Medicaid Modernization: The Iowa Department of Human Services (DHS) released a Request for Proposal (RFP) for Governor Branstad's Medicaid Modernization on February 16, 2015. This initiative aims to improve the coordination and quality of care while providing predictability and sustainability for taxpayers in Medicaid spending. The RFP, titled the Iowa High Quality Health Care Initiative, asks for bids from potential vendors as the state moves toward a risk-based managed care approach for Iowa’s Medicaid program. Learn more by accessing the dedicated web page.
Provider Application Fees: The Iowa Medicaid Enterprise will require an application fee for newly enrolling and re-enrolling organizational providers effective January 1, 2015. Code of Federal Regulations section 455.460 requires organizational providers to pay the application fee with initial applications for new enrollment, applications for a new practice location and any re-enrollment. For more information, please refer to the Frequently Asked Questions or contact Provider Enrollment at 1-800-338-7909 (option 2) or in Des Moines 515-256-4609 (option 2) or by email at IMEProviderServices@dhs.state.ia.us.
CDAC Training Video: Learn more about being a CDAC provider by downloading the CDAC training video. You will be downloading a .zip file and when the download is complete, you will be able to view the training video. The training video is divided into six video segments: (download the training video)
- The CDAC Agreement
- Daily Service Record (DSR)
- Claim for Targeted Medical Care (TMC)
- CDAC Procedures
- Audits and Reviews
ICD-10 is coming. Are you ready? As announced in Informational Letter 1440, the Iowa Medicaid Enterprise (IME) can no longer accept claims with ICD-9 codes for services delivered on or after October 1, 2015, and inpatient discharges occurring October 1, 2015 or after. Registration for Iowa Medicaid Enterprise (IME) ICD-10 Volunteer Testing is now open. To register for testing, please contact the IME Provider Services Unit at 1-800-338-7909, or locally in Des Moines at 515-256-4609 or by email at ICDemail@example.com.
Hydrocodone Combination Products: Effective October 6, 2014, all hydrocodone combination products (HCPs) are classified as schedule II controlled substances pursuant to a rule adopted by the United States Drug Enforcement Administration (D.E.A.) on August 22, 2014. This requirement is not Iowa Medicaid specific.
What does this mean for our providers?
1. Pharmacies cannot accept prescriptions for HCPs by telephone.
2. Prescriptions for HCPs cannot be refilled.
3. Prescriptions for HCPs may be written on a hard copy, original prescription, or received by electronic transmission, where allowed. Receipt by fax will not be allowed. HCPs as Schedule II will require additional recordkeeping and security requirements. Additional information is available on the Iowa Board of Pharmacy website.