Medicaid Initiatives

Managed Health Care
The Iowa Department of Human Services (DHS), with support from the Iowa Medical Society and the Iowa Osteopathic Medical Association, developed and Implemented the Managed Health Care program in Iowa as mandated by the Iowa Legislature via House File 2447 in 1988 and Senate File 541 in 1989. Learn more about the various managed health care options available.

International Classification of Diseases, 10th Edition (ICD-10):
The ICD-9 code set currently used to report medical diagnoses and hospital inpatient procedures is being replaced by the ICD-10 code set.  ICD-10 will affect diagnosis and inpatient procedure coding and is required for everyone covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  The change will NOT affect CPT coding for outpatient procedures.

Heath Information Technology:
Iowa's Medicaid Electronics Health Records (EHR) Incentive Program is playing an important role in establishing critical health information technology designed to reduce costs, improve care, and advance coordination across the healthcare platform. This focused effort is leading to better coordination, quality of care, and fostering healthier lives in Iowa. Eligible professionals and hospitals can apply for the EHR via the Provider Incentive Payment Program (PIPP) system at http://www.imeincentives.com/.

Iowa Medicaid Care Management Programs:
The Iowa Medicaid Care Management consists of Care Management, Disease Management, Maternity, and Lock-In. The common themes across these programs are to provider a high level of care coordination to high utilization high risk Medicaid members. The goals of the programs are to support the provider's plan of care and to coordinate services deemed necessary. Medicaid members receiving the best possible health outcomes from high quality health care.

Iowa Medicaid Pharmaceutical Care Management:
Iowa Medicaid Pharmaceutical Care Management (PCM) is an Iowa Medicaid service provided by physicians and pharmacists working together to closely manage the total medication regimens of their most complex patients. The services are provided to Medicaid members who are identified as being at high risk for medication-related problems. The innovative care delivered through this program is based on a model of care known to improve medication safety in hospital and clinic settings where pharmacists and physicians practice under the same roof and have access to patient care records.