Notice is hereby given, in accordance with 42 CFR §447.205, that the Iowa Department of Human Services (DHS) has posted for public comment a Medicaid State Plan Amendment (SPA), IA-22-0007.


Pending federal approval, effective July 1, 2022, DHS will no longer make COVID-19 Relief Rate (CRR) payments to nursing facilities. During the COVID-19 public health emergency (PHE), DHS has been making CRR payments to nursing facilities that meet one of the following requirements:

  1. The facility has a designated isolation unit for the treatment of COVID‐19; or
  2. The facility, in its entirety, is designated for the treatment of COVID‐19.

CRR payments of $300 per day have been made to eligible facilities for each enrollee residing in a designated isolation unit or COVID-19 designated facility who:

  • Was discharging from a hospital to the nursing facility; or
  • Was pending test results for COVID‐19; or
  • Had a positive COVID‐19 diagnosis.

The CRR payments were in addition to the already established nursing facility per diem rates.

Fiscal Impact

Fiscal Impact
Fee for Service Total Federal State
SFY22 Payments (FFY22)     $9,300     $6,356 $2,944
SFY23 Payments (FFY23) $0 $0 $0

Public Review and Comments

A copy of SPA IA-22-0007 and this public notice are posted on the DHS website at To reach all stakeholders, non-electronic copies will be made available for review at each local DHS office.

 Written comments may be sent to: Jessica McBride, Program Manager, Iowa Medicaid, 1305 E. Walnut Street, Des Moines, IA 50319-0114. Comments may also be sent via e-mail to Please indicate SPA 22-0007 in the subject line of the email.

All comments must be received by Friday, May 6,2022 at 4:30 p.m.


7.4.A. Recission to the State’s Disaster Relief Policies for the COVID-19 National Emergency

Submitted by:  

Elizabeth Matney, Medicaid Director

Iowa Department of Human Services