Confirmation of Coverage
Members will receive a Confirmation of Coverage Letter
over the next several weeks. This letter will include the Managed Care Organization (MCO) they're enrolled with, whether they actively made a selection or kept their assignment.
If a member does not know which MCO they were assigned, they can call Member Services at 1-800-338-8366. If a member is not happy with their assignment or choice, they may change their plan until May 18, 2016 for any reason, and after that for "Good Cause" reasons.
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Provider Training Webinars Have Been Posted
Provider training events took place across the state during January and the beginning of February. For those who were unable to attend, webinars with information covered in these events have been posted
here.
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Contracting Continues
Providers are encouraged to continue working with the three managed care organizations (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 95,000 contracts with the MCOs. Each plan has enrolled over 88 percent of the currently active Fee-for-Service Iowa providers in their network. Nearly 60 percent of current providers have signed with all 3 MCOs.
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New State Innovation Model Webpage Launched
Iowa is one of only 11 states to receive the State Innovation Model (SIM) testing grant. Iowa will use the SIM grant to implement and evaluate a sustainable health care delivery and payment system that will improve population health, improve patient care, and control health care cost trends. Visit the new
Iowa SIM webpage
to learn more.
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Managed Care Improves Quality and Access
Robert Damler, a consulting actuary with Milliman, Inc., testified Tuesday before the Health and Human Services Appropriations Subcommittee.
He said states that move to Medicaid managed care can improve quality and access for patients.
In New York, he said, Medicaid performance results matched or exceeded commercial results. Medicaid managed care gave better access to primary care, prescription drugs and disability services as rated by California Medicaid patients. His presentation can be found here.
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Managed Care Organization Provider Resource Pages Available
Comprehensive resource pages are available for each Managed Care Organization (MCO), featuring provider training manuals, webinars and important updates. You may view them below:
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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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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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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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Current Toolkits
The IA Health Link toolkits are full of resources including FAQs, social media posts, images, links and more. View the links below.
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