2012 Informational Letters


Published Informational Letters

Letter# Description Issue Date Effective Date

1201

Reimbursement Changes for Pharmacy and Important Dates #4

12/21/2012

02/01/2013

1200

Home and Community Based Service (HCBS) Waiver Provider Two Percent Rate Increase

12/28/2012

01/01/2013

1199

Limited Emergent Hospital Coverage for IowaCare Members

12/13/2012

Immediately

1198

High Technology Radiology

12/06/2012

12/08/2012

1197

January 2013 Residential Care Facility (RCF) Maximum Per Diem Rate and Personal Needs Allowance Increases

12/10/2012

01/01/2013

1196

Direct Secure Messaging (DSM) and the Iowa Health Information Network (IHIN) Connectivity

12/14/2012

Immediately

1195

Pharmacy Program and Atypical Antipsychotic Update

12/06/2012

01/01/2013

1194

Increased Medicaid Payment for Primary Care
- 12/21/12 CMS Guidance on PCP Increase on Qualifying Sub-specialties and more

11/30/2012

01/01/2013

1193

Changes to Mental Health Current Procedural Terminology (CPT) Codes
- Psychiatric Services Crosswalk

11/30/2012

01/01/2013

1192

IowaCare Care Coordination Pool Billing

11/30/2012

Upon Receipt

1191

Iowa Medicaid Pharmacy Program Changes

11/30/2012

01/01/2013

1190

Medicaid Site of Service (SoS) Differential Update

11/30/2012

01/01/2013

1189

Annual Update of Hospice Rates Revised Updated Information Shown as Highlighted

11/26/2012

10/01/2012

1188

2012 Provider Quality Management Self-Assessment

11/27/2012

Immediately

1187

Annual Update of Hospice Rates-Revised
- Replaced by Info Letter 1189

11/13/2012

10/01/2012

1186

Home and Community Based Services (HCBS) Quality Oversight Documentation Submission and Updated Contact Information-Updated Link

10/26/2012

Immediately

1185

Vaccine for Children (VFC) Program: Administration Code Changes

10/26/2012

12/01/2012

1184

Fee Schedule Change for Reusable Underpads (T4537 & T4540)

10/22/2012

11/01/2012

1183

Annual Resubmission Requirements - Employee Policies Regarding Prevention and Detection of Medicaid Fraud and Abuse

10/22/2012

Immediately

1182

Optical Policy Changes

10/18/2012

11/01/2012

1181

Home and Community Based Services Quality Oversight Documentation Submission and Updated Contact Information
- Replaced by Info Letter 1186

10/16/2012

Immediately

1180

Dental Services Performed for Meridian HMO Members

10/09/2012

Upon Receipt

1179

Medicaid Provider Screening and Enrollment Changes

10/05/2012

11/15/2012

1178

Iowa Medicaid Enterprise ICD-10 Provider Readiness Survey

09/28/2012

Immediately

1177

Iowa Health Information Network Services for Reporting Clinical Quality Measures

09/26/2012

Immediately

1176

CDAC Enrollment Renewal Launch 2012
- 470-4612
- 470-2965

10/15/2012

Immediately

1175

Annual Update of Medicaid Hospice Rates
- Wage Indexes 2012
- 10-12 Hospice Wage Adjusted Rates by County

10/02/2012

10/01/2012

1174

Iowa Medicaid Pharmacy Program Changes

09/21/2012

10/22/2012

1173

Reimbursement Changes for Pharmacy and Important Dates # 3

09/24/2012

01/01/2013

1172

Special Accommodation Capability Available For Dental Providers

09/21/2012

Immediately

1171

Implementation of the Iowa Medicaid Recovery Audit Contractor (RAC)

09/19/2012

Immediately

1168

New 2012 American Dental Association (ADA) Claim Form

10/11/2012

10/01/2012

1167

Update to the Medicare Hospital Acquired Conditions (HACs) List-Corresponding IME Update

