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 its methods and standards for calculating the PACE rates under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).
Summary of Submission
The state is updating language to provide a more robust explanation of the methodology used to calculate annual PACE rates; specifically, the Amount That Would Have Otherwise Been PAID (AWOP) development and payment rate selection process.
AWOP is used for PACE rate development to describe the amount that would otherwise have been paid under the State plan if the participants were not enrolled in PACE.
Fiscal Impact
No expected fiscal impact to the state
Public Review and Comments
A copy of the Medicaid State Plan Amendment and this public notice are posted on the HHS website at the following link: https://hhs.iowa.gov/public-notice/2026-06-01/state-plan-amendment-ia-26-0003
To reach all stakeholders, non-electronic copies will be made available for review at each local HHS office.
Submission of Comments
Written comments concerning this notice may be addressed to the Quality Innovation and Medical Policy Team, Iowa Department of Health and Human Services, Division of Medicaid, 321 East 12th Street, Des Moines, IA 50319 or may be emailed to qimp_public_comment@hhs.iowa.gov. Please indicate PACE Rate Calculation in the subject line of the email.
All written and emailed comments must be received within 30 days from the issuance of this notice and no later than June 30, 2026, by 4:30 p.m.
Submitted by:
Lee Grossman, Medicaid Director
Iowa Department of Health and Human Services