from the member and will send this request in writing.
Once a member’s determination of eligibility has been completed, they will receive a notice in the mail if there are any changes to their benefits.
Details regarding Phase 2 of the PHE unwinding will be shared in a future edition of Medicaid e-News.
Read Informational Letter (IL) 2229-MC-FFS-CVD for more details.
|
|
COVID-19 PHE Extended
Last week, the U.S. Department of Health and Human Services (HHS) extended the COVID-19 Public Health Emergency (PHE) for an additional 90 days. The PHE is now scheduled to expire on July 14, 2021, unless it is extended again. You can find more information on the renewal of the PHE, here.
The renewal of the PHE means that all of Iowa Medicaid's waivers and flexibilities currently in place will stay in place through at least the end of the PHE.
|
|
New Coverage Groups, Provider Administration Fee for COVID-19 Vaccines
In IL 2207-MC-FFS-CVD, the Iowa Medicaid Enterprise (IME) announced information regarding billing and coding for administration fees of the COVID-19 vaccines.
With the recent federal approval of the American Rescue Plan Act (ARPA), IME is updating its COVID-19 vaccine administration rate for both Managed Care and Fee-for-Service to match the new Medicare rate of $40.
Additionally, based on the ARPA, Medicaid is expanding the following coverage groups to include the COVID-19 vaccine:
- COVID testing coverage
- Hawki - dental only
- Presumptive eligibility for pregnant women
- Limited Medicaid for non-citizens
The expanded coverage groups are effective with dates of service March 11, 2021, or after.
The administration rate per COVID-19 vaccine dose is effective April 1, 2021. This is $80 total for a two dose series vaccine and $40 for a single dose vaccine. Doses provided prior to the effective date will be paid at the administrative rate identified in IL-2207-MC-FFS-CVD. All other billing guidance provided in IL-2207-MC-FFS-CVD remains in effect.
|
|
CMS COVID-19 Vaccine Resources
The Centers for Medicare and Medicaid Services (CMS) is taking action to protect the health and safety of the nation's patients and providers and keeping everyone updated on the latest COVID-19 resources. This includes vaccine resources to support vulnerable populations such as older adults and people with disabilities.
Stakeholders can find up-to-date resources, materials, and information on the COVID-19 vaccine on the CMS COVID-19 Partner Resources Page.
|
|
Latest Managed Care Quarterly Performance Report Available
The latest quarterly report for the Iowa Medicaid Managed Care Organizations (MCOs) is now available on the DHS website.
This report includes performance data from October through December 2020 for Amerigroup, Iowa and Iowa Total Care.
|
|
New Asynchronous Teledentistry Code Available to For Providers to Bill
IME is now allowing asynchronous teledentistry (D9996). Using asynchronous teledentistry, the member's clinical information is gathered at the originating site, but the information is sent via store and forward technology to a dentist (distant site) for review and subsequent intervention at a later point in time.
All Iowa Medicaid recipients are eligible to receive services via asynchronous teledentistry.
Read IL 2224-MC-FFS-D-CVD for more details.
|
|
DHS Dashboards Now Available
DHS has developed a series of online dashboards to share up-to-date, accurate data with the public to increase awareness of its programs and performance. The Department's vision for this initiative is to increase comfort and confidence in the quality of services it provides.
Stakeholders are encouraged to use this data to help drive conversations and inform decisions that affect the health, well-being, and prosperity of Iowans.
Start exploring the data on the DHS website.
|
|
Medicaid Reference Guide Now Available
Nearly one in four Iowans rely on Iowa Medicaid for their health care. To better shine a light on the state’s Medicaid program, the people it serves and the services it provides, DHS has created the Iowa Medicaid Reference Guide.
DHS created this resource for lawmakers and stakeholders to understand how the Medicaid program operates in Iowa. The Department's goal in creating this guide has been to strike the right balance of providing enough information to be educational and thorough, while being concise enough to be useful. The Department will update the guide annually before each legislative session.
The 2021 guide is available on the DHS website.
|
|
Helpful Tip When Applying Online for Assistance
Some individuals have recently had trouble accessing the Department's online portal to apply for Medicaid, food assistance, and other benefits.
Individuals have reported that they receive an error message when trying to access the application, particularly with Google Chrome users.
The Department's online application is working.
If you receive an error message, try clearing your Internet history and then try to open the application again. (Google Chrome users can clear their Internet history by selecting "History" from the right-most icon (3 dots) on the menu bar.)
|
|
Iowa Total Care Donation Provides Books to Children
Iowa Total Care has gifted $10,000 to the Broadlawns Medical Center Foundation to support the medical center's First Book Program, which ensures every child cared for at Broadlawns receives a brand new, age appropriate book.
Iowa Total Care's gift will provide 6,000 new books to the program. The gift also covers an expansion of the program to ensure books are purchased which demonstrate inclusivity, empower women, and feature characters the positively reflect Broadlawns' diverse patient base.
"Iowa Total Care is honored to support Broadlawns Medical Center which is a critical resource to mothers and babies in our community," said Mitch Wasden, Iowa Total Care's Plan President and CEO.
|
|
Dental Wellness Plan Contacts |
|
IA Health Link Success Stories |
|
IA Health Link is a managed care program that works to make sure members get the health care they need. Click the image at the right to read IA Health Link success stories. |
|
|
|
|
