Iowa Medicaid's procurement office issues a Request for Proposal (RFP) to find organizations to handle different aspects of healthcare. RFPs require detailed answers in each request, outlined in the Bidders' Libraries.
Bidders' Libraries
- Iowa Medicaid
- Iowa Medicaid Organization Chart (79.76 KB) .pdf
- Agency Dashboards
- Iowa Medicaid Dashboard
- HHS Telework Policy (993.04 KB) .pdf
Current Contract Documents
Executed MED-20-004 Original Contract (5.04 MB) .pdf
Executed Amendment 1 MED-20-004 (530.91 KB) .pdf
Executed Amendment 2 MED-20-004 (1.21 MB) .pdf
Executed Amendment 3 MED-20-004 (403.14 KB) .pdf
Executed Amendment 4 MED-20-004 (98.82 KB) .pdf
Executed Amendment 5 MED-20-004 (132.5 KB) .pdf
Executed Amendment 6 MED-20-004 (236.02 KB) .pdf
Executed Amendment 7 MED-20-004 (183.25 KB) .pdf
Current standard operating procedures
- CSA -SOP APPEALS_092025.pdf (109.35 KB) .pdf
- CSA Assessment Training (98.22 KB) .pdf
- CSA Assessment (641.89 KB) .pdf
- CSA Communications (0 bytes) .pdf
- CSA Complaints (134.84 KB) .pdf
- CSA Compliment (140.2 KB) .pdf
- CSA ENA (2.17 MB) .pdf
- CSA Health Literacy (110.21 KB) .pdf
- CSA Information Security (141.19 KB) .pdf
- CSA OYA (668.68 KB) .pdf
- CSA QA (140.2 KB) .pdf
- CSA Referral Scheduling (2.17 MB) .pdf
Current monthly reports
- Monthly By Waiver Report July 25 (35.58 KB) .xlsx
- Monthly By Waiver Report Aug. 25 (159.92 KB) .pdf
- Monthly By Waiver Report Sept. 25 (37.41 KB) .xlsx
- Monthly By Waiver Report Oct. 25 (39.75 KB) .xlsx
- Monthly By Waiver Report Nov. 25 (40.42 KB) .xlsx
- Monthly By Waiver Report Dec. 25 (39.65 KB) .xlsx
- Monthly Performance Report July 25 (72.63 KB) .pdf
- Monthly Performance Report Aug. 25 (72.83 KB) .pdf
- Monthly Performance Report Sept. 25 (71.74 KB) .pdf
- Monthly Performance Report Oct 25 (70.46 KB) .pdf
- Monthly Performance Report Nov.25 (28.89 KB) .xlsx
- Monthly Performance Report Dec. 25 (27.43 KB) .xlsx
Assessment counts by type for January 1, 2023 through December 31, 2025 (17.9 KB) .xlsx
HOME waiver redesign information, including quick guides for phases 1 and 2
- HOME Phase 1 Waiver service quick guide (219.1 KB) .pdf
- HOME Phase 2 Waiver service quick guide (195.92 KB) .pdf
Assessment Tool Questionnaires
- Current Waiver Members Assessment Tool Questionnaire Desk Guide (403.27 KB) .docx
- Current Member Screeners for Adults and Children (DRAFT)
- New Waiver Members Assessment Tool Questionnaire Desk Guide (631.18 KB) .docx
- New Member Screeners for Adults and Children (DRAFT)
interRAI Supplemental Questions
- IA HOME Adult Core Set of Questions (120.55 KB) .docx
- IA HOME Child Core Set of Questions (183.85 KB) .pdf
IoWANS workflows
- CFO764 (239.35 KB) .pdf
- CFO782 (275.74 KB) .pdf
- CFO790 (241.63 KB) .pdf
- CFO791 (219.79 KB) .pdf
- CFO792 (264.67 KB) .pdf
- CFO811 (148.85 KB) .pdf
- CFO813 (135.17 KB) .pdf
- MFO701 (214 KB) .pdf
Off Year Assessment
Emergency Needs Assessment
Iowa Medicaid
- Iowa Medicaid
- Iowa Medicaid Organization Chart (79.76 KB) .pdf
- Iowa Health Link Program
- Managed Care Contracts
- Iowa Medicaid Dashboard
- Iowa Medicaid Strategic Plan (337.58 KB) .pdf
Member Communication
Member Demographics
Users can find detailed information on member demographics. The section allows users the ability to filter by date, plan coverage group, age, gender, race/ethnicity, county and any of these combinations.
Key financial metrics are found here, including net rates cells, Medical Loss Ratios (MLR), Third Party Liability (TPL), historical expenditures, market shares based on expenditures and financial information by county.
Bidder's Conference Presentation Documents
- IA Health Link - SFY26 Rate Development (438.14 KB) .pdf
- IA Health Link - SFY26 Rate Estimate Appendices (81.51 KB) .xlsx
- Optumas_IA RFP Rate Estimate PPT (445.5 KB) .pdf
- MED-26-001 IA Health Link Bidder's Conference PPT (1.82 MB) .pdf
Provider
Policy
Programs
Long Term Services and Supports
- Facility
- HCBS
- HCBS Waivers
- HCBS Critical Incident Form (239.1 KB) .pdf
- MFP
- CCO
- HBCS Settings
- 1915i Habilitation Services
- Pharmacy - note that these links may be inactive due to Change Healthcare's nationwide outage. More information here.
- Informational Letters
- Pharmacy Reimbursement
- Pharmacy POS Informational Letters
State Plan Waivers
- State Plan
- 1915c
- Iowa Health and Wellness
- 1915b Wavier Narrative and 1915b Wavier Appendix
- 1915i
IA Health Link Performance Reports
Business Requirements Documents
- Social Determinants of Health (202.96 KB) .docx
- Service Plan Active Monthly Snapshot (138.57 KB) .docx
Vendor Security Questionnaire (VSQ)
Current Contract Documents
MED-19-003 Executed (2.98 MB) .pdf
MED-19-003 Executed Amendment 1 (411.04 KB) .pdf
MED-19-003 Executed Amendment 2 (292.36 KB) .pdf
MED-19-003A Executed Amendment 3 (1.63 MB) .pdf
MED-19-003A Executed Amendment 5 (297.11 KB) .pdf
MED-19-003A Int'l Business Machines Corp AMD4 Signed (794.12 KB) .pdf
Managed Care Plan Oversight Templates
Final Amendment F1 Iowa Financial MRT-TPL (30.35 KB) .xlsx
MCP PI1-P17 Program Integrity Report (395.26 KB) .xlsx
MCP PI8-PI10 Program Integrity Cumulative-Quarterly Update and Reporting (38.6 KB) .xlsx
MCP PI11 Single Case Agreement Quarterly Report (11.26 KB) .xlsx
MCP PI12 Program Integrity Annual Work Plan (13.25 KB) .xlsx
MCP PI13 Program Integrity Compliance Plan (38.7 KB) .docx
MCP PI14 Non-PI Recoveries (54.09 KB) .xlsx
Member Tip Form (95.43 KB) .pdf
Program Integrity Reporting Companion Guide (86.19 KB) .docx
Program Integrity Templates and Matrix
Monthly Program Integrity Reporting (38.37 KB) .xlsx
PI1 Investigative Activities Report (292.25 KB) .xlsx
Reporting Plan Template (11.94 KB) .xlsx
Provider Alert List Templates
Dental Provider Alert List (695.46 KB) .xlsx
Medical Provider Alert List (695.24 KB) .xlsx
Standard Operating Procedures
Audits and Investigations
Cost Avoidance Study Proposal (649.62 KB) .pdf
Deficit Reduction Act (375.1 KB) .pdf
Full Review Investigative Process (685.8 KB) .pdf
Guidelines for Preparation and Management of Provider Appeal Related to FWA (113.04 KB) .pdf
Payment Error Rate Measurement (PERM) Process (365.28 KB) .pdf
Provider On-Site Reviews (519.99 KB) .pdf
Unified Program Integrity Contractor (UPIC) Investigation Collaboration
Vetting of Tips and Referrals (749.11 KB) .pdf
Data Analytics
Deceased Provider File Comparison
Identifying and Recouping Capitation Payments for Deceased Members (568.61 KB) .pdf
Identifying and Recouping Capitation Payments for HIPP Members (76.79 KB) .pdf
