Iowa Department of Human Services

2.1 Application, Determination of Eligibility and Furnishing Medicaid

• Attachment A: Definition of an HMO that is Not Federally Qualified

2.2 Coverage and Conditions of Eligibility

• Attachment A- Groups Covered and Agencies Responsible for Eligibility

  • S3 -Supplement 3 to Attachment A

2.3 Residence

2.4 Blindness

2.5 Disability

2.6 Financial Eligibility

• Attachment A- Eligibility Conditions and Requirements

  • Supplement 1 to Attachment 2.6-A - Income Eligibility Levels- Categorically Needy, Medically Needy and Qualified Medicare Beneficiaries

  • Supplement 2 to Attachment 2.6-A- Resource Levels- Categorically Needy, Including Groups with Income up to a Percentage of the Federal Poverty Level, Med

  • Supplement 3 to Attachment 2.6-A- Reasonable Limits on Amounts for Necessary Medical or Remedial Care Not Covered Under Medicaid

  • Supplement 4 to Attachment 2.6-A- Section 1902(f) Methodologies for Treatment of Income that Differ from those of the SSI Program

  • Supplement 5 to Attachment 2.6-A- Section 1902(f) Methodologies for Treatment of Resources that Differ from those of the SSI Program

  • Supplement 5a to Attachment 2.6-A- Methodologies for Treatment of Resources for Individuals with Income up to a Percentage of Federal Poverty Level

  • Supplement 6 to Attachment 2.6-A- Standards for Optional State Supplementary Payments

  • Supplement 7 to Attachment 2.6-A- Income Levels for 1902(f) States- Categorically Needy Who Are Covered Under Requirements More Restrictive than SSI

  • Supplement 8 to Attachment 2.6-A- Resource Standards for 1902(f) States- Categorically Needy

  • Supplement 8a to Attachment 2.6-A -More Liberal Methods of Treating Income Under Section 1902 r (2)

  • Supplement 8b to Attachment 2.6-A- Supplement 8b to Attachment A

  • Supplement 9 to Attachment 2.6-A- Transfer of Resources

  • Supplement 9a to Attachment 2.6-A- Supplement 9a to Attachment A

  • Supplement 9b to Attachment 2.6-A- Supplement 9b to Attachment A

  • Supplement 10 to Attachment 2.6-A- Consideration of Medicaid Qualifying Trusts- Undue Hardship

  • Supplement 11 to Attachment 2.6-A- Cost-Effective Methods for COBRA Groups (States and Territories)

  • Supplement 12 to Attachment 2.6-A- Supplement 12 to Attachment A

  • Supplement 13 to Attachment 2.6-A- Supplement 13 to Attachment A

  • Supplement 16 to Attachment 2.6-A- Supplement 16 to Attachment A

  • Supplement 17 to Attachment 2.6-A- Supplement 17 to Attachment A

  • Supplement 18 to Attachment 2.6-A- Supplement 18 to Attachment A

2.7 Medicaid Furnished Out of State

3.1 Amount, Duration, and Scope of Services

• Attachment A- Amount, Duration and Scope of Medical and Remedial Care and Services Provided to the Categorically Needy

  • S1 - Supplement 1 to Attachment A

  • S2 - Supplement 2 to Attachment A

  • S3 - Supplement 3 to Attachment A

• Attachment B

• Attachment C

• Attachment D

• Attachment E

• Attachment F

• Attachment H

  • PCP

  • SPMI

• Attachment L

  • Iowa Wellness Plan

  • Iowa Marketplace Choice Plan

3.2 Coordination of Medicaid with Medicare Part B

• Attachment A

• Attachment B

3.3 Medicaid for Individuals Age 65 or Over in Institutions for Mental Diseases

3.4 Special Requirements Applicable to Sterilization Procedures

3.5 Medicaid for Medicare Cost Sharing for Qualified Medicare Beneficiaries

3.6 Ambulatory Prenatal Care for Pregnant Women during Presumptive Eligibility Period

4.1 Methods of Administration

4.2 Hearings for Applicants and Recipients

4.3 Safeguarding Information on Applicants and Recipients

4.4 Medicaid Quality Control

4.5 Medicaid Agency Fraud Detection and Investigation Program

4.6 Reports

4.7 Maintenance of Records

4.8 Availability of Agency Program Manuals

4.9 Reporting Provider Payments to the Internal Revenue Service

4.10 Free Choice of Providers

4.11 Relations with Standard-Setting and Survey Agencies

• Attachment A

4.12 Consultation to Medical Facilities

4.13 Required Provider Agreement

4.14 Utilization Control

4.15 Inspections of Care in Skilled Nursing and Intermediate Care Facilities and Institutions for Mental Diseases

4.17 Liens and Recoveries

• Attachment A

4.18 Cost Sharing and Similar Charges

• Attachment A - Charges Imposed on Categorically Needy

• Attachment C - Charges Imposed on Categorically Needy and Other Optional Groups

• Attachment D - Premiums Imposed on Low-Income Pregnant Women and Infants

• Attachment E - Premiums Imposed on Qualified Disabled and Working Individuals

4.19 Payment for Services

• Attachment A - Methods and Standards for Establishing Payment Rates- Inpatient Hospital Care

• Attachment B - Methods and Standards for Establishing Payment Rates- Other Types of Care

  • S1- Supplement 1 to Attachment B

  • S2- Supplement 2 to Attachment B

• Attachment C - Payments of Reserved Beds

• Attachment D - Methods and Standards for Establishing Payment Rates- Skilled Nursing and Intermediate Care Facility Services

  • S1- Supplement 1 to Attachment D

  • S2- Supplement 2 to Attachment D

  • S3- Supplement 3 to Attachment D

  • S3- Supplement 4 to Attachment D

• Attachment E - Timely-Claims Payment- Definition of Claim

4.20 Direct Payments to certain Recipients for Physicians' or Dentists' Services

4.21 Prohibition Against Reassignment of Provider Claims

4.22 Third Party Liability

• Attachment A - Requirements for Third Party Liability- Identifying Liable Resources

• Attachment B - Requirements for Third Party Liability- Payment of Claims

• Attachment C - Cost-Effective Methods for Employer-Based Group Health Plans

4.23 Use of Contracts

4.24 Standards for Payments for Skilled Nursing and Intermediate Care Facility Services

4.25 Program for Licensing Administrators of Nursing Homes

4.27 Disclosure of Survey information and Provider or Contractor Evaluation

4.28 Appeals Process for Skilled Nursing and Intermediate Care Facilities

4.29 Conflict of Interest Provisions

4.30 Exclusion of Providers and Suspension of Practitioners Convicted and Other Individuals

• Attachment OT - Attachment to 4.30

4.31 Disclosure of Information by Providers and Fiscal Agents

4.32 Income and Eligibility Verification System

• Attachment A - Income and Eligibility Verification System Procedures: Requests to Other State Agencies

4.33 Medicaid Eligibility Cards for Homeless Individuals

• Attachment A - Method for Issuance of Medicaid Eligibility Cards to Homeless Individuals

4.34 Systematic Alien Verification for Entitlements

• Attachment A

4.35 Remedies for Skilled Nursing and Intermediate Care Facilities that Do Not Meet Requirements of Participation

• Attachment A

• Attachment B

• Attachment C

• Attachment D

• Attachment E

• Attachment F

• Attachment G

• Attachment H

4.36 Required Coordination Between the Medicaid and WIC Programs

4.38 Nurse Aide Training and Competency Evaluation for Nursing Facilities

4.39 Preadmission Screening and Annual Resident Review in Nursing Facilities

• Attachment A

4.40 Survey and Certification Process

• Attachment A

• Attachment B

• Attachment C

• Attachment D

• Attachment E

4.41 Resident Assessment for Nursing Facilities

4.43 Frequency and Description of Method of Compliance Oversight

• Attachment A

5.1Standards of Personnel Administration

5.3Training Programs; Subprofessional and Volunteer Programs

6.1 Fiscal Policies and Accountability

• Attachment to 6.1

6.2 Cost Allocation

6.3 State Financial Participation

7.1Plan Amendments

7.2Nondiscrimination

• Attachment A - Methods of Administration- Civil Rights Act (Title VI)

7.3Maintenance of AFDS Effort

7.4State Governor's Review

Drugs

Hospitals

ICF

ICF-MR

SNF