The Iowa Department of Health and Human Services (HHS), pursuant to the requirements outlined in 42 C.F.R. ยง440.386, hereby gives notice of the following proposed actions regarding State Plan Amendments (SPAs) IA-23-0011 and IA-23-0012 related to dental benefit changes in the Iowa Dental Wellness Plan (DWP).


The basic dental benefit package is being removed as a result of the elimination of the previously required dental healthy behaviors requirement to obtain the full dental benefit package under the DWP. All enrollees will receive the same dental benefit package. During the COVID-19 Public Health Emergency (PHE), dental healthy behaviors were suspended, and these SPAs will terminate the dental healthy behaviors requirement permanently now that the PHE has ended. Additionally, it makes a technical correction to reflect fabrication of removable dentures are not included in the $1,000 dental benefit maximum per enrollee per state fiscal year.

The State will ensure compliance with 42 CFR ยง440.345 related to early and periodic screening, diagnostic, and treatment (EPSDT) requirements by inspecting medical and peer review records, as well as regular reports of health screenings and examination related activities. The State will assure compliance with the provisions of section 5006(e) of the American Recovery and Reinvestment Act of 2009 by continuing to engage in tribal consultations, in accordance with federal law and the Iowa Medicaid State Plan. Tribal notice has been provided for these SPAs.

These changes are effective July 1, 2023, pending federal approval.

Estimated Fiscal Impact

There is no anticipated fiscal impact as the current policy of reducing dental services to the basic dental benefit package for failure to complete dental healthy behaviors or pay premiums has been suspended since the implementation of the PHE in March 2020.

Public Review and Comments

A copy of this SPA is posted on the HHS website at the following link: To reach all stakeholders, the SPA is also available for public review at each local HHS office.

Submission of Comments

Written comments may be addressed to Heather Miller, Department of Health and Human Services, Iowa Medicaid Enterprise, 1305 East Walnut, Des Moines, IA 50309-0114. or may be emailed to Please indicate SPA IA-23-0011/12 in the subject line of the email. All written and emailed comments must be received by July 23, 2023, at 4:30 p.m.


Submitted by:

Elizabeth Matney

Medicaid Director

Iowa Department of Health and Human Services