PUBLIC NOTICE: Public Comment Period for Medicaid Home Health Low Utilization Payment Adjustment (LUPA) Rates

The Iowa Department of Human Services (DHS), 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 providers under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Pursuant to the authority of 2021 Iowa Acts, House File (HF) 891, Section 29, reimbursement rates for home health agencies shall continue to be based on the Medicare Low Utilization payment adjustment (LUPA) methodology with state geographic wage adjustments and shall be adjusted to increase the rates to the extent possible within the state funding, including the $2,000,000 appropriated for this purpose. The department shall continue to update the rates every two years to reflect the most recent Medicare LUPA rates.

The Medicaid State Plan Amendment (SPA) IA-21-0013 will amend Attachment 4.19-B to change the effective date of the Home Health LUPA rates in effect July 1, 2021. The Medicaid reimbursement rates in effect July 1, 2021, will be established at 91.71% of the January 1, 2021, state geographic wage-adjusted Medicare LUPA rates. This represents a Medicaid budget-neutrality factor of -8.29%.

The estimated increase in Medicaid Fee-for-Service (FFS) expenditures for State Fiscal Year (SFY) 2022 related to the home health LUPA rate change is:

Total Dollars:                                                $ 155,762

Federal Dollars:                                            $ 98,970

State Dollars:                                                $ 56,791