Posted: January 2, 2024

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 outpatient hospital services provided by enrolled acute care hospitals under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Summary of Submission

Pursuant to the authority of 2023 Iowa Acts, Senate File (SF) 561, Section 30(c)(1), reimbursement rates for outpatient hospital services shall be rebased effective January 1, 2024, subject to Medicare upper payment limits rules, and adjusted as necessary to maintain expenditures within the amount appropriated to the department for this purpose.

Medicaid State Plan Amendment (SPA) IA-24-0001 will amend Attachment 4.19-B, page 1, to change the rate effective date and cost report periods used for the rate calculations.

Estimated Fiscal Impact

The estimated increase in Medicaid fee-for-service (FFS) expenditures for State Fiscal Year (SFY) 2024 related to the budget-neutral outpatient hospital service rebase is:

Total Dollars:                                                           $ 0

Federal Dollars:                                                      $ 0

State Dollars:                                                           $ 0

Public Review and Comments

A copy of the SPA-IA-24-0001 and public notice is posted on the HHS website at the following link:  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 Rebecca Wedemeier, Department of Health and Human Services, Iowa Medicaid, 1305 E. Walnut Street, Des Moines, IA 50319 or may be emailed to Please indicate SPA IA-24-0001 in the subject line of the email. 

All written and emailed comments must be received no later than Thursday, February 1, 2024, by 4:30 p.m.


Submitted by:

Elizabeth Matney

Iowa Medicaid Director