09/07/2012

10/01/2012

1166

Enrollment Renewal 2012-Reminder

09/10/2012

Immediately

1165

Update on the Atypical Code Conversion Project

09/10/2012

Immediately

1164

Adult Day Care and Prevocational Units of Service

09/25/2012

Immediately

1163

Pharmacy Dispensing Fee Increase

08/20/2012

Immediately

1161

New Electronic Process for Billing Part B Crossover Claims

08/06/2012

09/01/2012

1160

Electronic Adjustments and Recoupments

09/26/2012

Immediately

1159

Announcement of a New Program: Health Home for Members with Chronic Conditions

07/25/2012

07/01/2012

1158

Medicaid Mental Health and Disability Services (MHDS) System: Letter #4, Medicaid Participation

07/19/2012

07/01/2012

1157

Medicaid Mental Health and Disability Services (MHDS) System: Letter #3, Central Point of Coordination (CPC)

07/19/2012

07/01/2012

1156

Nursing Facility Quality Assurance Assessment and Hospice

07/19/2012

Upon Receipt

1155

Day Habilitation Units of Service

07/11/2012

Immediately

1154

Replenishment of Limited Emergent Hospital Coverage for IowaCare Members

07/19/2012

07/01/2012

1153

Reimbursement Changes for Pharmacy and Important Dates #2

07/20/2012

Upon Receipt

1152

Patient Protection and Affordable Care Act (PPACA) Requirement: Provider Payment Suspensions

07/19/2012

Immediately

1151

Use of the "U8" Modifier - State Supplied Vaccines

06/10/2012

Upon Receipt

1150

Medicaid Mental Health and Disability Services (MHDS) System: Letter #2, Service Plan Authorization and Rate Setting
- Supplemental Schedule D-4

06/29/2012

07/01/2012

1149

Clarification of Recent Legislative Action regarding Home and Community Based Services (HCBS)

07/13/2012

Upon Receipt

1148

HCBS Habilitation, ID and BI Waiver Service Plan Authorization and Rate Setting for Case Managers and Providers

06/25/2012

Upon Receipt

1147

Inpatient Readmissions within Seven Days for Same Condition
Replaced by Info Letter 1547

07/13/2012

09/01/2012

1146

Two Percent Reduction in Payment for Physician-Administered Drugs

07/16/2012

09/01/2012

1145

Iowa Medicaid Pharmacy Program Changes

06/27/2012

07/30/2012

1143

HCBS Quality Assurance (QA) and Technical Assistance (TA) Contract Changes

06/22/2012

07/01/2012

1142

HCBS Quality Assurance Reviews (Replaces Informational Letter 1133)

06/22/2012

07/01/2012

1141

Medicaid Mental Health and Disability Services (MHDS) System: Letter #1

06/15/2012

07/01/2012

1140

Annual Restraint and Seclusion Attestation Letters

06/21/2012

Upon Receipt

1139

Independent Audits of DSH Payment Programs

06/21/2012

Upon Receipt

1137

Notice of Changes to the Medical Billing Remittance (MBR)

06/21/2012

Upon Receipt

1136

Reimbursement Changes for Pharmacy and Important Dates#1

06/06/2012

Immediately

1135

Member Lock-In: Altering a Prescription Claim and Changing the Prescribing Provider's National Provider Identifier (NPI)

06/04/2012

Immediately

1134

HCBS Quality Management and Technical Assistance Survey

05/30/2012

Upon Receipt

1133

HCBS Quality Assurance Reviews
- Replaced by Info Letter 1142

05/30/2012

07/01/2012

1132

Mental Health and Disability Services (MHDS) Redesign Webinar

06/13/2012

Immediately

1131

Member Co-pay Clarification

05/21/2012

Immediately

1130

Exclusion from Participation in Federal Health Care Programs

05/15/2012

Immediately

1129

Preferred Diabetic Blood Glucose Monitors and Test Strips

05/15/2012

07/01/2012

1128

Enrollment Renewal Launch 2012
- Designated Contact Person

05/15/2012

Immediately

1127

Change of Ownership

05/11/2012

Immediately

1126

Annual Provider Training 2012

05/11/2012

Immediately

1124

New Document Submission Process for Children's Mental Health (CMH) Waiver and Habilitation Level of Care Reviews

05/04/2012

Immediately

1123

Third Party Liability (TPL) and Vision Claims

05/15/2012

Upon Receipt

1122

High Technology Radiology Prior Authorizations-Additional Codes
- Codes Requiring Prior Authorization

