Pursuant to the requirements outlined in 42 CFR 447.205, notice is hereby given that the Iowa Department of Human Services (DHS) has posted for public comment Medicaid State Plan Amendment (SPA) IA-21-0002.
The effective date of the SPA is October 1, 2021.
On February 26, 2016, the Center for Medicaid and CHIP Services (CMCS) issued a State Health Official letter (SHO) to inform state Medicaid agencies and other state health officials about an update in payment policy affecting federal funding for services received by Medicaid-eligible individuals who are American Indian or Alaska Native (AI/AN) through facilities of the Indian Health Service (IHS), whether operated by IHS or by Tribes. Under the updated policy, IHS/Tribal facilities may enter into written care coordination agreements with non-IHS/Tribal providers to furnish certain services for their patients who are AI/AN Medicaid beneficiaries. Amounts paid by the state Medicaid program for services requested by facility practitioners in accordance with those agreements are eligible for federal matching funds at the enhanced federal matching rate (FMAP) of 100 percent.
Effective for services provided on or after October 1, 2021, the Iowa Medicaid Enterprise (IME) proposes to amend Attachment 4.19-B of the Iowa Medicaid State Plan to designate payment for Tribal Federally Qualified Health Centers (FQHCs) at the Indian Health Services (IHS) All Inclusive Rate (AIR) as an Alternative Payment Methodology (APM) consistent with section 1902(bb)(6) of the Act. The Medicaid agency will calculate a Prospective Payment System (PPS) rate for the Tribal FQHC, consistent with section 1902(bb)(4) of the Act, so that the agency can demonstrate on an annual basis that the APM is at least equal to the PPS rate the facility would otherwise receive, consistent with section 1902(bb)(6)(B) of the Act. The Tribal facility would not be required to report its costs for purposes of establishing a PPS rate.
There is no fiscal impact.
PUBLIC NOTICE: PUBLIC COMMENT PERIOD FOR "OUTSIDE THE FOUR WALLS" REQUIREMENT FOR IHS/TRIBAL FACILITIES
|
Post Date: |
August 30, 2021 |
|
End Date: |
September 30, 2021 |
|
Purpose: |
This SPA proposes to designate payment for Tribal Federally Qualified Health Centers (FQHCs) at the Indian Health Services (IHS) All Inclusive Rate (AIR) as an Alternative Payment Methodology (APM). |
|
Notice: |
Public Notice: Public Comment Period for "Outside the Four Walls" Requirement for IHS/Tribal Facilities |
WRITTEN NOTICE MAY BE ADDRESSED TO:
Alisa Horn
Iowa Medicaid Enterprise
1305 E. Walnut Street
Des Moines, IA 50319
Comments may also be sent via electronic mail to ahorn@dhs.state.ia.us.