2015 Informational Letters


Published Informational Letters

Letter #         Description Issue Date Effective Date
                        Informational letters that pertain to managed care are designated with the letters "MC" at the end of the informational letter number.    
1598 Inpatient Psychiatric Hospital Services 12/31/2015 01/01/2016
1597 Behavioral Health and Substance Abuse Services 12/30/2015 01/01/2016
1596 Final Reminder: All Ordering, Prescribing and Referring Providers Must be Enrolled with Iowa Medicaid 12/29/2015 01/04/2016
1595 Nursing Facility Rate Rebase Time Line 12/23/2015 Immediately
1594-MC IA Health Link Transition-Updates 12/22/2015 Immediately
1593-MC IHH Provider and Member Enrollment for Fee For Service (FFS) 12/28/2015 Immediately
1592 January 2016 Personal Needs Allowance Increase 12/22/2015 01/01/2016
1591-MC Prior Authorizations (PA) for Providers Participating with Managed Care Organizations (MCOs)
Replaced by Info Letter 1628-MC
12/15/2015 01/01/2016
1590 Published in 2016. Please go to the 2016 Informational Letters listing.    
1589-MC Reimbursement Rates for Providers Participating with Managed Care Organizations (MCOs) 12/11/2015 01/01/2016
1588-MC CDAC Provider Enrollment with Managed Care Organizations 12/09/2015 01/01/2016
1587 Electronic Health Record (EHR) Incentive Program 12/15/2015 Immediately
1586-MC Behavioral Health and Substance Abuse Services 12/11/2015 01/01/2016
1585 Inpatient Readmissions within 30 Days for Same Condition 12/18/2015 07/01/2015
1584 Tips and Tools for Fee-For-Service (FFS) - IHH 12/15/2015 01/01/2016
1583 Tips and Tools for Fee- For- Service (FFS) - HH 12/15/2015 01/01/2016
1582-MC Managed Care Organization Training Summit 12/01/2015 Immediately
1581 Update to IME Medicare Crossover Claim Forms 12/02/2015 Immediately
1580 To be announced    
1579 Iowa Medicaid Pharmacy Program Changes 11/25/2015 01/01/2016
1578-MC Managed Care Rate Floors for Private Duty Nursing and Personal Care Services-UPDATED 11/23/2015 01/01/2016
1577-MC Managed Care Rate Floors for Private Duty Nursing and Personal Care Services 11/19/2015 01/01/2016
1576 Low Utilization Payment Adjustment (LUPA) Reimbursement  Methodology
2015 LUPA Rates
11/18/2015 07/01/2015
1575 Reminder- Site Visits Conducted for Medicaid Provider Enrollment Screening 12/14/2015 Upon Receipt
1574 Healthy Behaviors  Wellness Exam ICD-10 Update 11/18/2015 10/01/2015
1573-MC Iowa Medicaid Universal Provider Enrollment Application 11/17/2015 Immediately
1572 Termination Notice of Iowa Medicaid ACO Agreements 11/06/2015 12/31/2015
1571 Enrollment Renewal 11/04/2015 Immediately
1570 Annual Update of Hospice Rates 11/09/2015 10/01/2015
1569 FluMist Provided by the Vaccine for Children (VFC) Program 10/30/2015 10/01/2015
1568-MC Medicaid Modernization Transition-Provider Fact Sheet 11/19/2015 01/01/2016
1567 Reminder: ICD-10 Implementation 10/30/2015 10/01/2015
1566 Reporting Present on Admission – ICD-10 Update 10/23/2015 Immediately
1565 Elective C-Section Coverage and Payment – ICD-10 Update 10/30/2015 Immediately
