Medicaid Resources - Iowa
Provider Services Contact Information:
- 800.338.7909 Toll Free
- 515.256.4609
Wellpoint
- 800.454.3730
- Wellpoint website
- Iowamedicaid@amerigroup.com
Iowa Total Care:
- 833.404.1061
- https://www.iowatotalcare.com
- Provider Resources
System Instructions:
- Electronic Visit Verification Resource Center (EVV)
- Electronic Data Interchange Support Services (EDISS)
- Iowa Medicaid Electronic Record System (IMERS)
- Iowa Medicaid Portal Access (IMPA)
- IMPA Information
Forms:
- Iowa Medicaid Cost Report and Instructions by Provider Type website
- Remittance Advice Provider Access Request Form
- Critical Incident Reporting Access Request Form
- Client Participation Access Form
QAAF:
QAAF Fees and Form 470-4836 are due 30 days after the end of the previous quarter.
- January 30 for quarter October 1 - December 31
- April 30 for quarter January 1 - March 31
- July 30 for quarter April 1 - June 30
- October 30 for quarter July 1 - September 30
HCBS:
- Federal Regulations on HCBS - See parts 431.50, 435.3, 435.217, 435.726, 440.1, 440.180, 440.250, 441.300 through 441.306, and 441.310.
- Medicaid Website on HCBS
- Iowa HHS - HCBS Website
- Iowa HHS - HCBS Provider Manual
HCBS Settings Rule:
The largest change to HCBS in recent years is the HCBS Settings Rule. According to CMS, the HCBS Settings Rule is meant to ensure HCBS services in residential and non-residential settings provide full access to the benefits of community living and offers services in the most integrated settings.
HCBS Services will be required to determine if provider-owned/controlled HCBS that are located in, on the grounds of, or immediately adjacent to nursing facilities, institutions for mental disease, intermediate care facilities for individuals with intellectual disabilities and hospitals fit the criteria in the final rule to be eligible to receive Medicaid waiver funding.
The following provider regulations and guidance on the HCBS Settings Rule:
- HCBS Setting Requirements final rule CMS-2249-F; CMS-2296-F
- CMS HCBS Settings Rule Compliance Toolkit
Iowa's Initial Statewide Transition Plan (STP) was approved August 9, 2016.
- Iowa's Initial Approved STP (2016)
- Initial STP Approval Letter (2016)
Final STP were developed and submitted to CMS explaining the results of the state's discovery, assessment, remediation and monitoring processes. The final STP also outlined the state's ongoing monitoring processes.
Iowa's final STP was approved on March 17, 2023.
- Iowa's Final Approved STP (2023)
- Final STP Approval Letter (2023)
Even though Iowa's final STP was approved, there was still some work that needed to be done to fully demonstrate compliance. Iowa, and many other states are working through a corrective action plan (CAP) to finish up work around heightened scrutiny and validation of results.
- Iowa's STP CAP was approved on June 23, 2023.
Other Resources: