2013 Informational Letters


Published Informational Letters

Letter
#
Description Issue Date Effective Date

1338

Iowa Medicaid Pharmacy Provider Portal

12/24/2013

Immediately

1337

Billing a Wellness Exam and a Sick Visit Revised

12/19/2013

Immediately

1336

HCBS Intellectual Disability (ID) and Brain Injury (BI) Waiver Supported Community Living (SCL) services approval process
-Daily SCL D-4 Review Workflow and the Service Plan Review Workflow

12/20/2013

Immediately

1335

Electronic Health Record (EHR) Incentive Payment Program and Meaningful Use Attestation Updates -- Patient Volume Methodology

12/20/2013

Immediately

1334

Presumptive Eligibility Changes under the Affordable Care Act (ACA)

12/13/2013

01/01/2014

1333

Accepting Application for Certification to Become a Qualified Entity (QE)

12/13/2013

Immediately

1332

Accepting new paper version of the CMS-1500 (02/12) Health Insurance Claim Form

12/13/2013

01/06/2014

1331

Nursing Facility Rates Effective July 1, 2013

12/13/2013

07/01/2013

1330

Referring or Prescribing Providers Must be Enrolled with Medicaid

12/10/2013

01/06/2014

1329

Extension of the Hospital Health Care Access Assessment Program through June 30, 2016

12/03/2013

07/01/2013

1328

CMS Approval of Low Utilization Payment (LUPA) Methodology

12/03/2013

07/01/2013

1327

HCBS Incident Report Training

11/27/2013

Immediately

1326

Hospice in Nursing Facilities-Matching Date Ranges

11/27/2013

01/01/2014

1325

Iowa Medicaid Pharmacy Program Changes

11/26/2013

01/01/2014

1324

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

11/26/2013

01/01/2014

1323

Preferred Diabetic Lancets, Syringes, Blood Glucose Meters and Test Strips

11/22/2013

01/01/2014

1322

Updated Website Address for Pharmacy Reimbursement

11/22/2013

Immediately

1321

Completion of Case Activity Report-PACE in a Nursing Facility

11/22/2013

Upon Receipt

1320

Completion of Case Activity Report-Facilities

11/22/2013

Upon Receipt

1319

Completion of Case Activity Report-Hospice in a Nursing Facility

11/22/2013

Upon Receipt

1318

Billing a Wellness Exam and a Sick Visit
- Replaced by Info Letter 1337

12/13/2013

Immediately

1317

New Facility Client Participation Notice Process-Updated Information

11/12/2013

Immediately

1316

Legal Representatives as Paid Employees

11/22/2013

01/01/2014

1315

Repair Codes for Eyeglass Lenses and Frames

11/15/2013

Upon Receipt

1314

Coverage of Custom Wheelchairs in a Nursing Facility

11/15/2013

01/01/2014

1313

Inpatient Crossover or Inpatient Medicaid Duplicate Claims

11/06/2013

Upon Receipt

1312

IowaCare Transition Updates

12/13/2013

01/01/2014

1311

HCBS Waiver Transportation Reimbursement Rates

11/08/2013

Immediately

1310

Electronic Health Record (EHR) Incentive Payment Program Pilot for Reporting Clinical Quality Measures (CQM) Electronically

11/05/2013

Immediately

1309

Iowa Medicaid Pharmacy Provider Portal
- Replaced by Info Letter 1338

11/01/2013

11/01/2013

1308

Pricing Modifiers for Medical Equipment

10/31/2013

09/01/2013

1307

Update to Respiratory Syncytial Virus (RSV) 2013-2014 Season

10/22/2013

Immediately

1306

Medicaid Members Desiring an Available Private Room

10/21/2013

07/01/2013

1305

Update to Increased Medicaid Payment for Primary Care

10/24/2013

01/01/2013

1304

Qualified Entities Providing Presumptive Eligibility Determinations

10/17/2013

01/01/2014

1303

Electronic Dental X-Rays (Addition of X-Ray Date)

11/01/2013

Immediately

1302

Presumptive Eligibility Changes under the Affordable Care Act (ACA)
- Replaced by Info Letter 1334

10/17/2013

01/01/2014

1301

Asthma Quality Improvement Program

10/21/2013

10/28/2013

1300

New Facility Client Participation Notice Process
- Replaced by Info Letter 1317

10/29/2013

Immediately

1299

Rate Maximum for Private Duty Nursing and Personal Care Services

10/17/2013

07/01/2013

1298

Reminder on Electronic Billing of Long Term Care Claims

10/17/2013

12/01/2013

1297

Correct Code for Habilitation Targeted Case Management (TCM)

10/07/2013

07/01/2013

1296

Use of the U4 Modifier for Intellectual Disability (ID) Testing and Pre- Procedure Psychological Evaluation

10/30/2013

Immediately

1295

2013 Provider Quality Management Self-Assessment

10/03/2013

Immediately

1294

Annual Update of Hospice Rates
Iowa Hospice Wage Indexes and Rates
Out-of-State Hospice Wage Indexes and Rates

10/03/2013

10/01/2013

1293

Iowa Medicaid Pharmacy NCPDP D. Payer Sheet and Guidance- Updated Information

09/16/2013

09/23/2013

1292

Respiratory Syncytial Virus (RSV) 2013-2014 Season

09/23/2013

Immediately

1291

Limited Emergent Hospital Coverage for IowaCare Members

09/16/2013

Immediately

1290

Electronic Health Record (EHR) Incentive Payment Program Testing with the Immunization Registry Information System (IRIS)

09/16/2013

Immediately

1289

Coverage of Wheelchairs in an ICF/ID Facility

09/13/2013

09/01/2013

1288

Iowa Health and Wellness Plan Education and Training

09/12/2013

Upon Receipt

1287

Iowa Medicaid Cost Report Changes

09/11/2013

Immediately

1286

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

09/09/2013

Immediately

1285

Notice of termination, Consumer Directed Attendant Care Services (CDAC) Rules in ARRC 0883C

08/29/2013

08/28/2013

1284

Iowa Medicaid Pharmacy NCPDP D. Payer Sheet and Guidance
- Replaced by Info Letter 1293

09/03/2013

09/23/2013

1283

Iowa Medicaid Pharmacy Program Changes

08/29/2013

10/01/2013

1282

Transition of Individual Consumer Directed Attendant Care Services-CM-SW-SAM
- Replaced by Info Letter 1285

08/23/2013

10/01/2013

1281

Transition of Individual Consumer Directed Attendant Care Services-Agency
- Replaced by Info Letter 1285

08/23/2013

10/01/2013

1280

Transition of Individual Consumer Directed Attendant Care Services-ISB
- Replaced by Info Letter 1285

08/23/2013

10/01/2013

1279

Transition of Individual Consumer Directed Attendant Care Services-I-CDAC
- Replaced by Info Letter 1285

08/23/2013

10/01/2013

1278

Additional Update to Prior Authorization Required for Swing Bed Admission and Continued Stay

09/06/2013

Immediately

1277

17-Alpha Hydroxyprogesterone Caproate Follow Up

10/25/2013

Immediately

1276

Nursing Facility Rates

08/12/2013

07/01/2013

1275

Background Check Fee

08/07/2013

07/01/2013

1274

Increased Medicaid Payment for Primary Care-Retroactive Adjustments

08/07/2013

01/01/2013

1273

Rule Changes to add Coverage of Several Items and a New Prior Authorization (PA)

08/06/2013

09/01/2013

1272

Discount for National Committee for Quality Assurance (NCQA) Patient Centered Medical Home (PCMH) Submission Fees

08/05/2013

07/18/2013

1271

Electronic Billing of Long Term Care Claims

08/05/2013

02/01/2014

1270

Birth Control Service Fee-SE Modifier

07/30/2013

07/30/2012

1269

Update to Prior Authorization Required for Swing Bed Admission and Continued Stay

07/30/2013

Immediately

1268

Replenishment of Limited Emergent Hospital Coverage for IowaCare Members

07/25/2013

07/31/2013

1267

Change in Case Management Reimbursement Rate Methodology

08/01/2013

07/01/2013

1266

Proper Claim Submission for Medicare Psychiatric (psych) Reduction Copayments

07/24/2013

Upon Receipt

1265

HCBS Rate Changes Effective July 1, 2013

07/18/2013

07/01/2013

1264

Diabetes Quality Improvement Program

07/22/2013

07/22/2013

1263

Iowa Medicaid Enterprise ICD-10 Provider Readiness Survey

07/16/2013

Immediately

1262

Rate Changes Effective July 1, 2013

07/16/2013

07/01/2013

1261

Habilitation Transition to the Iowa Plan Member Enrollment and Service Authorization

07/10/2013

07/01/2013

1260

Elective C-Section Coverage and Payment FOLLOW UP

07/03/2013

07/01/2013

1259

Atypical Code Conversion Project Effective July 1, 2013

07/09/2013

07/01/2013

1258

IowaCare Program is Ending, Enrollment Cap on July 1, 2013

07/08/2013

12/31/2013

1257

PMIC Maximum Reimbursement Rate Effective July 1, 2012

07/09/2013

07/01/2013

1256

LUPA Reimbursement Methodology
- Iowa HHA LUPA Wage Indexes and Rates

07/01/2013

07/01/2013

1255

Money Follows the Person Expansion and Additional Responsibilities
- Transition Specialists Assigned by County
- Letter to Residents/Guardians

06/25/2013

Upon Receipt

1254

Private Duty Nursing / Personal Care Services for Members under Age 21

06/25/2013

07/01/2013

1253

Annual Year-End Cost Reporting of HCBS Waiver and Habilitation Service Member-Specific Limited Costs

06/19/2013

Upon Receipt

1252

Annual Year-End Cost Reporting of HCBS Waiver and Habilitation Service Transportation Costs

06/19/2013

Upon Receipt

1251

Increased Medicaid Payment for Primary Care-Retroactive Adjustments

06/17/2013

01/01/2013

1250

Pharmacy Reimbursement

06/12/2013

06/21/2013

1249

Elective C-Section Coverage and Payment

06/04/2013

07/01/2013

1248

Transition of Habilitation Services to Magellan Behavioral Care of Iowa - Cost Report and Payment Issues

06/18/2013

07/01/2013

1247

Limited Initial Institutional Stay

06/06/2013

07/01/2013

1246

Electronic Dental X-Rays

06/04/2013

Immediately

1245

Prior Authorization Required for Swing Bed Admission and Continued Stay

06/05/2013

07/01/2013

1244

Iowa Medicaid Pharmacy Program Changes

05/22/2013

07/01/2013

1243

Dental Policy Changes-Updated Information

05/08/2013

05/01/2013

1242

Reminder Regarding Prior Authorization (PA) Requirements

05/10/2013

Upon Receipt

1241

Involuntarily Dissolved Providers

05/06/2013

07/01/2013

1240

Habilitation Services Transition to the Iowa Plan

04/24/2013

07/01/2013

1239

Secure Messaging through the Iowa Health Information Network (IHIN) for Dental Prior Authorizations

05/02/2013

Immediately

1238

Billing for Dental Encounters at Federally Qualified Health Centers and Indian Health Services

04/24/2013

07/01/2013

1237

Dental Policy Changes
- Replaced by Info Letter 1243

04/24/2013

05/01/2013

1236

New Billing Code for Oral Health Screenings (D0190)

04/24/2013

05/01/2013

1235

Exclusion from Participation in Federal Health Care Programs

04/19/2013

Immediately

1234

Outpatient Hospital Rebase Fiscal Impact Analysis

04/18/2013

01/01/2012

1233

Updated Templates for Medicare Crossover Claims

04/16/2013

06/01/2013

1232

Change in Health Home Member Attributes in the Iowa Medicaid Portal Access (IMPA) System

04/10/2013

06/01/2013

1231

Home and Community Based Services (HCBS) Habilitation, Home Based Habilitation (HBH) Rate Changes

04/16/2013

04/01/2013

1230

Annual Provider Training 2013

04/11/2013

Upon Receipt

1229

2013 Civil Money Penalty Quality Improvement Initiative Grant (CMPQII)

03/25/2013

Upon Receipt

1228

Respiratory Syncytial Virus (RSV)

03/21/2013

Immediately

1227

Iowa Medicaid Pharmacy Program Changes

03/21/2013

05/01/2013

1226

Details of Atypical Conversion Documentation and Billing

03/21/2013

07/01/2013

1225

Cost Reporting Due Date for Nursing Facilities

03/14/2013

Immediately

1224

Increased Medicaid Payment for Primary Care-Attestation Extension

03/08/2013

01/01/2013

1223

2012 Provider Quality Management Self-Assessment Reminder and Clarification

03/06/2013

Immediately

1222

Implementation of Atypical Conversion

03/14/2013

07/01/2013

1221

CC and KR Modifiers

03/22/2013

05/01/2013

1220

Iowa Medicaid Hospice Reminders

03/20/2013

Immediately

1219

Implementing NCCI PTP Edits for Immunization Administration and Preventive E&M Service Codes

02/25/2013

04/01/2013

1218

Iowa Medicaid Enterprise ICD-10 Provider Readiness Survey

02/21/2013

Immediately

1217

HCBS Habilitation and Intellectual Disability (ID) Waiver Day Habilitation Services

02/28/2013

Immediately

1216

Atypical Conversion Letter #1 Highlights

02/25/2013

07/01/2013

1215

Update on the Atypical Code Conversion Project

02/06/2013

07/01/2013

1214

Flu Vaccine Provided by the Vaccines for Children (VFC) Program

02/07/2013

Immediately

1213

Iowa Medicaid Pharmacy Program Changes

01/18/2013

03/04/2013

1212

Iowa Family Planning Network Coverage Changes

01/18/2013

01/01/2013

1211

MediPASS Assignment Request Attestations

01/22/2013

03/01/2013

1210

IowaCare Updates

01/18/2013

Immediately

1209

IowaCare FQHC Medical Home Reimbursement Rates

01/18/2013

01/01/2013

1208

Procedure Code T1001 and H1003 Revisions

01/22/2013

Upon Receipt

1207

Reimbursement Changes for Pharmacy and Important Dates # 5

01/30/2013

02/01/2013

1206

Money Follows the Person Expansion and Additional Responsibilities #1

01/08/2013

Upon Receipt

1205

Clarification of Disclosure Requirements for Enrollment Renewal

01/11/2013

Immediately

1204

Assisted Living On-Call Service for Elderly Waiver

01/02/2013

03/01/2013

1203

17-Alpha Hydroxyprogesterone Caproate

01/03/2013

Immediately

1202

Health Home: Tips and Tools

01/02/2013

Immediately