2016 Informational Letters

Effective on and after August 15, 2016, all Informational Letters published include a modifier after the Informational Letter number that designates which program(s) the Informational Letter applies to. The modifiers are: MC for Managed Care, FFS for Fee-for-Service and D for Dental. For example, Informational letters that pertain to managed care are designated with the letters "MC" at the end of the Informational Letter number. All Informational Letters for 2016, regardless of modifier, are included here. For more information see IL 1710.

Published Informational Letters

Letter #         Description Issue Date Effective Date
1753-MC-FFS Reimbursement of Emergency Room (ER) Visits 12/23/2016 04/01/2016
1752-MC-FFS Multiple Procedure Payment Reductions (MPPR) for Therapy Claims 12/19/2016 01/01/2017
1751-MC-FFS Important Mailing Dates to all Medicaid Members 12/15/2016 Upon Receipt
1750-MC-FFS Preferred Diabetic Syringes 12/15/2016 01/01/2017
1749-MC-FFS Reminder of Upcoming Webinar on the Revised Critical Incident Report (CIR) Form 470-4698 12/09/2016 01/01/2017
1748-FFS Use of Modifier “82” for Surgical Assistance 12/13/2016 01/01/2017

Change in Provider Enrollment Application Fee

12/01/2016 01/01/2017
1746-MC-FFS-D Iowa Medicaid Pharmacy Program Changes 11/28/2016 01/01/2017
1745-MC-FFS Iowa Medicaid Critical Incident Reporting (CIR) Revision and Training for HCBS and Habilitation Providers 11/22/2016 01/01/2017
1744-MC Accountable Care Organization (ACO) Participating Tax Identification Numbers (TINs) 11/18/2016 Immediately
1743-MC-FFS Limitations of HCBS Home Delivered Meals 11/10/2016 Immediately
1742-MC-FFS-D Electronic Health Record (EHR) Incentive Program 11/07/2016 Immediately
1741-MC-FFS Supplementation Submission 11/22/2016 Upon Receipt
1740-FFS Residential Care Facility (RCF) Maximum Per Diem Rate Increase and Personal Needs Allowance Decrease 11/03/2016 01/01/2017
1739-MC Electronic Visit Verification (EVV) 11/01/2016 Immediately
1738-FFS Monthly Provider Assessment Update 11/04/2016 07/01/2016
1737-MC-FFS-D New Centers for Medicare and Medicaid Services (CMS) Guidance on Access and Cultural Considerations 11/01/2016 Immedialtey
1736-MC-FFS-D Statewide Alert Notification (SWAN) Process Change 10/27/2016 Immediately
1735-MC-FFS Hospice Provided in an Intermediate Care Facility for the Intellectually  Disabled (ICF/ID) 11/01/2016 Immediately
1734-MC-FFS-D Documentation Submission Process 11/01/2016 12/01/2016
1733-MC IA Health Link- Extension of Due Dates for Medicaid Managed Care Wraparound Payments and Further Clarification 10/27/2016 Immediately
1732-MC-FFS Reminder – Iowa Wellness Plan (IWP) Copayment Requirement Non-emergent Use of the Emergency Department (ED) 10/28/2016 12/01/2016
1731-MC-FFS-D Affordable Care Act Section 1557 Operational Requirements 11/04/2016 Immediately
1730-MC-FFS-D Affordable Care Act Section 1557 Communications Requirements 11/04/2016 Immediately
1729-MC-FFS 2016 Provider Quality Management Self-Assessment 10/19/2016 Upon Receipt
1728-MC Further Clarification of the IA Health Link Managed Care Wraparound Payments 10/10/2016 Immedialtey
1727-MC-FFS-D Annual Submission Requirements - Employee Policies Regarding Prevention and Detection of Medicaid Fraud and Abuse 10/06/2016 Immediately
1726-MC-FFS Managed Care Information available through the Individualized Services Information System (ISIS) 10/05/2016 Immediately
1725-MC-FFS-D 1915(b)(3) Mental Health and Substance Abuse Services 09/29/2016 04/01/2016
1724-MC-FFS IA Health Link Newborn Eligibility 10/24/2016 04/01/2016
1723-MC-FFS-D Reminder - Provider Enrollment Renewal 09/19/2016 Immediately