05/1082012

06/01/2012

1121

PMIC Maximum Reimbursement Rate and Restoration of the 5 Percent Reduction

05/03/2012

Varies

1119

Incident Reporting Requirements and Expectations

05/09/2012

Immediately

1118

Hypertonic Saline for Inhalation Therapy

04/20/2012

Immediately

1117

Electronic Billing Quarterly Prophylaxis and Fluoride Treatments

05/18/2012

Upon Receipt

1116

Reporting Referral on Emergency Room (ER) Visits

04/27/2012

06/01/2012

1115

Important 5010 and ICD-10 HIPAA Transition Information

01/05/2012

Upon Receipt

1114

2012 Civil Money Penalty Quality Improvement Initiative Grant (CMPQII)

04/02/2012

Upon Receipt

1113

Update on the Atypical Code Conversion Project

03/23/2012

Immediately

1112

Prior Authorization

04/13/2012

Upon Receipt

1111

Adjustment and Recoupment request Form Changes

03/28/2012

05/01/2012

1110

Iowa Medicaid Pharmacy Program Changes

03/15/2012

04/09/2012

1109

Preadmission Screening and Resident Reviews (PASRR)

03/15/2012

Immediately

1108

Reporting Present On Admission

03/13/2012

09/01/2011

1107

Iowa Medicaid Maternity Management Program

03/08/2012

Immediately

1106

Iowa Medicaid Disease Management Healthy Iowans Initiative

03/08/2012

Immediately

1105

Iowa Family Planning Network Coverage Issues

03/05/2012

01/01/2012

1104

Medicare Crossover Form Requirement

03/05/2012

Immediately

1103

Claim for Targeted Medical Care Claim Form

01/28/2012

03/01/2012

1102

Electronic Data Interchange Support Services (EDISS) and the 5010 HIPAA Recertification

03/05/2012

Upon Receipt

1101

Coverage for D2933 and D9110, Billing for Crowns and Crown Build-Ups; Billing for Multi- Surface Restorations; Occlusal Guards

02/28/2012

Upon Receipt

1100

Electronic Health Record (EHR) Incentive Payment Program and Meaningful Use Attestation Updates

02/24/2012

Immediately

1099

Billing for Naso Alveolar Molding (NAM)

02/16/2012

Upon Receipt

1098

Clarification of Non-Emergency Medical Transportation (NEMT) Services for Transportation of Habilitation Members to Habilitation Services

02/16/2012

Immediately

1097

Iowa Family Planning Network (IFPN)Changes

02/13/2012

01/01/2012

1096

Exclusion from Participation in Federal Health Care Programs
- Replaced by Info Letter 1130

02/10/2012

Immediately

1095

Elimination of Co-pays on Medicare Part D for Dual Eligible Beneficiaries Receiving Home and Community Based Services (HCBS) Waivers

02/03/2012

01/01/2012

1094

Clarification of Non-Emergency Medical Transportation (NEMT) Services for Transportation of HCBS Members to Waiver Services

02/01/2012

Immediately

1093

Consumer Directed Attendant Care (CDAC) Agreements

01/27/2012

Immediately

1092

Developmental Services Procedure Codes 96110 and G0451

01/20/2012

01/01/2012

1091

Important 5010 HIPAA Transition Information

01/17/2012

01/01/2012

1090

Dental Procedure Codes on Outpatient Hospital Claims Payable under APC 00330

01/17/2012

10/01/2011

1088

CDAC Daily Service Record Documentation Form Supplies

01/12/2012

01/01/2012

1087

Certificate of Medical Necessity for Home and Community Based Waiver Prior Authorization

01/12/2012

10/01/2011

1086

CDAC Daily service Records Documentation Form Supplies
- Replaced by Info Letter 1088

01/06/2012

01/01/2012

1085

January 2012 Residential Care Facility (RCF) Maximum Per Diem Rate and Personal Needs Allowance Increases

01/04/2012

01/01/2012

1079

Date Span Billing for Durable Medical Equipment Rental and Medical Supplies

01/04/2012

02/01/2012

1076

Non-Rebatable Physician Administered Drugs

01/09/2012

Immediately