The Iowa Department of Health and Human Services (HHS), pursuant to the requirements outlined in 42 C.F.R. ยง447.205, hereby gives notice of the following proposed action regarding changes to the reimbursement rates for dental services provided by qualifying Iowa non-state government-owned dentistry clinics under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).
Summary of Submission
Effective October 1, 2023, for dental services rendered by eligible professional service practitioners who are employed by, under contract to, or who assigned Iowa Medicaid payments to a non-state government-owned dentistry clinic located in a county with a population over three hundred fifty thousand within the state of Iowa, will be eligible for rate payment adjustments. The non-federal share of any payments will be provided solely by intergovernmental transfers from the state governmental entity providing funding to and which oversees the Iowa non-state government-owned dentistry clinic with which the affiliated physicians and professional services practitioners are associated.
The payment rate adjustments will be subject to federal upper payment limits. Aggregate rate adjustment payments available, without exceeding upper payment limits, will be determined by measuring the difference between:
- Fee-for-service amounts paid for services provided to Medicaid patients and
- Estimated payment amounts for such services if payments were based on the average rate of the top three (3) commercial payors.
Estimated Fiscal Impact
The estimated increase in Medicaid fee-for-service (FFS) expenditures for State Fiscal Year (SFY) 2024 related to the enhanced fee schedule for dental services at qualifying Iowa non-state government-owned dentistry clinics is:
Total Dollars: $ 3,130
Federal Dollars: $ 2,000
State Dollars: $ 1,131
Public Review and Comments
A copy of this SPA IA-23-0021 is posted on the HHS website at the following link: https://hhs.iowa.gov/public-notices. To reach all stakeholders, non-electronic copies will be made available for review at each local HHS office.
Submission of Comments
Written comments may be sent to Dex Walker, Department of Health and Human Services, Iowa Medicaid, 1305 E. Walnut Street, Des Moines, IA 50319 or may be emailed to dwalker@dhs.state.ia.us. Please indicate SPA IA-23-0021 in the subject line of the email.
All written and emailed comments must be received no later than October 19, 2023, by 4:30 p.m.
Attachments
Submitted by:
Elizabeth Matney
Iowa Medicaid Director
Iowa Department of Health & Human Services