1722-MC-FFS Iowa Medicaid Pharmacy Program Changes 09/14/2016 10/01/2016
1721-FFS Implementation and Reprocessing of Inpatient Hospital Rebase and Recalibration and Outpatient Hospital Rebase 09/14/2016 Immediately
1720-MC-FFS Approval of the HCBS Waiver Settings Statewide Transition Plan (STP) 09/14/2016 Immedialtey
1719-MC-FFS Same Day Billing for Mental Health and Primary Care Services 09/19/2016 10/01/2016
1718-MC Electronic Visit Verification (EVV) 09/14/2016 Upon Receipt
1717-MC-FFS In-Home Health Related Care (IHHRC) and Iowa Medicaid 09/07/2016 Immediately
1716-MC-FFS Iowa Medicaid Pharmacy Program Changes
Replaced by Info Letter 1722-MC-FFS
08/30/2016 10/01/2016
1715-D Interpretive Services 08/30/2016 Immediately
1714-MC-FFS-D IA Health Link-Managed Care Wraparound Payments-Updated Forms and Clarifications 08/22/2016 Immediately
1713-MC-FFS Crossover Claims for Ambulance Services for Dually Eligible Medicare and Medicaid Members 08/22/2016 Immediately
1712-D Dental Wellness Plan (DWP) Program Clarifications 08/17/2016 Immediately
1711-MC-FFS HH Agency Condition Codes-Clarification 08/15/2016 08/01/2016
1710 New Naming Convention for Informational Letters (ILs) 08/11/2016 08/05/2016
1709-MC-FFS-D Annual Provider Training 2016 08/15/2016 Upon Receipt
1708 Electronic Health Record (EHR) Incentive Program Webinar 08/09/2016 Immediately
1707-MC HCBS Rate and Rate Floor Changes 08/05/2016 07/01/2016
1706-MC Respiratory Syncytial Virus (RSV) 2016-2017 Season 08/01/2016 Immediately
1705-MC Pharmacy Dispensing Fee Change 07/28/2016 08/01/2016
1704-MC HCBS Waiver Slot Attrition Guidelines 08/05/2016 Immediately
1703 Release of HCBS Waiver Slots 08/09/2016 07/01/2016
1702 Provider Enrollment Renewal 2016 08/01/2016 Immediately
1701-MC IA Health Link-Managed Care Wraparound Payments 07/25/2016 04/01/2016
1700 HCBS Prevocational and Supported Employment Service Procedure 07/25/2016 09/01/2016
1699-MC IA Health Link-Extension of Due Date for Managed Care Wraparound Payments 07/21/2016 04/01/2016
1698 Electronic Health Record (EHR) Incentive Program Webinar 07/19/2016 Immediately
1697-MC Medicaid HCBS Projected Rate Setting- Supplemental Schedule D-4 07/25/2016 Immediately
1696 Dental Wellness Plan Announcements 07/12/2016 Immediately
1695-MC Cost Reporting Requirements and Medicaid Fee-For-Service (FFS) Cost Settlement 07/15/2016 Immediately
1694-MC HH Agency Condition Codes 07/20/2016 08/01/2016
1693-MC Testing Completed for Medicare Crossover Claims-Coordination of Benefits (COB) with MCOs 07/12/2016 07/25/2016
1692-MC Service Plan Extensions 07/01/2016 07/01/2016
1691 Ambulance Claims Processing Changes 07/05/2016 07/01/2016
1690 Age of Adulthood for IHH Tier and Payment-Clarification 07/12/2016 Immediately
1689-MC File Transfer Data from the IME to MCOs 07/01/2016 Immediately
1688 Home- and Community-Based Services (HCBS) Habilitation
Replaced by Info Letter 1754-FFS
07/05/2016 04/01/2016
1687-MC Non-emergency Medical Transportation (NEMT) and Home and Community Based Services (HCBS) Waiver Transportation Update
07/01/2016 Immediately
1686-MC Testing Period Extended for Medicare Crossover Claims-Coordination of Benefits (COB) with MCOs 06/28/2016 Immediately
1685-MC Monthly Provider Assessment Update
Replaced by Info Letter 1738-FFS
06/23/2016 07/01/2016
1684 Provider Enrollment Application Fee 06/22/2016 08/01/2016
1683-MC Iowa Medicaid Pharmacy Program Changes 06/22/2016 08/01/2016
1682 Electronic Health Record (EHR) Incentive Program Webinar 06/17/2016 Immediately
1681-MC Qualifications of Community Based Case Management (CBCM) through the IA Heath Link 06/16/2016 Immediately
1680-MC Quitline Iowa for Smoking Cessation 06/13/2016 07/01/2016
1679 Age of Adulthood for IHH Tier and Payment 06/10/2016 07/01/2016
1678-MC Home- and Community-Based Services (HCBS) Waiver Funding and Service Planning 06/06/2016 Immediately
1677 interRAI™ Assessments 07/19/2016 Immediately
1676 Pharmacy Point of Sale (POS) - Nonprescription or Over-the-Counter (OTC) Drugs 06/03/2016 07/18/2016
1675-MC Waiver Provider Requirements-Reminders 05/26/2016 Upon Receipt
1674-MC Level of Care (LOC) Process-Clarification 05/25/2016 04/01/2016
1673-MC IA Health Link Newborn Coverage 05/25/2016 04/01/2016
1672-MC Process for American Indian/Alaskan Natives (AI/AN) “Race Option” Member Application 05/10/2016 Immediately
1671-MC Service Plan Extensions 05/04/2016 04/01/2016
1670 Radiology Prior Authorization (PA) Submission Process Changes 05/20/2016 07/01/2016
1669 Reminder-IME Processing of Medicare Crossover Claims 05/10/2016 Upon Receipt
1668 Submitting Claims to the IME after Third Party Liability (TPL) Adjudication 05/04/2016 Upon Receipt
1667 Dental Wellness Plan 05/03/2016 Immediately
1666 Electronic Health Record (EHR) Incentive Program 05/05/2016 Immediately
1665 HCBS Prevocational and Supported Employment Service Changes 05/03/2016 05/04/2016
1664-MC Iowa Medicaid Pharmacy Program Changes 04/29/2016 06/01/2016
1663 Physician-Administered Drugs and National Drug Code (NDC) Billing Requirements 04/27/2016 Immediately
1662 IME Billing Tips 04/27/2016 Immediately
1661-MC Updated - Child Care Medical Services 04/12/2016 04/01/2016
1660-MC Minimum Data Set (MDS) 3.0 Section “Q” Referral Process 04/14/2016 04/01/2016
1659-MC Child Care Medical Services
Replaced by Info Letter 1661-MC
04/08/2016 04/01/2016
1658 HCBS Waiver and State Plan HCBS Amendments 04/07/2016 Immediately
1657-MC Billing for Medicaid Services - Updated 04/04/2016 Immediately
1656-MC IA Health Link- Managed Care Wraparound Services
Wrap Around Support Master Template
04/01/2016 04/01/2016
1655-MC Updates for Psychiatric Medical Institutions for Children (PMIC) 03/30/2016 04/01/2016
1654 Nonprescription or Over-the-Counter (OTC) Drugs 03/30/2016 Immediately
1653-MC Tobacco Cessation Coverage and the IA Health Link 03/30/2016 04/01/2016
1652-MC Billing for Hospital Services 03/30/2016 Immediately
1651-MC Community-Based Neurobehavioral Rehabilitation Services (CNRS) 04/07/2016 04/01/2016
1650-MC Eligibility and Verification Information System (ELVS) and Checking Eligibility with the MCOs 03/31/2016 Immediately
1649-MC Lock-In (LI) Program for Medicaid Fee-for-Service (FFS) Members 03/30/2016 04/01/2016
1648-MC Update-Electronic Billing 04/07/2016 04/01/2016
1647 Enrollment Renewal for Medicaid Providers 03/24/2016 Immediately
1646 Updated - Federal Upper Limit (FUL) Pharmacy Reimbursement 03/30/2016 05/01/2016
1645-MC Enrollment and Payment Policies for PA Services 03/30/2016 04/01/2016
1644-MC Medicaid Preferred Drug List for Medicaid and hawk-i Members 03/28/2016 04/01/2016
1643-MC Incident Reporting Notice 03/30/2016 04/01/2016
1642-MC Reimbursement for Vaccines for hawk-i Members 03/30/2016 04/01/2016
1641-MC Billing for Medicaid Services
Replaced by Info Letter 1657-MC
04/01/2016 Immediately
1640-MC CDAC Claim Forms and Submission Details for the MCOs 04/01/2016 04/01/2016
1639-MC Mental Health and Substance Abuse Services Billed on the UB-04 03/21/2016 01/01/2016
1638-MC Update - 340B Drug Pricing Program 03/21/2016 Immediately
1637-MC Daily Nursing Facility Room and Board Reimbursement 04/07/2016 04/01/2016
1636-MC Update to Monthly Provider Assessment
Replaced by Info Letter 1685-MC
