Posted: December 30, 2021
Pursuant to the authority of Iowa Code Section 249A.4, the Iowa Department of Human Services (DHS) has proposed changes to the state plan under Medicaid State Plan Amendment (SPA) Attachment 3.1-H (Integrated Health Homes) (IA-22-0004). This SPA is intended to update the reimbursement rate for the payment tier six assigned to the Integrated Health Home Program. The SPA also intends to update the informational code for Comprehensive Transitional Care Management.
Summary
The State of Iowa’s Medicaid program currently operates the Integrated Health Home (IHH). The proposed changes in the SPA are summarized below:
Integrated Health Home (IHH SPA IA-22-0004)
- Updated the Comprehensive Transitional Care code from G2065 to 99426 based on the Centers for Medicare and Medicaid Services (CMS) Code updates.
- Updated the monthly reimbursement rate for tier 6 from $121.14 to $200.97.
Fiscal Impact
The Governor has appropriated additional funding to address the reduction in the non-intensive care management (ICM) reimbursement rate that went into effect July 1, 2021. Effective for dates of service beginning January 1, 2022, IHHs will be reimbursed at the rate of $200.97 for both tier 6 (99490 TG) and tier 8 (99490 U2). IHHs will continue to include the Level II modifier on the claim to indicate an ICM and Non-ICM enrollee.
There is no fiscal impact related to the changes proposed in the IHH SPA.
The changes in the reimbursement amounts are budget neutral.
Public Review and Comments
A copy of this SPA IA-22-0004 and this public notice are posted on the DHS website at: https://dhs.iowa.gov/public-notices/IHH_1. To reach all stakeholders, non-electronic copies will be made available for review at the DHS Field Offices.
Written comments concerning this notice, or the proposed amendments may be addressed to: Health Home Program, Iowa Department of Human Services, Iowa Medicaid Enterprise, 1305 East Walnut, Des Moines, Iowa 50319 or may be emailed to:
Healthhomes@dhs.state.ia.us. Please indicate SPA IA-21-0004 in the subject line of the email.
Attachments
IA-22-004 Public Notice as of 122921