1564 Reminder:  All Ordering, Prescribing and Referring Providers Must be Enrolled with Iowa Medicaid 10/21/2015 01/04/2016
1563-MC DHS Announces Medicaid Modernization Contracts 10/09/2015 Immediately
1562-MC Managed Care Organization (MCO) Provider Reimbursement Rate Floors 10/27/2015 01/01/2016
1561 Core Standardized Assessment (CSA) Tool Listening Sessions for Persons Receiving Mental Health Services 10/13/2015 Immediately
1560 Balancing Incentive Program (BIP) Core Standardized Assessment Implementation 10/23/2015 Immediately
1559 Electronic Health Record (EHR) Incentive Program 10/12/2015 Immediately
1558 2012 American Dental Association (ADA) Claim Form 10/12/2015 01/01/2016
1557 Processing of Family Planning ICD-10 Diagnosis Codes 10/07/2015 10/01/2015
1556 2015 Provider Quality Management Self-Assessment 10/06/2015 Immediately
1555 Processing of Family Planning ICD-10 Diagnosis Codes
Replaced by Info Letter 1557
09/29/2015 10/01/2015
1554 Clarification on Billing of Procedure Code D4381 09/25/2015 Immediately
1553 Rate Change Letter 09/17/2015 Upon Receipt
1552 Iowa Medicaid Pharmacy Program Changes 09/17/2015 10/01/2015
1551 Respiratory Syncytial Virus (RSV) 2015-2016 Season 09/22/2015 Immediately
1550 HCBS Waiver and Nursing Facility Level of Care (LOC) Review Process Webinar 09/09/2015 Upon Receipt
1549 Termination Notice of Managed Care Patient Manager Agreements 09/28/2015 12/21/2015
1548 Annual Submission Requirements - Employee Policies Regarding Prevention and Detection of Medicaid Fraud and Abuse 09/11/2015 Immediately
1547 Inpatient Readmissions within 30 Days for Same Condition 09/04/2015 07/01/2015
1546 Clarification of Emergent Medical Condition Coverage 09/04/2015 Immediately
1545 Clarification of Payment for Botox® 09/08/2015 10/01/2015
1544 HCBS Waiver Quality Improvement (QI) Training 09/02/2015 Upon Receipt
1543 Ambulance Claims Processing Changes 09/01/2015 10/01/2015
1542 Iowa Medicaid Pharmacy Program Changes
Replaced by Info Letter 1552
09/01/2015 10/01/2015
1541-MC IA Health Link Provider Toolkit 09/18/2015 Upon Receipt
1540 Payment of Botox
Replaced by Info Letter 1545
08/26/2015 10/01/2015
1539-MC DHS Announces Winning Bidders for Medicaid Modernization Initiative 08/20/2015 Immediately
1538 Staff Training as a Direct Operating Expense 08/28/2015 Upon Receipt
1537-MC Annual Provider Training 2015 08/20/2015 Upon Receipt
1536 Cost Report Review Requirement 08/17/2015 Immediately
1535 Clarification of Emergent Medical Condition Coverage.
Replaced by Info Letter 1546
08/24/2015 Immediately
1534 Final IME ICD-10 Provider Readiness Survey 08/06/2015 Immediately
1533 Preadmission Screening and Resident Review (PASRR) Care Planning Tools 08/03/2015 Immediately
1532 Preparation for ICD-10 Implementation 08/03/2015 Upon Receipt
1531 AssessMyHealth Health Risk Assessment Tool Updates 07/31/2015 Upon Receipt
1530 HCBS Waiver Consumer Choices Option (CCO) Training 08/04/2015 Upon Receipt
1529 Clarification of Attending Physician Requirement on Claims
Replaced by Info Letter 1625
07/28/2015 10/01/2015
1528

Elderly Waiver Assisted Living On-Call Service  

08/13/2015 12/16/2015
1527 Additional ICD-10 Testing Opportunities 07/21/2015 Upon Receipt
1526 ICD-10 Diagnosis Code Z76.89 Replaces ICD-9 Diagnosis Code V00.01 07/21/2015 10/01/2015
1525 Per Encounter Rate for Procedure Code H0031 07/09/2015 07/01/2015
1524 Processing of Emergency ICD-10 Diagnosis Codes 07/09/2015 10/01/2015
1523 IME ICD-10 Provider Readiness Survey 06/30/2015 Immediately
1522 Annual Restraint and Seclusion Attestation Letters and Incident Reporting 07/01/2015 Upon Receipt
1521 Clarification on Billing the Ventilator Rate 06/25/2015 Upon Receipt
1520 Countdown to the October 1, 2015, ICD-10 Implementation Date 06/22/2015 Upon Receipt
1519 Clarification of Processing of Pregnancy ICD-10 Diagnosis Codes 06/19/2015 10/01/2015
1518 Rule Changes to the HCBS Waiver Transportation Service and the Intellectual Disability Waiver Program 06/18/2015

07/01/2015

1517 Iowa Medicaid Pharmacy Program Changes 06/08/2015 07/06/2015
1516 Added Requirements for Billing Hospice Claims 06/11/2015 07/01/2015
1515 Billing for Hospice Direct Physician Care 06/11/2015 07/01/2015
1514 ICD-10 Diagnosis Crosswalk  06/11/2015 10/01/2015
1513 ICD-10 Diagnosis Code Z76.89 Replaces ICD-9 Waiver Diagnosis Code V00.01 06/05/2015 10/01/2015
1512 Clarification on Multiple Surgery Rules for Providers Billing on CMS-1500 Claim Forms 06/02/2015 Upon Receipt
1511 Clarification on Multiple Surgery Rules 06/02/2015 Upon Receipt
1510 ICD-10 Implementation – Clarification of Procedure Classification System (PCS) Code Structure and Reimbursement 06/02/2015 10/01/2016
1509 HCBS Waiver and Nursing Facility (NF) Level of Care (LOC) Review Process Webinar 05/28/2015 Immediately
1508 Implementation of Referring or Prescribing Provider Requirement for Prescription Medications Delayed 06/01/2015 Upon Receipt
1507 Cost Reporting Requirements 05/28/2015 Immediately
1506 Nursing Facility Level of Care Certification for HCBS Waiver Program Form 470-4392 05/15/2015 Upon Receipt
1505 Clarification on Exception to Policy (ETP) Rules and Procedures 05/06/2015 Immediately
1504 ICD-10 Implementation – Procedure Classification Systems Code Structure and Reimbursement                           05/04/2015 10/01/2015
1503
Core Standardized Assessment (CSA) for Elderly Waiver Service
05/01/2015 Immediately
1502 Documents for I-CDAC Enrollment Renewal 05/01/2015 Immediately
1501 HCBS Waiver Consumer Choices Option (CCO) Training Webinar 04/28/2015 Upon Receipt
1500 Iowa Medicaid Pharmacy Program Changes 04/21/2015 06/01/2015
1499 Healthy Behaviors Expansion 04/20/2015 01/01/2015
1498 Behavioral Health and Substance Abuse Services Appeal Process 03/31/2015 Immediately
1497 Claims Processing Changes and Clarification 03/25/2015 Immediately
1496 Initial Nursing Facility Care Evaluation and Management Codes 03/23/2015 05/01/2015
1495 ICD-10 Implementation-Centers for Medicare and Medicaid Services (CMS) Edits for ICD-10-CM Diagnosis Codes 03/26/2015 10/01/2015
1494 Individual CDAC Enrollment Renewal 04/03/2015 Immediately
1493 HCBS Settings Transition Plan Public Comment Period 03/12/2015 Upon Receipt
1492 HCBS Waiver Renewals and Amendments Public Comment Period 03/13/2015 Upon Receipt
1491 Supports Intensity Scale® and Off-Year Assessment Reports for Individuals with Intellectual Disability  03/30/2015 05/01/2015
1490 ICD-10 Testing Terms and Schedule Update 03/25/2015 Upon Receipt
1489 ICD-10 Implementation – Excludes1 Note ICD-10 Editing 04/08/2015 10/01/2015
1488

Alternative Reimbursement  

03/06/2015 04/01/2015
1487 HCBS AIDS/HIV Waiver Renewal and Children’s Mental Health (CMH) Waiver Amendment Public Comment Period   03/04/2015 Upon Receipt
1486 Proper Claim Submission for Medicare Psychiatric Reduction Copayments 03/06/2015 Upon Receipt
1485 ICD-10 Implementation-Claim Submission Code Set and Service Date Requirements 03/03/2015 10/01/2015
1484 Additional “J-Codes” that Require National Drug Codes (NDC) for Payment 03/02/2015 04/01/2015
1483 Dental Wellness Plan Wraparound Services-Clarification on Clinical Risk Assessment 02/24/2015 Immediately
1482 Preadmission Screening and Resident Review (PASRR) Updates 02/24/2015 Immediately
1481 Modification to the ICD-10 Testing Calendar 02/20/2015 Upon Receipt
1480 Cost Reporting Requirements 02/24/2015 Immediately
1479 2015 Civil Money Penalty Quality Improvement Initiative Grant (CMPQII) 02/16/2015 Upon Receipt
1478 Other Provider Preventable Conditions (OPPC) - Nursing Facilities (NF) 02/16/2015 03/01/2015
1477 ICD-10-CM Diagnosis Coding Conventions and Guidelines 02/04/2015 10/01/2015
1476 Coverage of Outpatient Prescribed Drugs for Hospice Patients 01/22/2015 02/17/2015
1475 HCBS Waiver Incident Report Training 01/20/2015 Up[on Receipt
1474 Provider Enrollment Application Fee - Delayed Implementation 01/14/2015 Upon Receipt
1473 Anesthesia Reimbursement Updates 01/14/2015 12/01/2014
1472 ICD-10 Testing of Claim Submission for Seamless Transition 01/14/2015 Upon Receipt
1471 Complex Pharmaceutical Oversight Program 01/07/2015 01/01/2015
1470 Background Checks and Program Exclusion Status 02/19/2015 Immediately
1469 Core Standardized Assessment (CSA) for Health and Disability, Physical Disability or AIDS/HIV Waiver Services 01/06/2015 Immediately