Identifying and Recouping Capitation Payments for Incarcerated Members (79.33 KB) .pdf
Financial
Complying with State Auditor Requests (462.41 KB) .pdf
Confirming PI Credit Balances for Revenue Collections (437.4 KB) .pdf
Deceased Providers (536.86 KB) .pdf
Deficit Reduction Act of 2005, Section 6032: Reviewing Provider Policies
Extrapolating Error Rate from Statistical Sampling to Larger Populations (476.19 KB) .pdf
Interest on Program Integrity Overpayments (472.77 KB) .pdf
Maintaining and Updating the Over 60-Day Report (386.89 KB) .pdf
Overpayment Findings, Revision, in AR Database to Original Findings
Overpayment, Claims Billed Using Deceased Provider Numbers (262.59 KB) .pdf
Overpayments, DIA and MFCU Recoveries (357.86 KB) .pdf
Preparing to Release or End Liens Against Provider Real Property (374.37 KB) .pdf
Receiving and Processing Iowa Department of Revenue Recovery Reports (445.52 KB) .pdf
Receiving and Processing Transfers of Overpayments from other Iowa Medicaid Units (452.76 KB) .pdf
Verification of Financial Data in Recoupment Spreadsheets (291.72 KB) .pdf
Verification of Month-End AR Data Uploaded to the Data Warehouse (453.4 KB) .pdf
Write-Off of Uncollectable Program Integrity Accounts Receivable (424.74 KB) .pdf
Managed Care Oversight
MCP On-Site Audits (441.48 KB) .pdf
MCP Provider Notice Process (571.92 KB) .pdf
Performance Tracking and Dashboards (647.03 KB) .pdf
Preparing MCP Monthly Meetings (561.71 KB) .pdf
Provider Alert List (624.76 KB) .pdf
Provider Enrollment from MCP Provider Actions (628.31 KB) .pdf
Real Time Open Case Report Process (617.37 KB) .pdf
Responding to MFCU Referrals (479.12 KB) .pdf
Review of Monthly MCP Report for Monthly Template Questions (379.48 KB) .pdf
Reviewing of Annual MCP Report
Reviewing of Monthly MCP Report (568.97 KB) .pdf
Review of Quarterly MCP Report
Sending a Good Cause Exception (GCE) Request
Sending a Tip Referral to MCP (550.74 KB) .pdf
Special Projects (Ad Hocs) (536.88 KB) .pdf
Updating the MFCU Referral Case Review Spreadsheet (560.08 KB) .pdf
Iowa Medicaid Resources
Iowa Medicaid Organization Chart (79.76 KB) .pdf
Managed Care Contracts and Prior Managed Care Procurements
HHS Telework Policy (993.04 KB) .pdf
Iowa Medicaid Strategic Plan (337.58 KB) .pdf
Policy
About Iowa Medicaid (Medicaid Program Information)
Iowa Medicaid Organizational Chart
Iowa Medicaid Table of Organization
Previous Procurement Documents for Technical Assistance and Program Support for Iowa Medicaid
Previous RFP Documents
- Berry Dunn Cost Proposal (176.99 KB) .pdf
- Berry Dunn Technical Proposal (4.5 MB) .pdf
- Health Management Cost Proposal (130.07 KB) .pdf
- Health Management Technical Proposal (2.87 MB) .pdf
- Mercer Cost Proposal (488.59 KB) .pdf
- Mercer Technical Proposal (24.77 MB) .pdf
- Navigant Cost Proposal (121.28 KB) .pdf
- Navigant Technical Proposal (5.22 MB) .pdf
- Sellers Dorsey Cost Proposal (429.21 KB) .pdf
- Sellers Dorsey Technical Proposal (3.55 MB) .pdf
- RFP Scoring Sheet (84.5 KB) .xls
Previous and Current Contract Documents
- MED-13-011 Contract – Executed (2.18 MB) .pdf
- MED-13-011 Amendment 1 - Executed (114.8 KB) .pdf
- MED-13-011 Contract Renewal - Executed (47.34 KB) .pdf
- MED-19-011 Contract – Executed (595.83 KB) .pdf
- MED-19-011 Amendment 1 – Executed (475.72 KB) .pdf
- MED-19-011 Amendment 2 – Executed (208.52 KB) .pdf
- MED-19-011 Amendment 3 – Executed (88.82 KB) .pdf
- MED-19-011 Amendment 4 – Executed (358.6 KB) .pdf
- MED-19-011 Amendment 5 – Executed (230.43 KB) .pdf
- Payments for Past Fiscal Years (90.8 KB) .pdf
Executed Amendment 1 MED-19-001 (384.61 KB) .pdf
Executed Amendment 2 MED-19-001 (207.37 KB) .pdf
Executed Amendment 3 MED-19-001 (99.81 KB) .pdf
Executed Amendment 4 MED-19-001 (516.3 KB) .pdf
Executed Amendment 5 MED-19-001 (412.92 KB) .pdf
Executed Contract MED-19-001 Actuarial Services (8.12 MB) .pdf
Iowa Medicaid Member Population (477.99 KB) .pdf
Iowa Medicaid Resources
- Iowa Medicaid Homepage
- Iowa Medicaid Organization Chart (79.76 KB) .pdf
- Agency Dashboards
- Iowa Health Link
- Informational Letters
Enrollment Queue Only Calls for MBR and Hawki (16.44 KB) .xlsx
Sample Appeal Documents
- Blank Claims Appeal Summary (55.31 KB) .pdf
- Contribution Appeal Summary Template (96.04 KB) .pdf
- ME Denial Appeal Summary Template (240.55 KB) .pdf
- ME Review Cancellation Appeal Summary Template (66.61 KB) .pdf
- Redacted Claim Exhibit (50.28 KB) .pdf
- Redacted Med Exempt Denial Letter (44.22 KB) .pdf
- Redacted Med Exempt Survey (16.1 KB) .pdf
Reports
- Sample Performance Reporting Tool (107.14 KB) .pdf
- Emails Managed Per Month (35.89 KB) .pdf
- Member Services Call Volumes (49.35 KB) .pdf
Call Volume Monthly Reports
- February 2019 (475.8 KB) .pdf
- March 2019 (501.98 KB) .pdf
- April 2019 (503.92 KB) .pdf
- May 2019 (498.63 KB) .pdf
- June 2019 (496.43 KB) .pdf
- July 2019 (471.56 KB) .pdf
- August 2019 (471.5 KB) .pdf
- September 2019 (415.1 KB) .pdf
- October 2019 (478.64 KB) .pdf
- November 2019 (477.61 KB) .pdf
- December 2019 (491.9 KB) .pdf
- January 2020 (498.11 KB) .pdf
- February 2020 (496.94 KB) .pdf
- March 2020 (410.88 KB) .pdf
- April 2020 (499.42 KB) .pdf
- May 2020 (499.85 KB) .pdf
- June 2020 (499.14 KB) .pdf
- July 2020 (497.29 KB) .pdf
- August 2020 (500.19 KB) .pdf
- September 2020 (497.74 KB) .pdf
- October 2020 (502.23 KB) .pdf
- November 2020 (496.94 KB) .pdf
- December 2020 (504.32 KB) .pdf
- January 2021 (523.72 KB) .pdf
- February 2021 (523.69 KB) .pdf
- March 2021 (524.5 KB) .pdf
- April 2021 (502.51 KB) .pdf
- May 2021 (499.98 KB) .pdf
- June 2021 (525.59 KB) .pdf
- July 2021 (501.65 KB) .pdf
- August 2021 (518.47 KB) .pdf
- September 2021 (522 KB) .pdf
- October 2021 (499.52 KB) .pdf
- November 2021 (499.34 KB) .pdf
- December 2021 (499.2 KB) .pdf
- January 2022 (502.49 KB) .pdf
- February 2022 (413.19 KB) .pdf
- March 2022 (500.63 KB) .pdf
- April 2022 (501.11 KB) .pdf
- May 2022 (522.16 KB) .pdf
- June 2022 (499.64 KB) .pdf
- July 2022 (519.07 KB) .pdf
- August 2022 (502.17 KB) .pdf
- September 2022 (501.17 KB) .pdf
- October 2022 (503.22 KB) .pdf
- November 2022 (498.61 KB) .pdf
- December 2022 (500.38 KB) .pdf
- January 2023 (504.65 KB) .pdf
- February 2023 (504.31 KB) .pdf
- March 2023 (505.3 KB) .pdf
- April 2023 (574.41 KB) .pdf
- May 2023 (578.38 KB) .pdf
- June 2023 (505.06 KB) .pdf
- July 2023 (527.72 KB) .pdf
- August 2023 (507.65 KB) .pdf
- September 2023 (504.58 KB) .pdf
- October 2023 (505.25 KB) .pdf
- November 2023 (506.95 KB) .pdf
- December 2023 (506.46 KB) .pdf
- January 2024 (507.45 KB) .pdf
- February 2024 (509.51 KB) .pdf
- March 2024 (509.41 KB) .pdf
- April 2024 (510.66 KB) .pdf
- May 2024 (510.5 KB) .pdf
- June 2024 (512.06 KB) .pdf
- July 2024 (509.17 KB) .pdf
- August 2024 (515.36 KB) .pdf
Initial Contract (4.33 MB) .pdf
Amendments
- MED-19-012: Amendment 1 (573.96 KB) .pdf
- MED-19-012: Amendment 2 (213.6 KB) .pdf
- MED-19-012: Amendment 3 (285.49 KB) .pdf
- MED-19-012: Amendment 4 (199.65 KB) .pdf
- MED-19-012: Amendment 5 (199.68 KB) .pdf
- MED-19-012: Amendment 6 (1.52 MB) .pdf
- MED-19-012: Amendment 7 (249.03 KB) .pdf
- MED-19-012: Amendment 8 (244.72 KB) .pdf
- MED-19-012: Amendment 9 (272.2 KB) .pdf
- MED-19-012: Amendment 10 (240.11 KB) .pdf
- MED-19-012: Amendment 11 (238.91 KB) .pdf
- MED-19-012: Amendment 12 (452.1 KB) .pdf
- MED-19-012: Amendment 13 (293.91 KB) .pdf
- MED-19-012: Amendment 14 (175.19 KB) .pdf
- MED-19-012: Amendment 15 (173.39 KB) .pdf
Documents
- MEM - Accessing Language Line/Telecommunications Device for the Deaf (TDD) (56.7 KB) .pdf
- MEM – Calls about Accounts Receivable and Accounts Payable Issues (281.59 KB) .pdf
- MEM – CC – 1095-B Mail Process (55.26 KB) .pdf
- MEM – CC – After Hours Callbacks (55.43 KB) .pdf
- MEM – CC – Creating and Completing Contact Logs (53.24 KB) .pdf
- MEM – CC – Determining Review Date and Issuing Review Paperwork (55.21 KB) .pdf
- MEM – CC – DHS Services Portal Planned Outages (50.81 KB) .pdf
- MEM – CC – Member Calls to Appeal a DHS Decision (58.47 KB) .pdf
- MEM – CC – Member Calls to Submit Phone Application (53.73 KB) .pdf
- MEM – CC – Workers Call to Report an ELIAS System Issue (54.13 KB) .pdf
- MEM – Dental Carrier Good Cause Disenrollment (144.15 KB) .pdf
- MEM – ELIAS Planned Outages (51.18 KB) .pdf
- MEM – MPEP Unplanned Outages (52.17 KB) .pdf
- MEM-Fee-for-Service (FFS) Member Calls Regarding Bills or Refusals of Service (69.79 KB) .pdf
- MEM – Medical Assistance Advisory Council (MAAC) Minutes IA Health Link Public Comment Meeting Minutes (279.2 KB) Archived .pdf
- MEM – Medical Assistance Advisory Council (MAAC) IA Health Link Public Comment Meetings (281.8 KB) .pdf
- MEM – Medical Assistance Advisory Council (MAAC) Minutes (279.2 KB) Archived .pdf
- MEM – Medical Assistance Advisory Council (MAAC) Public Member Employment (309.19 KB) .pdf
- MEM – Medical Assistance Advisory Council (MAAC) Public Member Reimbursement (313.05 KB) .pdf
- MEM – Managed Care Enrollment Form Complete (58.02 KB) .pdf
- MEM – Managed Care Good Cause Disenrollment (65.54 KB) .pdf
- MEM – Managed Care Organization (MCO) Escalated Issues – Member Services (137.87 KB) .pdf
- MEM – Managed Care Quarterly Reports (47.84 KB) .pdf
- MEM – Mass Disenrollment Procedures (52.01 KB) .pdf
- MEM – Managed Care Organization (MCO) Escalated Issues – Member Services (137.87 KB) .pdf
- MEM – Managed Care Organization (MCO) Urgent Issues – Member Services (57.23 KB) .pdf
- MEM – Medical Assistance Advisory Council (MAAC) Agenda (278.96 KB) Archived .pdf
- MEM – Medicare Buy-In Quality Assurance (56.47 KB) .pdf
- MEM – IME Member Services Electronic Communications (52.66 KB) .pdf
- MEM – Medicare E-Mail Process (199.36 KB) .pdf
- MEM - Member Requests for Claims History (54.71 KB) .pdf
- MEM – Annual Reminder (213.42 KB) .pdf
- MEM – Member Calls about Accounts Receivable and Accounts Payable Issues (281.59 KB) .pdf
- MEM - Member Calls about Third-Party Liability Issues (68.6 KB) .pdf
- MEM - Member Calls Involving Appeals (243.47 KB) .pdf
- MEM - Member Calls for Eligibility and Benefits (159.63 KB) .pdf
- MEM-Fee-for-Service (FFS) Member Calls Regarding Bills or Refusals of Service (69.79 KB) .pdf
- MEM – Member Calls Regarding Health Insurance Portability and Accountability Act (HIPAA) Breaches (54.89 KB) .pdf
- MEM – Member Complaints (55.3 KB) .pdf
- MEM - Member Demographic Change – Field Office Notification (56.01 KB) .pdf
- MEM - Member Requests for Claims History (54.71 KB) .pdf
- MEM - Member Services Supply Orders (53.42 KB) .pdf
- MEM – Choice Counseling Policies and Procedures (53.62 KB) .pdf
- MEM – Dental Wellness Plan Carrier Selection (53.29 KB) .pdf
- MEM – Dental Wellness Plan Enrollment Packets (53.65 KB) .pdf
- MEM – IA Health Link Enrollment Packet Reprint (290.57 KB) .pdf
- MEM-IA Health Link Managed Care Enrollment Packets (55.79 KB) .pdf
- MEM-Medical Exemption Processing (77.9 KB) .pdf
- MEM – Member Content Process and Procedure (54.66 KB) .pdf
- MEM – PRV – Potential Fraudulent Call (220.51 KB) .pdf
- MEM – Supplemental Insurance Questionnaire (353.97 KB) .pdf
- MEM – MPEP Planned Outages (51.17 KB) .pdf
- MEM – State Ombudsman and Long Term Care Ombudsman Inquiries (134.01 KB) .pdf
- MEM – Provision of Medical Certificate of Creditable Coverage Requested by Member (54.94 KB) .pdf
- MEM – Publishing to the Member Services Website (59.81 KB) .pdf
- MEM - Member Requests for Publications (118.36 KB) .pdf
- MEM – Responding to Member’s Written Inquiries (53.44 KB) .pdf
- MEM – Supplemental Insurance Questionnaire (353.97 KB) .pdf
- MEM – Updating EPP Date Table in the Medicaid Management Information System (MMIS) (138.09 KB) .pdf
- MEM – Updating the Print Date Table in the Medicaid Management Information System (MMIS) (137.76 KB) .pdf
- MEM – Updating the Enrollment Date Table in the Medicaid Management Information System (MMIS) (140.65 KB) .pdf
- MEM – Tracking Qualified Entity (QE) Discrepancy Activity (196.87 KB) .pdf
- MEM – Managed Care Good Cause Disenrollment (65.54 KB) .pdf
- MEM – Medicare Buy-In Quality Assurance (56.47 KB) .pdf
- MEM - Member Demographic Change – Field Office Notification (56.01 KB) .pdf
- MEM – PRV - Mitigation of an Iowa Medicaid Enterprise (IME)/Managed Care Organization (MCO) Escalated Issue (159.75 KB) .pdf
- PRV – Presumptive Providers (PP) Annual Recertification (122.42 KB) .pdf
- PRV – Qualified Entity (QE) Annual Recertification (167.01 KB) .pdf
Find additional information for RFP MED-25-002 Quality Improvement Organization for Iowa Medicaid below.