03/14/2016 04/01/2016
1635-MC Electronic Billing
Replaced by Info Letter 1648-MC
03/30/2016 04/01/2016
1634 2016 Civil Money Penalty Quality Improvement Initiative Grant (CMPQII) 03/17/2016 Immediately
1633 Medicaid Member Co-pay Clarification 03/17/2016 Immediately
1632-MC Money Follows the Person (MFP) Program
Money Follows the Person Services Chart
03/14/2016 Upon Receipt
1631-MC Non-emergency Medical Transportation (NEMT) IA Health Link Transition Update 03/04/2016 03/28/2016
1630 Annual Restraint and Seclusion Attestation Letters and Incident Reporting 03/17/2016 Immediately
1629 Iowa Medicaid Pharmacy Program Changes 03/07/2016 04/11/2016
1628-MC Prior Authorizations (PA) for Providers Participating with MCOs 03/11/2016 04/01/2016
1627-MC Updated - Managed Care Organization (MCO) Pharmacy Provider Reimbursement Rate Floors 03/14/2016 04/01/2016
1626-MC Managed Care Organization (MCO) Pharmacy Billing Reference
Iowa Medicaid MCO Pharmacy Billing Reference
03/07/2016 04/01/2016
1625 Clarification of Attending Physician Requirement on Claims 03/09/2016 04/01/2016
1624-MC Launch of IA Health Link set for April 1, 2016 02/24/2016 Immediately
1623-MC Autism Related Services and Supports 02/24/2016 01/01/2016
1622-MC Non-emergency Medical Transportation (NEMT) IA Health Link Transition Update
Replaced by Info Letter 1631-MC
03/02/2016 03/18/2016
1621-MC Home and Community Based Services (HCBS) Habilitation 02/18/2016 01/01/2016
1620 Magellan Claim Wrap-up 02/18/2016 Immediately
1619-MC Medicare Crossover Claims-Coordination of Benefits (COB) with MCOs 03/21/2016 04/01/2016
1618 Documentation Submission Process for Home and Community Based Services (HCBS) Waivers, Habilitation Level of Care Reviews and Waiver Prior Authorization Reviews 03/01/2016 Immediately
1617-MC Cost Reporting and Reimbursement 03/08/2016 01/01/2016
1616 Balancing Incentive Program (BIP) Core Standardized Assessment (CSA) Implementation of SIS-C® Assessment for Children 02/12/2016 03/01/2016
1615-MC WellCare of Iowa, Inc. Reassignment 02/05/2016 Immediately
1614 Pharmacy Cost of Dispensing Survey 02/05/2016 02/03/2016
1613-MC Billing Updates for Mental Health and Substance Abuse Services
Replaced by IL 1829-MC-FFS
02/01/2016 01/01/2016
1612-MC Ownership and Control Disclosure Requirements 01/29/2016 Immediately
1611-MC WellCare of Iowa, Inc. Reassignment
Replaced by Info Letter 1615-MC
01/29/2016 Immediately
1610 Change in Quality Assurance Assessment Fee (QAAF) 02/03/2016 07/01/2015
1609-MC Billing Updates for Mental Health and Substance Abuse Services
Replaced by Info Letter 1613-MC
01/29/2016 01/01/2016
1608-MC Service Plan Extensions
Replaced by Info Letter 1671-MC
01/28/2016 03/01/2016
1607-MC Updated-Prior Authorizations (PA) for Providers Participating with Managed Care Organizations (MCOs)
Replaced by Info Letter 1628-MC
01/21/2016 03/01/2016
1606-MC Updates for Psychiatric Medical Institutions for Children (PMIC) 01/22/2016 01/01/2016
1605 Home and Community Based Services (HCBS) Waiver Statewide Transition Plan 01/22/2016 02/01/2016
1604-MC Monthly Provider Assessment
Replaced by Info Letter 1636-MC
01/22/2016 03/01/2016
1603 Updated Mental Health and Substance Abuse Services and “B-3” Services Fee Schedules 01/14/2016 01/01/2016
1602 Electronic Health Record (EHR) Incentive Program 01/15/2016 Immediately
1601 Habilitation Incident Reporting Process 01/08/2016 Immediately
1600-MC 2016 Medicaid Modernization Update Training for Providers 01/08/2016 Immediately
1599 Updates for Integrated Health Homes 01/08/2016 01/01/2016
1590 Important Phone Announcement - New Phone Line for Billing Agencies 01/19/2016 Immediately