Medicaid Projects

On March 11, 2021, President Joe Biden signed the American Rescue Plan Act (ARPA). Section 9817 of the ARPA provides qualifying states with a temporary 10 percentage point increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures for HCBS programs from April 1, 2021, through March 31, 2022. States must use these federal funds to supplement existing state funds for Medicaid HCBS in effect as of April 1, 2021.

In addition, states must use state funds equal to the amount of federal funds attributable to the increased FMAP to implement or supplement one or more activities to enhance, expand, or strengthen HCBS under the Medicaid program. States will be permitted to use the increased FMAP funds through March 31, 2024, on activities aligned with the goals of section 9817 of the ARPA and as listed in the Centers for Medicare and Medicaid Services (CMS) guidance. Under ARPA, states can implement a variety of activities, including enhancements to HCBS services, eligibility, infrastructure, and reimbursement methodologies, to enhance, expand, or strengthen Medicaid HCBS.

The Iowa Medicaid COVID-19 unwind is composed of two pieces:

the continuous coverage unwind, which began in February 2023, and

the public health emergency (PHE) unwind; the PHE ended May 11, 2023.

It is important for Medicaid members and providers to understand the differences between the two processes and know what is needed of them as each extended benefit unwinds.

During the COVID-19 PHE, Iowa Medicaid was required to keep continuous healthcare coverage for all members and expand Medicaid benefits to support the Medicaid population during the emergency.

Electronic Visit Verification (EVV) is a federal requirement for states to roll out in January 2024. In December 2016, the 21st Century Cures Act was signed into law. This law requires EVV for personal care and home health services.

Iowa HHS is using a Managed Care implementation model for EVV. All Managed Care Organizations (MCOs) are using the same vendor, CareBridge.

EVV is used to track the delivery and use of personal care and home health services and will provide verification of the visit with location information and a time stamp. EVV will be used to ensure quality and program integrity (PI).

In addition to the PI characteristics associated with EVV, Iowa HHS also considers this to be a valuable mechanism to ensure that members are receiving the care they need that is outlined in their service plan. This system will help provide real time alerts when a provider is late or misses a medically necessary service included in a member’s service plan.

More information on EVV for Home Health Care Services is coming soon! Home Health EVV service code requirements can be found in Informational Letter No. 2338-MC on the Informational Letters webpage.

Hope and Opportunity in Many Environments (HOME) is a project in Iowa that is working to improve and ensure that everyone has access to high-quality behavioral health, disability and aging services in their communities.

To achieve this, the Iowa Department of Health and Human Services (Iowa HHS) collaborated with partners at Mathematica and The Harkin Institute. They conducted an evaluation of community-based services and published a final evaluation report in early 2023. The report provides recommendations on how Iowa can improve these services.

Based on those recommendations, the team created a transformation plan to guide the next steps and implement the suggested improvements.

Iowa Medicaid has recently launched a systems modernization initiative, beginning with solutions targeted at achieving the top business priority: improving the experience for providers and Medicaid staff in provider enrollment, screening, credentialing and maintenance of provider information. This effort is called the Medicaid Enterprise Modernization Effort (MEME).

Sometimes children need extra support. It's great when a child can be supported in their home, but there are also children in foster care who need these supports. Therapeutic Foster Care (TFC) is a program that considers the needs of children and uses Medicaid services to provide increased care. TFC helps children who are likely to experience multiple placements or being in an institution, then places them with specially trained foster parents to receive these supports in a home setting. TFC offers daily care and guidance from trained foster parents to help prepare the child for reunification, a traditional foster home, or adoption. This is not a permanent family solution like adoption or guardianship.