Iowa Medicaid
Iowa Medicaid Organization Charts (79.76 KB) .pdf
Telework Policy (1005.9 KB) .pdf
Quality Improvement Organization (QIO)
QIO Contract
MED-18-005: QIO Services Amendment 1 (433.64 KB) .pdf
MED-18-005: QIO Services Amendment 2 (21.12 MB) .pdf
MED-18-005: QIO Services Amendment 3 (91.82 KB) .pdf
MED-18-005: QIO Services Amendment 4 (457.22 KB) .pdf
MED-18-005: QIO Services Amendment 5 (404.12 KB) .pdf
MED-18-005: QIO Services Contract (3.15 MB) .pdf
QIO Standard Operational Procedures
QIO A15 Service Plan Reduction (88.32 KB) .pdf
QIO Business Continuity Plan (98.28 KB) .pdf
QIO Child Daycare PA (136 KB) .pdf
QIO Facility 456 (171.09 KB) .pdf
QIO Habilitation (261.37 KB) .pdf
QIO HCBS Administrative Duty (85.6 KB) .pdf
QIO Agency Closure (44.33 KB) .pdf
QIO CBCM Oversight (109.99 KB) .pdf
QIO HCBS Certification Review (60.6 KB) .pdf
QIO HCBS Chapter 24 Review (42.13 KB) .pdf
QIO HCBS Complaint (204.02 KB) .pdf
QIO HCBS Focused Review (60.46 KB) .pdf
QIO HCBS Incident Reporting (84.76 KB) .pdf
QIO HCBS MFP Survey (337.71 KB) .pdf
QIO HCBS New Provider Application (50.19 KB) .pdf
QIO HCBS Periodic Review (83.84 KB) .pdf
QIO HCBS Provider Self-Assessment (49.12 KB) .pdf
QIO HCBS Residential Setting (291.8 KB) .pdf
QIO HCBS Slot Management (193.88 KB) .pdf
QIO HCBS Targeted Review (80.46 KB) .pdf
QIO Health Home Program (546.99 KB) .pdf
QIO Hospital 456 (218.39 KB) .pdf
QIO Inpatient Psych (251.96 KB) .pdf
QIO MDS Section Q (96.48 KB) .pdf
QIO MDS Validation (136.04 KB) .pdf
QIO Medical Support (310.14 KB) .pdf
QIO Pre-procedure (250.51 KB) .pdf
QIO Swing Beds PA (269.18 KB) .pdf
Report Examples
QIO Services Monthly Deliverables Report (947.07 KB) .pdf
QIO Services Monthly ETP Fiscal Impact Report (327.66 KB) .pdf
QIO Annual Report (518.25 KB) .pdf
Vendor Security Questionnaire (71.79 KB) .docx
2018 RFP Proposals and Evaluation
KEPRO MED-18-015 Iowa QIO Services: Attachment F - Cost Proposal (97.87 KB) .pdf
KEPRO MED-18-015 Iowa QIO Services: Tab 4.1-4.2 Redacted 1 (13.47 MB) .pdf
KEPRO MED-18-015 Iowa QIO Services: Tab 4.1-4.2 Redacted 2 (1.43 MB) .pdf
KEPRO MED-18-015 Iowa QIO Services: Tab 4.3-4.4.8 Redacted 2 (10.42 MB) .pdf
KEPRO MED-18-015 Iowa QIO Services: Tab 5 Redacted 2 (7.13 MB) .pdf
MED-18-015 Iowa QIO Services: RFP Scoring Sheet (38.76 KB) .xlsx
Telligen Iowa QIO Services: Attachment F Cost Proposal (352.08 KB) .pdf
Telligen Iowa QIO Services: Technical Proposal Public Copy Redacted (9.49 MB) .pdf
Iowa Medicaid
Iowa Medicaid Table of Organization Chart (79.76 KB) .pdf
Agency Telework Policy (993.04 KB) .pdf
Revenue Collections and Estate Recovery Contract (4.66 MB) .pdf
Operational Procedures
1. Accounts Receivable Procedure (769.79 KB) .pdf
2. Affidavit Procedure (635.63 KB) .pdf
3. Carrier Refund Request through Fiscal Management (713.76 KB) .pdf
4. Check Handling and Deposit Operational Procedure (847.8 KB) .pdf
5. Check Indexing Procedure (2.17 MB) .pdf
6. Data Match Process Manual (635.55 KB) .pdf
7. Disallowance Procedure (1.39 MB) .pdf
9. Initial Contact Letter (804.5 KB) .pdf
10. Intake of Referrals (1.19 MB) .pdf
11. Iowa Care Premium and Waiver Processing Procedure (1.11 MB) .pdf
12. Iowa Medicaid Trust Program Processing Procedure (581.92 KB) .pdf
13. Keywording Procedure (1.33 MB) .pdf
14. Mail Returned Procedure (538.52 KB) .pdf
15. Medical Assistance Income Trust (Miller Trust) (551.5 KB) .pdf
16. Obtaining Debt Information (539.61 KB) .pdf
17. Pay and Chase Procedure (2.01 MB) .pdf
18. Provider Withholding Procedure (1 MB) .pdf
19. Refund Manual Check Request (694.45 KB) .pdf
20. Returned Warrants Procedure (576.17 KB) .pdf
21. Revenue Collections MEPD Premium Processing Procedure (959.36 KB) .pdf
22. Review of Medical Assistance Debt Response Forms (MADRF) (700.21 KB) .pdf
23. SSA Report Procedure (947.95 KB) .pdf
24. Verification of Insurance Procedure (1.24 MB) .pdf
25. Yield Management (2.02 MB) .pdf
Report Examples
1. Template - IACI HMS REBILLS (524.97 KB) .xlsx
2. Template - Maestro <Month/Year> Deposit Report (13.42 KB) .xlsx
3. Template - OnBase <Month/Year> Deposit Report (14.02 KB) .xlsx
4. Template - IAFF <Month/Year> (28.5 KB) .xlsx
Find additional information for RFP MED-24-004 Dental Wellness Plan (DWP) and Hawki request for proposal (RFP) below:
Iowa Medicaid
Iowa Medicaid Organization Chart
Member Demographics
Enrollment Report for State Fiscal Year (SFY) 2022 (14.92 KB) .xlsx
Enrollment Report for SFY 2022 by Month (83.08 KB) .xlsx
Provider Communication
Dental Wellness Plan Fee Schedule, Coverage
Member Communication
Dental Wellness Plan Member Materials
Policy
Iowa Administrative Code Chapter 441
Dental Wellness Plan Provider Manual (254.75 KB) .pdf
Iowa TPL Action Plan (227.27 KB) .pdf
State Plan Waivers
Iowa Health and Wellness (IHAWP)
Performance Reports
Medicaid Managed Care Quarterly Reports
Iowa Managed Care Reporting Manual (765.28 KB) .pdf *
Iowa Managed Care Reporting Manual Calendar (565.25 KB) .pdf *
*Note: These materials are currently being used in Iowa HealthLink. The final Dental Reporting Manual is expected to follow this model and function similarly.
Rates
Procurement Rate Exhibits (35.57 KB) .xlsx
SFY25 Rate Development (302.26 KB) .pdf
Bidder's Conference
Date and Time:
Monday, June 5, 2023 2:00 PM to 3:30 PM
Location
Zoom link: https://www.zoomgov.com/j/1601365358
Meeting ID: 160 136 5358
Materials
Iowa Medicaid Presentation (927.08 KB) .pdf
Optumas Presentation (321.62 KB) .pdf
Security and Privacy Requirements
Vendor Security Questionnaire (71.79 KB) .docx
Business Requirements Documents
Social Determinants of Health: Oral Health Equity Risk Assessment Questions (141.8 KB) .pdf
Iowa Medicaid
- Iowa Medicaid Homepage
- Iowa Medicaid Organization Chart
- Dental Wellness Plan
- Hawki Dental
- Managed Care Contracts
Member Demographics
Provider Communication
Member Communication
Policy
- Iowa Administrative Code Chapter 441
- Iowa Code
- Informational Letters
- Dental Wellness Plan Provider Manual (254.75 KB) .pdf
- Iowa TPL Action Plan (227.27 KB) .pdf
State Plan Waivers
Performance Reports
Iowa Managed Care Reporting Manual (765.28 KB) .pdf
Rates
- IA Dental -Procurement Rate Exhibits (51.62 KB) .xlsx
- IA Dental - SFY27 Rate Development (297.26 KB) .pdf
- Optumas IA Dental RFP Rate Estimate (273.34 KB) .pdf
Bidder's Conference
Date and Time: Tuesday, February 18th, 2025, from 2:00 PM – 3:30 PM CST
Location:
Meeting ID: 215 750 509 337
Security and Privacy Requirements
Business Requirements Documents
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