The Iowa Department of Health and Human Services (HHS), pursuant to the requirements outlined in 42 C.F.R. §447.205 and §1902(a)(13)(A) of the Social Security Act, hereby gives notice of the following proposed action regarding its methods and standards for changes to state-owned Intermediate Care Facilities for Persons with Intellectual Disabilities (ICFs.ID) annual cost reporting under the State Plan Title XIX of the Social Security Act Medical Assistance Program (Medicaid).
Summary:
The proposed State Plan Amendment (SPA) IA-25-0022 will update the frequency of cost reporting required by state-owned ICFs.ID facilities from a semi-annual to annual requirement. Iowa Administrative Code section 441-82.4(16)h has been submitted for adopted filing to read as follows:
IAC 441-82.4(16)h State-owned ICFs/ID shall submit annual cost reports and will receive annual rate adjustments based on actual costs of operation inflated by the percentage change in the Consumer Price Index.
Estimated Fiscal Impact:
With the change described above, there is no significant fiscal impact anticipated. Medicaid payments to the state-owned ICFs.ID could decrease since their per diems tend to increase slightly with each cost report and the semi-annual increase would no longer be recognized. Contributing to the minimal impact is the ICFs/ID budget based on the current rate, not the prospective rate. Further, re-processing issues may result in the increases not always being paid.
The proposed amendment will be effective July 1, 2025.
Public Review and Comments:
A copy of this SPA IA-25-0022 and public notice is posted on the HHS website at the following link: https://hhs.iowa.gov/public-notice/2025-06-25/public-notice-public-comment-period-changes-state-owned-intermediate-care-facilities-persons.
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 Marlie Atwood, Policy Program Manager, Department of Health and Human Services, Iowa Medicaid, 321 East 12th Street, Des Moines, IA 50319 or may be emailed to ltssfacilities@hhs.iowa.gov. Please indicate SPA IA-25-0022 in the subject line of the email.
All written and emailed comments must be received no later than July 25, 2025, by 4:30 p.m.
Submitted by:
Rebecca Curtiss, Interim Medicaid Director