Public Notice: Public Comment Period For 1915(b) Waiver Amendment

Notice is hereby given that the Iowa Department of Human Services (DHS) will be submitting an amendment to the Iowa High Quality Healthcare Initiative 1915(b) Waiver to the Centers for Medicare and Medicaid Services (CMS). The submission proposes to amend the managed care enrollment process for Medicaid eligibility groups mandatorily enrolled in managed care, adds an additional managed care organization, and makes technical edits effective July 1, 2019. This notice provides a summary of the purpose of the proposed changes and describes the method for providing comments and questions.

Summary:

The proposed 1915(b) waiver amendment adds Iowa Total Care as a managed care organization (MCO) available to provide coverage for Medicaid enrollees effective July 1, 2019. Additionally, DHS is proposing to revise its managed care enrollment process to implement a passive enrollment process effective July 1, 2019. Under this process, Medicaid enrollees in eligibility groups mandatorily enrolled in managed care will be automatically assigned to an MCO, effective the first day of the month of the enrollee's Medicaid eligibility, with the exception of periods of retroactive eligibility using the State’s passive assignment process. Enrollees will continue to have 90 days from the date of enrollment to request to be enrolled with a different MCO.

Additionally, the amendment proposes technical revisions to the 1915(b) waiver to remove a reference to the Iowa Marketplace Choice Plan, revise the training received by Peer Support Specialists, and, consistent with 2016 federal managed care regulations and current DHS policy, revise the timeframe by which an enrollee or provider on behalf of an enrollee, must file an appeal from 30 days to 60 days.

Public Notice: Public Comment Period For 1915(b) Waiver Amendment

Written notice may be addressed to: