Prior Authorization Process Clarification
Informational Letter 1591-MC directed providers on the Prior Authorization (PA) process for the IA Health Link program. Further clarification on this process for both pharmacy drugs that require a PA, and all other services requiring a PA, can be found in
Informational Letter 1607-MC.
PAs are used by the Iowa Medicaid Enterprise (IME) to ensure program integrity, by requiring that all services are medically necessary. The MCOs will honor existing IME PAs for 90 days for all services and providers.
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Provider Training Continues
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Contracting Continues
Providers are encouraged to continue working with the three MCOs to complete contracts and credentialing requirements in time for the anticipated March 1, 2016, launch date. Find the
MCO contacts here.
Iowa providers have signed more than 84,579 contracts with the MCOs. Each plan has enrolled over 76 percent of the currently active fee-for-service Iowa providers in their network. Nearly 45 percent of current providers have signed with all 3 MCOs.
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Managed Care Organization Provider Resource Pages Now Available
Updated and improved provider resource pages are now available for each Managed Care Organization (MCO), featuring provider training manuals, webinars and important updates. You may view them below:
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Help get the word out in your community!
Iowa Medicaid has scheduled several member training events in communities across Iowa. Promotional flyers are available below. These can be printed and posted at clinics, on community bulletin boards and used as handouts.
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Toolkits Have Been Updated
The IA Health Link toolkits are full of useful resources including FAQs, social media posts, images, important links and more. They have been updated with the most recent and accurate information on implementation and MCO choice options. View the links below.
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Medical Assistance Advisory Council (MAAC) Update:
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MAAC Special Executive Committee Meeting
Director Palmer requested a special meeting of the MAAC Executive Committee (EC), which took place on January 12, 2016. The objective of this meeting was to continue to encourage collaboration and expert input from the EC members.
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Reminder: Provider Informational Letters
Informational letters are posted through the Iowa Medicaid Portal Application (IMPA) system and are available on the DHS website here.
These letters communicate important policies and procedures for providers and their administrative staff. Providers should watch closely for updates during the transition period.
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Electronic Health Record (EHR) Incentive Program
The Centers for Medicare and Medicaid Services (CMS) released a final rule change in October 2015 that impacts the guidelines by which providers attest to receive EHR Incentives for 2015 and beyond. Additional information on the rule changes can be found on the
CMS webpage.
The IME is making system modifications to comply with the new federal guidelines prior to accepting the remainder of the 2015 attestations. The IME attestation system will begin accepting 2015 attestations on February 1, 2016, through April 1, 2016, at 11:59 pm. To learn more see
Informational Letter 1602.
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IA Health Link coverage begins March 1, 2016.
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Managed Care Organizations:
1-800-600-4441
1-855-332-2440
1-800-464-9484
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