The Iowa Department of Health and Human Services (HHS), pursuant to the requirements outlined in 42 C.F.R. §447.205, hereby gives notice of the following proposed action regarding changes to the reimbursement rates for home health intermittent services provided by enrolled home health agencies under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).
Summary of Submission:
Beginning for services on or after July 1, 2025, the base fee schedule payment rates will be increased for an acuity add-on as follows for each service date, for individuals that meet the medical necessity of the following tier levels:
- Tier 1 – 10% increase
- Tier 2 – 30% increase
- Tier 3 – 60% increase
Acuity is based on the members need(s) identified from a diagnosis of the medical condition and the individual plan of care. The higher level of acuity is associated with the complexity of the need and the care required to address it.
Estimated Fiscal Impact:
The estimated increase in Medicaid fee-for-service (FFS) expenditures for State Fiscal Year (SFY) 2026 related to the budget-neutral outpatient hospital service rebase is:
Total Dollars: $ 102,563
Federal Dollars: $ 70,789
State Dollars: $ 31,774
Public Review and Comments:
A copy of the SPA-IA-25-0010 and public notice is posted on the HHS website at the following link: PUBLIC NOTICE: State Plan Amendment (SPA) IA-25-0010 Medicaid Payment Rates for Home Health Intermittent Services | Health & Human Services. 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 Becki Wedemeier, Department of Health and Human Services, Iowa Medicaid, 1305 E. Walnut Street, Des Moines, IA 50319 or may be emailed to becki.wedemeier@hhs.iowa.gov. Please indicate SPA IA-25-0010 in the subject line of the email.
All written and emailed comments must be received no later than June 2, 2025, by 4:30 p.m.
Submitted by:
Rebecca Curtiss, Interim Medicaid Director